|
Background & Objective: With the development of medicine and the change of medical modality and the elevation of survival rate of nasopharyngeal carcinoma (NPC) patients after treatment, their quality of life (QOL) is more and more emphasized. Our study was designed to compare the factors correlated with their QOL after intensity modulated radiation (IMRT) and conventional radiotherapy (CRT), and to inquire into the importance of IMRT to decrease the side effects and to improve QOL.Methods: Thirty-five items were designed in the questionnaire according to EORTC QLQ-30 and combining the relative symptoms and the side effects of NPC. From January 2004 to December 2005, 142 patients with disease-free survival NPC were investigated by the questionnaire for the evaluation of the QOL at our hospital. The mean follow-up time was twenty-five months. And the information of social demography and clinical details were collected at that time. The patients were divided into IMRT group (75 patients) and CRT group (67 patients). Thirty-five items in six fields were recorded one to four grades according to the severity in the statistics. And the grades were transformed into zero to one hundred marks for the comparability with other studies. The higher marks meant higher QOL. With statistical software package SAS8.1, the details were determined with t-test, X2-test and multivariate linear regression analysis.Results: (1). The marks of affective cognitive domain were 82.8±14.7 (IMRT group) and 77.5±16.0 (CTR group) respectively (P=0.040 <0.05). The marks of diseases, relative symptoms of treatments and reactive domain were 78.9±10.3 (IMRT group) and 69.8±13.3 (CTR group)respectively (P=0.000<0.05). (2). Of fourteen items of diseases, relative symptoms of treatments and reactive domain in IMRT group and CRT group, xerostomia, difficulty of mouth opening, deglutitory choke, hoarseness, restriction of neck moving and dysphagia, etc., the marks were significantly different. And the marks were 53.8±23.8 and 35.3±22.4, 88.9±16.7 and 71.1±23.9, 87.6±18.8 and 76.6±24.6, 92.0±15.3 and 80.1±24.7, 82.2±22.1 and 73.6±26.3, 87.1±20.4 and 72.6±26.5 respectively;(all P<0.05). (3). Of influence factors of QOL, the domain of body function was sex and its regression coefficient was -4.692. The factors of self-evaluation of total QOL were follow-up time and educational background, and their regression coefficients were -0.618 and 12.316 respectively. The factor of economic status was family income per capita, and its regression coefficient was -11.133. The factors of diseases, relative symptoms of treatments and reactive domain were groups (IMRT and CRT)and age, and their regression coefficients were -9.384 and -5.853 respectively.Conclusions: IMRT could decrease the side effects of disease-free survival NPC including xerostomia, difficulty of mouth opening, restriction of neck moving and dysphagia, etc., and it could improve QOL of the patients. Sex, age, family income per capita, educational background, follow-up time and the technology of irradiations could affect QOL for patients with NPC in varying degrees. Improving the technology of irradiations, increasing economic income and enhancing educational status could improve QOL of the patients with NPC.
|