Department of Radiation Oncology, KU Leuven - University of Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
Department of Radiation Oncology, Iridium Kanker Netwerk, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Qual Life Res. 2021 Jan;30(1):117-127. doi: 10.1007/s11136-020-02628-w. Epub 2020 Sep 13.
A randomized trial was initiated to investigate whether a reduction of the dose to the elective nodal sites would result in less toxicity and improvement in Quality of Life (QoL) without compromising tumor control. This paper aimed to compare QoL in both treatment arms.
Two-hundred head and neck cancer patients treated with radiotherapy (RT) or chemo-RT were randomized (all stages, mean age: 60 years, M/F: 82%/18%). The elective nodal volumes of patients randomized in the experimental arm were treated up to a 40 Gy equivalent dose. In the standard arm, the elective nodal volumes were treated up to a 50 Gy equivalent dose. The QoL data were collected using The European Organization for Research and Treatment of Cancer (EORTC) core questionnaire QLQ-C30 and the EORTC Head and Neck Cancer module (H&N35).
A trend toward less decline in QoL during treatment was observed in the 40 Gy arm compared to the 50 Gy arm. Statistically significant differences for global health status, physical functioning, emotional functioning, speech problems, and trouble with social eating in favor of the 40 Gy arm were observed. A clinically relevant better outcome in the 40 Gy arm was found for physical functioning at the end of therapy.
QoL during RT for head and neck cancer tends to be less impaired in the 40 Gy arm. However, reducing the dose only on the elective neck does not result in clinically relevant improvement of QoL. Therefore, additional treatment strategies must be examined to further improve the QoL of HNSCC patients.
一项随机试验旨在研究降低选择性淋巴结照射剂量是否会降低毒性并提高生活质量（QoL），同时不影响肿瘤控制。本研究旨在比较两种治疗方案的 QoL。
200 例头颈部癌症患者接受放疗（RT）或放化疗（chemo-RT）随机分组（所有分期，平均年龄：60 岁，男女比例：82%/18%）。实验组的选择性淋巴结体积接受 40Gy 等效剂量照射。标准组的选择性淋巴结体积接受 50Gy 等效剂量照射。使用欧洲癌症研究与治疗组织（EORTC）核心问卷 QLQ-C30 和 EORTC 头颈部癌症模块（H&N35）收集 QoL 数据。
与 50Gy 组相比，40Gy 组在治疗期间 QoL 下降趋势较小。40Gy 组在总体健康状况、身体功能、情绪功能、言语问题和社会进食困难方面的评分均优于 50Gy 组，差异具有统计学意义。治疗结束时，40Gy 组在身体功能方面的结果具有临床意义的改善。
头颈部癌症患者在接受 RT 期间，40Gy 组的 QoL 受损程度较低。然而，仅在选择性颈部降低剂量并不能显著改善 QoL。因此，必须研究其他治疗策略，以进一步提高头颈部癌症患者的 QoL。
