Quality of Life Following Intensity-modulated Radiotherapy for Nasopharyngeal Carcinoma

Complications following conventional radiotherapy to the head and neck are substantial and seriously affect patient quality of life (QOL). Intensity-modulated radiotherapy is considered to yield fewer complications and thus may be less deleterious to QOL. Objective: to assess the impact of IMRT on the QOL of southern Chinese with nasopharyngeal carcinoma. Method: 26 newly diagnosed patients (16 male, 8 female; mean age 46.8 [SD,10.1] years; Tumour stage T1 or 2) took part in a prospective study. Evaluation points were before IMRT and 2 and 6 months after therapy. At each session, participants completed the EORTC QLQ-C30, QLQ-H&N35 and SF36 questionnaires. Mann-Whitney/ Friedman tests were used to compare changes over time. Results: at 2 months, there were significant decreases in mean SF36 sub-scale scores (physical function, role-physical, vitality, social functioning) and significant increases in EORTC C30 scales (physical functioning, fatigue, appetite loss) and H&N35 scales (swallowing, senses, social eating, social contact, dry mouth, sticky saliva) [p<0.005]. At 6 months, there were no differences in SF36 and EORTC C30 scores compared with baseline, whereas 6 H&N35 scores (swallowing, senses, social eating, opening mouth, dry mouth, sticky saliva) were significantly higher than baseline but only the mouth opening score was higher than at the 2 month evaluation (p<0.005). Conclusion: general QOL appeared to be impaired only in the short term whereas oral health-related QOL was still significantly poorer 6 months after IMRT. Supported by CRCG, HKU.