Department of Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Japan.
Department of Otorhinolaryngology and Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minamiku, Sagamihara, Japan.
Sci Rep. 2022 Feb 11;12(1):2387. doi: 10.1038/s41598-022-06441-y.
The purpose of this study was to evaluate the prognostic value of quality of life (QOL) scores acquired not only pre-treatment, but also 1 month after treatment for locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) in patients with pharyngeal cancer treated using radiotherapy. Data for 102 patients with naso-, oro-, or hypo-pharyngeal cancer treated between December 2008 and September 2017 were retrospectively analyzed. About 90% of the patients were male. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) was used for QOL assessments. Associations between QLQ-C30 scores before and 1 month after treatment and outcomes including LRC, DMFS, and OS were analyzed using Cox proportional hazard models. Median follow-up was 37 months (range, 5-117 months). Three-year LRC, DMFS, and OS rates were 77.8%, 60.0%, and 66.5%, respectively. Pre-treatment emotional functioning and diarrhea at 1 month after treatment were identified as significant predictors of LRC. Pre-treatment global QOL and diarrhea at 1 month after treatment were detected as significant predictors of DMFS. Pre-treatment emotional functioning, pre-treatment appetite loss, and diarrhea at 1 month after treatment were detected as significant predictors of OS. Diarrhea at 1 month after treatment was the most powerful QOL variable for predicting LRC, DMFS and OS. Our study revealed that several QOL scores not only before treatment but also 1 month after treatment correlated with LRC, DMFS and OS. In particular, the diarrhea domain of QOL at 1 month after treatment offered the most powerful prognosticator for pharyngeal cancer patients treated with radiotherapy.
本研究旨在评估生活质量（QOL）评分在治疗局部区域控制（LRC）、无远处转移生存（DMFS）和总体生存（OS）方面的预后价值，这些评分不仅在治疗前获得，而且在治疗后 1 个月获得，用于治疗接受放疗的咽癌患者。回顾性分析了 2008 年 12 月至 2017 年 9 月期间治疗的 102 例鼻、口或下咽癌患者的数据。约 90%的患者为男性。使用欧洲癌症研究与治疗组织（EORTC）生活质量问卷（QLQ-C30）进行 QOL 评估。使用 Cox 比例风险模型分析治疗前后 QLQ-C30 评分与 LRC、DMFS 和 OS 等结局之间的关系。中位随访时间为 37 个月（范围为 5-117 个月）。三年 LRC、DMFS 和 OS 率分别为 77.8%、60.0%和 66.5%。治疗前情绪功能和治疗后 1 个月的腹泻被确定为 LRC 的显著预测因子。治疗前总体 QOL 和治疗后 1 个月的腹泻被确定为 DMFS 的显著预测因子。治疗前情绪功能、治疗前食欲减退和治疗后 1 个月的腹泻被确定为 OS 的显著预测因子。治疗后 1 个月的腹泻是预测 LRC、DMFS 和 OS 的最有力的 QOL 变量。我们的研究表明，治疗前和治疗后 1 个月的几个 QOL 评分与 LRC、DMFS 和 OS 相关。特别是治疗后 1 个月的 QOL 腹泻领域为接受放疗的咽癌患者提供了最有力的预后预测指标。
