Prospective evaluation of quality of life and nutrition before and after treatment for nasopharyngeal carcinoma.
OBJECTIVE
To prospectively assess quality of life in patients undergoing chemoradiation therapy for nasopharyngeal cancer. Concurrent chemoradiotherapy is standard for advanced nasopharyngeal cancer; however, the toxic effects of this treatment are substantial.


METHODS
Prospective evaluation of quality of life and nutritional status before and after treatment for nasopharyngeal carcinoma.


METHODS
A cohort of 14 patients, treated with concurrent chemoradiotherapy for 7 weeks, completed the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire and Head and Neck Module before and 3, 6, 12, and 24 months after treatment. Changes in score were analyzed and correlated with the toxic effect grade.


RESULTS
Quality of life issues during the 24 months of follow-up included poorer global health (P = .01), fatigue (P = .01), appetite loss (P<.001), swallowing difficulties (P = .002), sense problems (P = .03), difficulty with social eating (P = .005), dental problems (P = .045), trismus (P = .001), xerostomia (P<.001), sticky saliva (P = .001), cough (P = .02), and feeling ill (P = .03). Pain (P = .004) and emotional functioning (P<.001) significantly improved from the pretreatment rating. The median weight loss was 7 kg, with most weight loss occurring during treatment, despite nutritional support with gastrostomy feeding tubes. One patient still required percutaneous endoscopic gastrostomy feeding at 2 years after treatment. Physician-scored toxic effects correlated poorly with quality-of-life scores.


CONCLUSIONS
Quality of life and functional assessment should be important end points in the follow-up of patients with nasopharyngeal cancer who receive chemoradiotherapy. This study supports the need for ongoing support and rehabilitation in a multidisciplinary setting.
Oates
Justine E
JE
Sydney Head and Neck Cancer Institute, Level 6, Gloucester House, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, New South Wales 2047, Australia. justine.oates@email.cs.nsw.gov.au
Clark
Jonathan R
JR
Read
Jane
J
Reeves
Nicole
N
Gao
Kan
K
Jackson
Michael
M
Boyer
Michael
M
O'brien
Christopher J
CJ
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000523:psychology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003371:Cough / Q000209:etiology; D003680:Deglutition Disorders / Q000209:etiology; D004644:Emotions; D004750:Enteral Nutrition; D005221:Fatigue / Q000209:etiology; D001068:Feeding and Eating Disorders / Q000209:etiology; D005500:Follow-Up Studies; D005774:Gastrostomy; D006801:Humans; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000523:psychology / Q000628:therapy*; D020360:Neoadjuvant Therapy; D009752:Nutritional Status / Q000502:physiology*; D011446:Prospective Studies; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D012463:Saliva / Q000502:physiology; D012678:Sensation Disorders / Q000209:etiology; D014076:Tooth Diseases / Q000209:etiology; D014313:Trismus / Q000209:etiology; D015431:Weight Loss; D014987:Xerostomia / Q000209:etiology