Analysis of the time-related quality of life for patients with early and late stages of the nasopharyngeal carcinoma after radiotherapy

The purpose of this study is to evaluate the quality of life (QoL) for patients with nasopharyngeal carcinoma after radiotherapy according to early and late stages. Three hundred and thirty-two nasopharyngeal cancer patients in two institutions were invited to participate; all were received not less than 70 Gy to nasopharynx and not less than 50 Gy to neck. Health-related quality of life was assessed 3 months or later after the completion of the radiotherapy by means of the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ C-30) and the EORTC head and neck cancer-specific questionnaire (QLQ H&N-35). After completion of radiotherapy, the periods to patients filling in the questionnaire were divided into 4 groups: 3-6 months, 6-12 months, 1-5 years and more than 5 years. In addition, tumor stages were divided into early and late stages. By oneway ANOVA analysis, all items and symptoms changing over time were divided into three types: X/XX type, X/YX type and other types. The eight items: speech problems (F = 5.028**), trouble with social contact (F = 4.090**), senses problems (F = 7.109***), coughing (F = 9.852***c), felt ill (F = 4.783**), using pain-killers (F = 2.938*), pain (F = 6.192***), and weight gain (F = 3.357*) showed statistical significance by two-way ANOVA analysis. These indicated that the quality of life items were difference after radiotherapy according to tumor stages and time intervals. The quality of life for nasopharyngeal cancer patients with early tumor stage was influenced by acute radiation effect significantly. The quality of life was improved over time after the completion of radiotherapy. Nasopharyngeal cancer patients with late tumor stage were influenced by both acute and late radiation effects. The quality of life may be getting worse or up and down after initial improvement during the later periods after completion of radiotherapy. Hence, improvement of the treatment technique, early screen and detection of nasopharyngeal cancer are important not only to increase patient's survival but also to improve the quality of life after completion of the treatment.