title: Pretreatment quality of life as a predictor of distant metastasis and survival for patients with nasopharyngeal carcinoma.
abstract: OBJECTIVE
  The purpose of this study was to examine the prognostic value of pretreatment quality of life (QoL) data on locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) in patients with nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  A total of 347 new patients with NPC, who were curatively treated by conformal radiotherapy from March 2003 to December 2007, were recruited. The Taiwan Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 was completed before treatment. Multivariate Cox's proportional hazards models were used to analyze the impact of clinical and QoL variables on the treatment results.
  
  
  RESULTS
  The 5-year LRC, DMFS, and OS rates were 72.9%, 79.1%, and 68.4%, respectively. After adjusting the clinical variables, 10 QoL variables were observed to be significantly (P < .05) related to OS, and four QoL variables were related to DMFS. No QoL variable was predictive of LRC. Among the QoL variables that significantly predicted OS and DMFS, physical functioning was the most powerful predictor. A 10-point increase in the physical functioning score was associated with a 23% (95% CI, 12% to 34%) reduction in the likelihood of death and a 22% (95% CI, 9% to 36%) reduction in the likelihood of distant metastasis.
  
  
  CONCLUSIONS
  Our findings indicate that pretreatment QoL variables, especially physical functioning, provide easily available prognostic value for distant metastasis and survival in patients with NPC.
authors: Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, 123 Ta-Pei Rd, Niao Sung Hsian, Kaohsiung Hsien, Taiwan. fang2569@adm.cgmh.org.tw
authors: Fu-Min
authors: FM
authors: Fang
authors: Wen-Ling
authors: WL
authors: Tsai
authors: Chih-Yen
authors: CY
authors: Chien
authors: Hui-Chun
authors: HC
authors: Chen
authors: Hsuan-Chih
authors: HC
authors: Hsu
authors: Tai-Lin
authors: TL
authors: Huang
authors: Tsair-Fwu
authors: TF
authors: Lee
authors: Hsuan-Ying
authors: HY
authors: Huang
authors: Chien-Hung
authors: CH
authors: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology* / Q000532:radiotherapy; D009362:Neoplasm Metastasis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016019:Survival Analysis