title: Physical distress, emotional status, and quality of life in patients with nasopharyngeal cancer complicated by post-radiotherapy endocrinopathy.
abstract: OBJECTIVE
  To explore factors affecting quality of life (QOL) among patients with nasopharyngeal cancer (NPC) complicated by post-radiotherapy endocrinopathy.
  
  
  METHODS
  This cross-sectional study was conducted in a tertiary medical center and involved a total of 43 post-radiotherapy, recurrence-free NPC patients with endocrinopathy. They performed self-assessment of their emotional status using the Beck Anxiety Inventory and Beck Depression Inventory-II, and their QoL with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) questionnaire and the H&N35 cancer module.
  
  
  RESULTS
  Emotional and cognitive functioning of EORTC QLQ-C30 were the most affected. Fatigue, insomnia, and pain were the main concerns. Of the patients, 22 (51.2%) had anxiety and 19 (44.2%) had depression. Both depression and anxiety were negatively correlated with functional scales and global QoL but positively correlated with symptom scales. Multiple linear regression analysis revealed that physical distress symptoms of QLQ-C30 and physical functioning were the significant predictors of global QoL. Emotional and social functioning could predict depression, whereas emotional and physical functioning were significant predictors of anxiety.
  
  
  CONCLUSIONS
  NPC patients with post-radiotherapy endocrinopathy exhibit impaired cognitive function and negative emotions. Symptoms of physical distress play an important role in QoL perception. Measurement of EORTC QLQ-C30 can be a useful instrument for the early detection of patients' impaired cognitive function and psychological morbidity. The high psychological distress related to the endocrine disturbances or the impact of NPC itself needs further study.
authors.affiliation: Department of Family Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Bee-Horng
authors.initials: BH
authors.lastname: Lue
authors.forename: Tien-Shang
authors.initials: TS
authors.lastname: Huang
authors.forename: Hsiu-Jung
authors.initials: HJ
authors.lastname: Chen
mesh_terms: D000309:Adrenal Insufficiency / Q000150:complications; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications; D004700:Endocrine System Diseases / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D005260:Female; D013006:Growth Hormone / Q000172:deficiency; D006801:Humans; D006966:Hyperprolactinemia / Q000150:complications; D007006:Hypogonadism / Q000150:complications; D007037:Hypothyroidism / Q000150:complications; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000150:complications / Q000523:psychology / Q000532:radiotherapy; D010146:Pain / Q000150:complications; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012044:Regression Analysis; D018434:Sickness Impact Profile; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications
chemical_list: D013006:Growth Hormone