Prognostic value of quality of life measured after treatment on subsequent survival in patients with nasopharyngeal carcinoma.
OBJECTIVE
Pretreatment quality of life (QoL) has been used to predict survival in cancer patients. In this study, we examined the prognostic value of QoL measured after treatment on subsequent survival in patients with nasopharyngeal carcinoma (NPC).


METHODS
We enrolled 273 patients with NPC who had been curatively treated for more than 1 year. The EORTC QLQ-C30 and H&N35 questionnaires were completed 1 year after radiotherapy. The predictability of QoL variables on disease-specific survival (DSS) and overall survival (OS) was analyzed using Cox's proportional hazards models.


RESULTS
Twenty-nine (10.6%) patients developed locoregional relapse and 27 (9.9%) had distant metastasis after the QoL survey with subsequent 5-year DSS and OS rates of 87.9% and 84.0 %, respectively. Based on the QLQ-C30, scales of physical functioning, fatigue, and appetite loss significantly predicted DSS and OS (p < 0.05). In the H&N35, only sexuality was significantly correlated with DSS and OS (p < 0.05). An increment of 10 points in physical functioning (HR: 0.69; 95% CI: 0.48-0.90; p = 0.004) or a decline of 10 points in fatigue problems (HR: 1.40; 95% CI: 1.19-1.61; p = 0.0002), appetite loss (HR: 1.21; 95% CI: 1.03-1.40; p = 0.02), and sexuality (HR: 1.14; 95% CI: 1.02-1.25; p = 0.019) was associated with better OS.


CONCLUSIONS
Some QoL variables measured after the treatment provide prognostic value on subsequent survival in patients with NPC.
Department of Biotechnical Cosmetology, Cheng Shiu University, Kaohsiung, Taiwan.
Wen-Ling
WL
Tsai
Chih-Yen
CY
Chien
Hsuan-Ying
HY
Huang
Kuan-Cho
KC
Liao
Fu-Min
FM
Fang
D000293:Adolescent; D000328:Adult; D000359:Aftercare; D000368:Aged; D002277:Carcinoma; D005221:Fatigue / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000523:psychology* / Q000532:radiotherapy*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome