Kan Yajing, Yang Shuang, Wu Xueting, Wang Siqi, Li Xueyu, Zhang Fangyuan, Wang Peiguo, Zhao Jing
Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Center Prevention and Therapy, Tianjin, China.
Graduate School of Tianjin Medical University, Tianjin, China.
Asia Pac J Oncol Nurs. 2023 May 26;10(7):100251. doi: 10.1016/j.apjon.2023.100251. eCollection 2023 Jul.
This article aims to longitudinally compare nasopharyngeal carcinoma (NPC) patients' quality of life (QoL) during radiotherapy (RT) and identify QoL correlates.
This study included 98 patients, with 85 completing full follow-up. Data were collected at baseline (T), midpoint of RT (T), and RT completion (T), between October 2021 and November 2022. QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). RIOM severity was evaluated by the toxicity criteria of Radiation Therapy Oncology Group (RTOG). The nutritional status was evaluated using the Nutritional Risk Screening 2002 (NRS 2002), body mass index (BMI), and the Patient-Generated Subjective Global Assessment (PG-SGA). The generalized estimating equation described the QoL evolution and correlated it with RIOM, nutritional status, and other influential factors.
Significant deterioration was observed in various subscales of EORTC QLQ-C30 during RT, including global health status (GHS), physical function, role function, emotional function, fatigue, nausea/vomiting, pain, insomnia, appetite loss, and constipation (all < 0.05). Substantial deterioration was also observed in RIOM, nutritional status, and part of hematological indexes (all < 0.05). The decline of QoL was associated with gender, age, education level, chemotherapy regimen, Karnofsky performance status (KPS) score, RIOM severity, NRS 2002 score, PG-SGA score, and lymphocyte level (all < 0.05).
QoL declined during RT and were associated with certain factors. Healthcare professionals should focus on alleviating treatment-related complications and identifying individuals at high risk of malnutrition early to improve outcomes for patients with NPC.
本文旨在纵向比较鼻咽癌（NPC）患者放疗（RT）期间的生活质量（QoL），并确定生活质量的相关因素。
本研究纳入98例患者，其中85例完成了全程随访。在2021年10月至2022年11月期间，于基线期（T0）、放疗中期（T1）和放疗结束时（T2）收集数据。使用欧洲癌症研究与治疗组织生活质量核心问卷30（EORTC QLQ-C30）评估生活质量。放射性口腔黏膜损伤（RIOM）严重程度根据放射肿瘤学组（RTOG）的毒性标准进行评估。使用营养风险筛查2002（NRS 2002）、体重指数（BMI）和患者主观整体评定法（PG-SGA）评估营养状况。广义估计方程描述了生活质量的变化，并将其与RIOM、营养状况和其他影响因素相关联。
放疗期间，EORTC QLQ-C30的各个子量表均出现显著恶化，包括总体健康状况（GHS）、身体功能、角色功能、情绪功能、疲劳、恶心/呕吐、疼痛、失眠、食欲减退和便秘（均P<0.05）。RIOM、营养状况和部分血液学指标也出现了显著恶化（均P<0.05）。生活质量的下降与性别、年龄、教育水平、化疗方案、卡氏功能状态（KPS）评分、RIOM严重程度、NRS 2002评分、PG-SGA评分和淋巴细胞水平有关（均P<0.05）。
放疗期间生活质量下降，并与某些因素相关。医疗保健专业人员应专注于减轻治疗相关并发症，并尽早识别营养不良高风险个体，以改善鼻咽癌患者的治疗效果。
