Department of Clinical Research, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
Radiat Oncol. 2024 Sep 20;19(1):125. doi: 10.1186/s13014-024-02473-y.
To investigate the prognosis of longitudinal health-related quality of life (HRQOL) during concurrent chemoradiotherapy (CCRT) on survival outcomes in patients with advanced nasopharyngeal carcinoma (NPC).
During 2012-2014, 145 adult NPC patients with stage II-IVb NPC were investigated weekly using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire core 30 (EORCT QLQ-C30) during their CCRT period. The effects of longitudinal trends of HRQOL on survival outcomes were estimated using joint modeling, and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were reported as a 10-point increase in HRQOL scores.
After a median follow-up of 83.4 months, the multivariable models showed significant associations of longitudinal increasing scores in fatigue and appetite loss during the CCRT period with distant metastasis-free survival: 10-point increases in scores of fatigue and appetite loss domains during CCRT period were significantly associated with 75% (HR: 1.75, 95% CI: 1.01, 3.02; p = 0.047) and 59% (HR: 1.59, 95% CI: 1.09, 2.59; p = 0.018) increase in the risk of distant metastasis, respectively. The prognostic effects of the longitudinal HRQOL trend on overall survival and progress-free survival were statistically non-significant.
Increases in fatigue and appetite loss of HRQOL during the CCRT period are significantly associated with high risks of distant metastasis in advanced NPC patients. Nutritional support and psychological intervention are warranted for NPC patients during the treatment period.
研究同期放化疗期间纵向健康相关生活质量（HRQOL）对晚期鼻咽癌（NPC）患者生存结局的预后影响。
2012-2014 年，对 145 例接受 II-IVb 期 NPC 同期放化疗的成年 NPC 患者每周使用欧洲癌症研究与治疗组织生活质量问卷核心 30 项（EORTC QLQ-C30）进行调查。使用联合建模估计 HRQOL 纵向趋势对生存结局的影响，并报告 HRQOL 评分每增加 10 分的风险比（HR）及其 95%置信区间（95%CI）。
中位随访 83.4 个月后，多变量模型显示同期放化疗期间疲劳和食欲丧失的纵向评分增加与无远处转移生存显著相关：同期放化疗期间疲劳和食欲丧失域评分增加 10 分，与远处转移风险分别显著增加 75%（HR：1.75，95%CI：1.01，3.02；p=0.047）和 59%（HR：1.59，95%CI：1.09，2.59；p=0.018）。纵向 HRQOL 趋势对总生存和无进展生存的预后影响无统计学意义。
同期放化疗期间疲劳和食欲丧失的 HRQOL 增加与晚期 NPC 患者远处转移的高风险显著相关。在治疗期间，需要为 NPC 患者提供营养支持和心理干预。
