State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, People's Republic of China.
BMC Cancer. 2018 Jan 31;18(1):114. doi: 10.1186/s12885-018-4003-8.
To evaluate the prognostic significance of pretreatment quality of life for patients with nasopharyngeal carcinoma treated with intensity-modulated radiotherapy.
We performed a prospective, longitudinal study on 554 newly diagnosed patients with NPC from April 2011 to January 2015. A total of 501 consecutive NPC patients were included. Patients were asked to complete the EORTC QLQ-C30 (version 3.0) and QLQ-H&N35 questionnaires before treatment.
Global health status among QLQ-C30 correlates with EBV DNA(P = 0.019). In addition, pretreatment appetite loss was significantly correlated with EBV DNA(P = 0.02). Pretreatment teeth, opening mouth, feeding tube was significantly correlated with EBV DNA, with P value of 0.003, < 0.0001, and 0.031, respectively. In multivariate analysis, pretreatment cognitive functioning of QLQ-C30 was significantly associated with LRFS, with HR of 0.971(95%CI 0.951-0.990), P = 0.004. Among scales of QLQ-H&N35 for multivariate analysis, pretreatment teeth (P = 0.026) and felt ill (P = 0.012) was significantly associated with PFS, with HR of 0.984 (95%CI 0.971-.998) and 1.004 (95%CI 1.001-1.007), respectively. Felt ill of QLQ-H&N35 was significantly associated with DMFS, with HR of 1.004(95%CI 1.000-1.007), P = 0.043. There is no QoL scale significantly associated with OS after multivariate analysis.
In conclusion, our analysis confirms that pretreatment teeth and felt ill was significantly associated with PFS in NPC patients treated with IMRT. In addition, the posttreatment EBV DNA was significantly associated with OS.
评估经调强放疗治疗的鼻咽癌患者治疗前生活质量对预后的意义。
我们对 2011 年 4 月至 2015 年 1 月期间的 554 例新诊断的 NPC 患者进行了前瞻性、纵向研究。共有 501 例连续 NPC 患者被纳入研究。患者在治疗前被要求完成 EORTC QLQ-C30（版本 3.0）和 QLQ-H&N35 问卷。
QLQ-C30 的总体健康状况与 EBV DNA 相关（P=0.019）。此外，治疗前的食欲丧失与 EBV DNA 显著相关（P=0.02）。治疗前的牙齿、张口度、喂养管与 EBV DNA 显著相关，P 值分别为 0.003、<0.0001 和 0.031。在多变量分析中，QLQ-C30 的治疗前认知功能与 LRFS 显著相关，HR 为 0.971（95%CI 0.951-0.990），P=0.004。在 QLQ-H&N35 的多变量分析中，治疗前的牙齿（P=0.026）和感觉不适（P=0.012）与 PFS 显著相关，HR 分别为 0.984（95%CI 0.971-.998）和 1.004（95%CI 1.001-1.007）。QLQ-H&N35 的感觉不适与 DMFS 显著相关，HR 为 1.004（95%CI 1.000-1.007），P=0.043。多变量分析后，没有 QoL 量表与 OS 显著相关。
综上所述，我们的分析证实，治疗前的牙齿和感觉不适与接受调强放疗的 NPC 患者的 PFS 显著相关。此外，治疗后 EBV DNA 与 OS 显著相关。
