鼻咽癌病患經放射治療後生活品質之急性變化

Purpose: The aim of this prospective, longitudinal study is to describe the acute changes of quality of life (QoL) and complications in patients with nasopharyngeal carcinoma from the time of diagnosis until 3 months after radiotherapy.Materials and Methods: One hundred and ninety-five nasopharyngeal carcinoma patients in two institutions were invited to participate; all the patients received radiation doses of at least 70 Gy to the nasopharynx and at least 50 Gy to the neck. Health-related QoL and complications of the patients were assessed 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 module (QLQ H&N-35) at four different stages: before treatment; end of treatment; and 1 and 3 months after treatment.Results: Our data shows that patients have the best overall health status three months after completion of radiotherapy. Patients' condition was significantly better than the time before treatment and at the end of treatment (p＜0.001). Differences in physical function (p=0.003), role function (p＜0.001) and emotional function (p=0.028) were statistically significant at different stages. Symptoms including fatigue (p＜0.001), nausea/vomiting (p＜0.001), pain (p＜0.001), insomnia (p＜0.001), poor appetite (p＜0.001), constipation (p＜0.001) and diarrhea (p=0.035) had statistically significant variations at different stages. In the QLQ H&N-35 module, patients had the worst QoL and complications at the end of treatment, with both factors gradually recovering 3 months after completion of treatment.Conclusion: As a whole, the QoL and complications show wide variations at different stages. The rapid deterioration of QoL and complications are noted at the end of treatment and improve by degrees at the first 3 months after treatment. In this study, our data may provide information to support clinical physicians in assessing the risk of side effects related to treatment, and help them in providing rehabilitation, mental consultation and supportive care after completion of treatment. The results may also help us to understand the acute changes in QoL after in patients with nasopharyngeal carcinoma after radiotherapy.