Pretreatment quality of life as a predictor of distant metastasis and survival for patients with nasopharyngeal carcinoma.
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.
Fang
Fu-Min
FM
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
Tsai
Wen-Ling
WL
Chien
Chih-Yen
CY
Chen
Hui-Chun
HC
Hsu
Hsuan-Chih
HC
Huang
Tai-Lin
TL
Lee
Tsair-Fwu
TF
Huang
Hsuan-Ying
HY
Lee
Chien-Hung
CH
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