Intensity-modulated or conformal radiotherapy improves the quality of life of patients with nasopharyngeal carcinoma: comparisons of four radiotherapy techniques.
BACKGROUND
It was reported previously that the dosimetric superiority of conformal radiotherapy (RT), either 3-dimensional conformal RT (3D-CRT) or intensity-modulated RT (IMRT), over conventional 2D-RT translated into clinical benefits for patients with nasopharyngeal carcinoma (NPC). In this study, the authors compared quality-of-life (QOL) outcomes of NPC survivors who received treatment with 1 of 4 different RT techniques at a single institute during different periods.


METHODS
The authors analyzed QOL data of from 237 patients with NPC who were cancer free for 2 or 3 years when their QOL was assessed. The study population included 152 patients who received conventional RT (2D-RT, 61 patients; 2D-RT plus 3D-CRT boost, 91 patients) and 85 patients who received conformal RT (3D-CRT, 33 patients; IMRT, 52 patients). The European Organization for the Research and Treatment of Cancer (EORTC) Core QOL questionnaire and the EORTC Head and Neck QOL questionnaire were completed.


RESULTS
Compared with patients who received with conventional RT, patients who received conformal RT had both statistically (P < .05) and clinically (a difference in mean scores >or=10 points) significant improvements in the scales of global QOL, pain, appetite loss, senses, speech, social eating, teeth, opening mouth, xerostomia, sticky saliva, and feeling ill. No significant difference was observed in any of the scales that compared 2D-RT with 2D-RT plus 3D-CRT boost or that compared 3D-CRT with IMRT. Survivors who received conformal RT had a 2.01-fold higher probability (odds ratio [OR], 2.01; 95% confidence interval [95% CI], 1.19-3.68) of reporting good global QOL and a 2.70-fold lower probability (OR, 0.37; 95% CI, 0.20-0.66) of reporting a high level of xerostomia than survivors who received conventional RT.


CONCLUSIONS
Conformal RT substantially improved head and neck-related symptoms and broad aspects of QOL for survivors of NPC.
Fang
Fu-Min
FM
Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan. fang2569@adm.cgmh.org.tw
Tsai
Wen-Ling
WL
Chen
Hui-Chun
HC
Hsu
Hsuan-Chih
HC
Hsiung
Ching-Yeh
CY
Chien
Chih-Yen
CY
Ko
Sheung-Fat
SF
D000328:Adult; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014987:Xerostomia / Q000209:etiology