title: Impact of late toxicities on quality of life for survivors of nasopharyngeal carcinoma.
abstract: BACKGROUND
  To investigate the impact of physician-assessed late toxicities on patient-reported quality of life (QoL) for nasopharyngeal carcinoma (NPC) patients with long-term survival.
  
  
  METHODS
  A cross-sectional survey of QoL and late toxicities was conducted in 242 NPC patients with disease-free survival of more than 5 years after treatment. The QoL was assessed by the European Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Late toxicities including neuropathy, hearing loss, dysphagia, xerostomia, and neck fibrosis were recorded based on the criteria of Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v.4.0). The general linear model multiple analysis of variance (GLM-MANOVA) was performed to predict factors associated with the QoL.
  
  
  RESULTS
  In the multifactor model of GLM-MANOVA, of the five late toxicities of CTCAE scales, neuropathy, hearing loss, and xerostomia were observed to be significantly associated with the overall outcome of the fifteen QLQ-C30 scales. A statistically significant trend (p <0.05) was observed, indicating that NPC survivors with more severe neuropathy, hearing loss or xerostomia had a worse outcome on global QoL, all five functional scales, and a variety of symptomatic scales.
  
  
  CONCLUSIONS
  To improve QoL outcome for NPC survivors, the development of a modern radiotherapeutic technique should not only focus on reduction of the dose to the salivary glands, but also on anatomical structures that are involved in neuropathy and hearing loss.
authors.forename: Wen-Ling
authors.initials: WL
authors.lastname: Tsai
authors.forename: Tai-Lin
authors.initials: TL
authors.lastname: Huang
authors.forename: Kuan-Cho
authors.initials: KC
authors.lastname: Liao
authors.forename: Hui-Ching
authors.initials: HC
authors.lastname: Chuang
authors.forename: Yu-Tsai
authors.initials: YT
authors.lastname: Lin
authors.forename: Tsair-Fwu
authors.initials: TF
authors.lastname: Lee
authors.forename: Hsuan-Ying
authors.initials: HY
authors.lastname: Huang
authors.affiliation: Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. fang2569@gmail.com.
authors.forename: Fu-Min
authors.initials: FM
authors.lastname: Fang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D002277:Carcinoma; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D009367:Neoplasm Staging; D063868:Patient Outcome Assessment; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017741:Survivors; D055815:Young Adult