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Prognostic value of quality of life measured after treatment on subsequent survival in patients with nasopharyngeal carcinoma

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Abstract

Purpose

Pretreatment quality of life (QoL) has been used to predict survival in cancer patients. In this study, we examined the prognostic value of QoL measured after treatment on subsequent survival in patients with nasopharyngeal carcinoma (NPC).

Methods

We enrolled 273 patients with NPC who had been curatively treated for more than 1 year. The EORTC QLQ-C30 and H&N35 questionnaires were completed 1 year after radiotherapy. The predictability of QoL variables on disease-specific survival (DSS) and overall survival (OS) was analyzed using Cox’s proportional hazards models.

Results

Twenty-nine (10.6 %) patients developed locoregional relapse and 27 (9.9 %) had distant metastasis after the QoL survey with subsequent 5-year DSS and OS rates of 87.9 % and 84.0 %, respectively. Based on the QLQ-C30, scales of physical functioning, fatigue, and appetite loss significantly predicted DSS and OS (p < 0.05). In the H&N35, only sexuality was significantly correlated with DSS and OS (p < 0.05). An increment of 10 points in physical functioning (HR: 0.69; 95 % CI: 0.48–0.90; p = 0.004) or a decline of 10 points in fatigue problems (HR: 1.40; 95 % CI: 1.19–1.61; p = 0.0002), appetite loss (HR: 1.21; 95 % CI: 1.03–1.40; p = 0.02), and sexuality (HR: 1.14; 95 % CI: 1.02–1.25; p = 0.019) was associated with better OS.

Conclusion

Some QoL variables measured after the treatment provide prognostic value on subsequent survival in patients with NPC.

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Abbreviations

EORTC:

European organization of research and treatment of cancer

HR:

Hazard ratio

CI:

Confidence interval

References

  1. Cancer registry annual report in Taiwan area. (2008). Department of Health, Executive Yuan, Republic of China 2011.

  2. Jen, Y., Shih, R., Lin, Y., Su, W., Ku, C., Chang, C., et al. (2005). Parotid gland-sparing 3-dimensional conformal radiotherapy results in less severe dry mouth in nasopharyngeal cancer patients: A dosimetric and clinical comparison with conventional radiotherapy. Radiotherapy and Oncology, 75(2), 204–209.

    Article  PubMed  Google Scholar 

  3. McMillan, A., Pow, E., Kwong, D., Wong, M., Sham, J., Leung, L., et al. (2006). Preservation of quality of life after intensity-modulated radiotherapy for early-stage nasopharyngeal carcinoma: Results of a prospective longitudinal study. Head and Neck, 28(8), 712–722.

    Article  PubMed  Google Scholar 

  4. Hsiung, C., Ting, H., Huang, H., Lee, C., Huang, E., & Hsu, H. (2006). Parotid-sparing intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma: Preserved parotid function after IMRT on quantitative scintigraphy and comparison with historical data after conventional radiotherapy. International Journal of Radiation Oncology Biology Physics, 66(2), 454–461.

    Article  Google Scholar 

  5. Fang, F., Tsai, W., Chen, H., Hsu, H., Hsiung, C., Chien, C., et al. (2007). Intensity-modulated or conformal radiotherapy improves quality of life of patients with nasopharyngeal carcinoma—comparisons of four radiotherapy techniques. Cancer, 109(2), 311–321.

    Article  Google Scholar 

  6. Sultanem, K., Shu, H., Xia, P., Akazawa, C., Quivey, J., Verhey, L., et al. (2000). Three-dimensional intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: The University of California-San Francisco experience. International Journal of Radiation Oncology Biology Physics, 48(3), 711–722.

    Article  CAS  Google Scholar 

  7. Lee, N., Harris, J., Garden, A., Straube, W., Glisson, B., Xia, P., et al. (2009). Intensity-modulated radiation therapy with or without chemotherapy for nasopharyngeal carcinoma: Radiation therapy oncology group phase II trial 0225. Journal of Clinical Oncology, 27(22), 3684–3690.

    Article  PubMed  Google Scholar 

  8. Gotay, C., Kawamoto, C., Bottomley, A., & Efficace, F. (2008). The prognostic significance of patient-reported outcomes in cancer clinical trials. Journal of Clinical Oncology, 26(8), 1355–1363.

    Article  PubMed  Google Scholar 

  9. de Graeff, A., de Leeuw, J., Ros, W., Hordijk, G., Blijham, G., & Winnubst, J. (2001). Sociodemographic factors and quality of life as prognostic indicators in head and neck cancer. European Journal of Cancer, 37(3), 332–339.

    Article  PubMed  Google Scholar 

  10. Fang, F., Liu, Y., Tang, Y., Wang, C., & Ko, S. (2004). Quality of life as a predictor for patients with advanced head and neck carcinoma treated with radiation therapy. Cancer, 100(2), 425–432.

    Article  PubMed  Google Scholar 

  11. Langendijk, H., Aaronson, N., de Jong, J., ten Velde, G., Muller, M., & Wouters, M. (2000). The prognostic impact of quality of life assessed with the EORTC QLQ-C30 in inoperable non-small cell lung carcinoma treated with radiotherapy. Radiotherapy and Oncology, 55(1), 19–25.

    Article  PubMed  CAS  Google Scholar 

  12. Dja¨rv, T., Metcalfe, C., Avery, K., Lagergren, P., & Blazeby, J. (2010). Prognostic value of changes in health-related quality of life scores during curative treatment for esophagogastric cancer. Journal of Clinical Oncology, 28(10), 1666–1670.

    Article  Google Scholar 

  13. Chiarion-Sileni, V., Del Bianco, P., De Salvo, G., Lo Re, G., Romanini, A., Labianca, R., et al. (2003). Quality of life evaluation in a randomised trial of chemotherapy versus bio-chemotherapy in advanced melanoma patients. European Journal of Cancer, 39(11), 1577–1585.

    Article  PubMed  CAS  Google Scholar 

  14. Efficace, F., Therasse, P., Piccart, M., Coens, C., van Steen, K., Welnicka-Jaskiewicz, M., et al. (2004). Health-related quality of life parameters as prognostic factors in a nonmetastatic breast cancer population: An international multicenter study. Journal of Clinical Oncology, 22(16), 3381–3384.

    Article  PubMed  Google Scholar 

  15. Wisløff, F., & Hjorth, M. (1997). Health-related quality of life assessed before and during chemotherapy predicts for survival in multiple myeloma: Nordic Myeloma Study Group. British Journal of Haematology, 97(1), 29–37.

    Article  PubMed  Google Scholar 

  16. Meyer, F., Fortin, A., Gelinas, M., Nabid, A., Brochet, F., Têtu, B., et al. (2009). Health-related quality of life as a survival predictor for patients with localized head and neck cancer treated with radiation therapy. Journal of Clinical Oncology, 27(18), 2970–2976.

    Article  PubMed  Google Scholar 

  17. Fang, F., Tsai, W., Chien, C., Chen, H., Hsu, H., Huang, T., et al. (2010). Pretreatment quality of life as a predictor of distant metastasis and survival for patients with nasopharyngeal Carcinoma. Journal of Clinical Oncology, 28(28), 4384–4389.

    Article  PubMed  Google Scholar 

  18. Osthus, A., Aarstad, A., Olofsson, J., & Aarstad, H. (2011). Head and neck specific health related quality of life scores predict subsequent survival in successfully treated head and neck cancer patients: A prospective cohort study. Oral Oncology, 47(10), 974–979.

    Article  PubMed  Google Scholar 

  19. Osthus, A., Aarstad, A., Olofsson, J., & Aarstad, H. (2011). Health-related quality of life scores in long-term head and neck cancer survivors predict subsequent survival: A prospective cohort study. Clinical Otolaryngology, 36(4), 361–368.

    Article  PubMed  CAS  Google Scholar 

  20. Bjordal, K., Ahlner-Elmqvist, M., Hammerlid, E., Boysen, M., Evensen, J., Biörklund, A., et al. (2001). A prospective study of quality of life in head and neck cancer patients part II: Longitudinal data. Laryngoscope, 111(8), 1440–1452.

    Article  PubMed  CAS  Google Scholar 

  21. Bjordal, K., & Kaasa, S. (1992). Psychometric validation of the EORTC core quality of life questionnaire, 30-item version and a diagnosis-specific module for head and neck cancer patients. Acta Oncologica, 31(3), 311–321.

    Article  PubMed  CAS  Google Scholar 

  22. Aaronson, N., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N., et al. (1993). The european organization for research and treatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85(5), 365–376.

    Article  PubMed  CAS  Google Scholar 

  23. Chie, W., Hong, R., Lai, C., Ting, L., & Hsu, M. (2003). Quality of life in patients of nasopharyngeal carcinoma: Validation of the Taiwan Chinese version of the EORTC QLQ-C30 and the EORTC QLQ-H&N35. Quality of Life Research, 12(1), 93–98.

    Article  PubMed  CAS  Google Scholar 

  24. Charlson, M., Pompei, P., Ales, K., & MacKenzie, C. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40(5), 373–383.

    Article  PubMed  CAS  Google Scholar 

  25. Fang, F., Chien, C., Tsai, W., Chen, H., Hsu, H., Lui, C., et al. (2008). Quality of life and survival outcome for patients with nasopharyngeal carcinoma receiving three-dimensional conformal radiotherapy versus intensity-modulated radiotherapy—A longitudinal study. International Journal of Radiation Oncology Biology Physics, 72(2), 356–364.

    Article  Google Scholar 

  26. Fang, F., Tsai, W., Chen, H., Hsu, H., Hsiung, C., Chien, C., et al. (2007). Intensity-modulated or conformal radiotherapy improves quality of life of patients with nasopharyngeal carcinoma—comparisons of four radiotherapy techniques. Cancer, 109(2), 313–321.

    Article  PubMed  Google Scholar 

  27. Bjordal, K., Hammerlid, E., Ahlner-Elmqvist, M., de Graeff, A., Boysen, M., Evensen, J., et al. (1999). Quality of life in head and neck cancer patients: Validation of the European organization for research and treatment of cancer quality of life questionnaire-H&N35. Journal of Clinical Oncology, 17(3), 1008–1019.

    PubMed  CAS  Google Scholar 

  28. Fayers, P., Aaronson, K., & Bjordal, K. (2002). EORTC QLQ-C30 scoring manual (2nd ed., p. 1999). Brussels: EORTC Data Center.

    Google Scholar 

  29. Osoba, D., Rodrigues, G., Myles, J., Zee, B., & Pater, J. (1998). Interpreting the significance of changes in health-related quality-of-life scores. Journal of Clinical Oncology, 16(1), 139–144.

    PubMed  CAS  Google Scholar 

  30. Abendstein, H., Nordgren, M., Boysen, M., Jannert, M., Silander, E., Ahlner-Elmqvist, M., et al. (2005). Quality of life and head and neck cancer: A 5 year prospective study. Laryngoscope, 115(12), 2183–2192.

    Article  PubMed  Google Scholar 

  31. Mehanna, H., & Morton, R. (2006). Does quality of life predict long-term survival in patients with head and neck cancer? Archives Otolaryngology Head Neck Surgery, 132(1), 27–31.

    Article  Google Scholar 

  32. Jameson, M., Karnell, L., Christensen, A., & Funk, G. (2008). First-year trends in self-reported general health predict survival in patients with head and neck cancer. Archives Otolaryngology Head Neck Surgery, 134(9), 958–964.

    Article  Google Scholar 

  33. Fuller, C., Braden, C., & Thomas, C. (2004). Quality of life: From a tower of barbel towel toward a unified voice. International Journal of Radiation Oncology Biology Physics, 58(5), 1334–1335.

    Article  Google Scholar 

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Acknowledgments

Supported by Grant “NSC 90-2320-B-182A-006-” from the National Science Council, Taiwan; “CMRPG860502” and “CMRPG860503” from the Chang Gung Memorial Hospital, Taiwan.

Conflict of interest

No financial disclosure from any author.

Author information

Authors and Affiliations

  1. Department of Biotechnical Cosmetology, Cheng Shiu University, Kaohsiung, Taiwan

    Wen-Ling Tsai

  2. Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Chih-Yen Chien

  3. Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Hsuan-Ying Huang

  4. Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta-Pei Rd., Niao Sung District, Kaohsiung City, Taiwan

    Kuan-Cho Liao & Fu-Min Fang

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  1. Wen-Ling Tsai
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  2. Chih-Yen Chien
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Correspondence to Fu-Min Fang.

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Tsai, WL., Chien, CY., Huang, HY. et al. Prognostic value of quality of life measured after treatment on subsequent survival in patients with nasopharyngeal carcinoma. Qual Life Res 22, 715–723 (2013). https://doi.org/10.1007/s11136-012-0213-8

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