Quality of Life and Survival Outcome for Patients With Nasopharyngeal Carcinoma Receiving Three-Dimensional Conformal Radiotherapy vs. Intensity-Modulated Radiotherapy—A Longitudinal Study

Fang, Fu-Min; Chien, Chih-Yen; Tsai, Wen-Ling; Chen, Hui-Chun; Hsu, Hsuan-Chih; Lui, Chun-Chung; Huang, Tai-Lin; Huang, Hsuan-Ying

doi:10.1016/j.ijrobp.2007.12.054

« Previous Next »International Journal of Radiation Oncology * Biology * Physics
Volume 72, Issue 2 , Pages 356-364, 1 October 2008

Quality of Life and Survival Outcome for Patients With Nasopharyngeal Carcinoma Receiving Three-Dimensional Conformal Radiotherapy vs. Intensity-Modulated Radiotherapy—A Longitudinal Study

Fu-Min Fang, M.D., Ph.D.
- Department of Radiation Oncology, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
- Kaohsiung Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
- Reprint requests to: Fu-Min Fang, M.D., Ph.D., Department of Radiation Oncology, Chang Gung Memorial Hospital Kaohsiung Medical Center, 123 Ta-Pei Rd., Niao Sung Hsian, Kaohsiung Hsien, Taiwan. Tel: (+886) 7-7317123, ext. 2600; Fax: (+886) 7-7322813
Chih-Yen Chien, M.D.
- Department of Otolaryngology, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
- Kaohsiung Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
Wen-Ling Tsai, Ph.D.
- Department of Radiation Oncology, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
- Department of Cosmetic Application and Management, Yung Ta Institute of Technology & Commerce, Pintung, Taiwan
Hui-Chun Chen, M.D.
- Department of Radiation Oncology, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
Hsuan-Chih Hsu, M.D.
- Department of Radiation Oncology, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
Chun-Chung Lui, M.D.
- Department of Radiology, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
- Kaohsiung Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
Tai-Lin Huang, M.D.
- Department of Hematology-Oncology, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
- Kaohsiung Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
Hsuan-Ying Huang, M.D.
- Department of Pathology, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
- Kaohsiung Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan

Received 13 September 2007; received in revised form 24 December 2007; accepted 27 December 2007. published online 20 March 2008.

Purpose

To investigate the changes of quality of life (QoL) and survival outcomes for patients with nasopharyngeal carcinoma (NPC) treated by three-dimensional conformal radiotherapy (3D-CRT) vs. intensity-modulated radiotherapy (IMRT).

Methods and Materials

Two hundred and three newly diagnosed NPC patients, who were curatively treated by 3D-CRT (n = 93) or IMRT (n = 110) between March 2002 and July 2004, were analyzed. The distributions of clinical stage according to American Joint Committee on Cancer 1997 were I: 15 (7.4%), II: 78 (38.4%), III: 74 (36.5%), and IV: 36 (17.7%). QoL was longitudinally assessed by the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC QLQ-H&N35 questionnaires at the five time points: before RT, during RT (36 Gy), and 3 months, 12 months, and 24 months after RT.

Results

The 3-year locoregional control, metastasis-free survival, and overall survival rates were 84.8%, 76.7%, and 81.7% for the 3D-CRT group, respectively, compared with 84.2%, 82.6%, and 85.4% for the IMRT group (p value > 0.05). A general trend of maximal deterioration in most QoL scales was observed during RT, followed by a gradual recovery thereafter. There was no significant difference in most scales between the two groups at each time point. The exception was that patients treated by IMRT had a both statistically and clinically significant improvement in global QoL, fatigue, taste/smell, dry mouth, and feeling ill at the time point of 3 months after RT.