Abstract
PurposeTo evaluate factors affecting psychology, cognitive function and quality of life (QOL) of nasopharyngeal carcinoma (NPC) patients with radiation-induced brain injury (RI).Methods and Materials46 recurrence-free NPC patients with RI and 46 matched control patients without RI were recruited in our study. Subjective and objective symptoms of RI were evaluated with the LENT/SOMA systems. Psychological assessment was measured with Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). Montreal Cognitive Assessment (MoCA) was carried out in these patients for assessing their cognitive function. QOL was evaluated by means of WHOQOL BREF.ResultsOf the patients with RI, 39(84.8%) had depression and 40(87.0%) had anxiety. The patients with RI got higher scores both in SDS and SAS than those without RI (SDS, 63.48±8.11vs. 58.67±7.52, p = 0.008; SAS, 67.36±10.41vs. 60.34±9.76, p = 0.005). Score in MoCA of patients with RI was significantly lower than that of patients without RI (21.32±2.45vs. 25.98±1.73, p<0.001). SAS was positive correlated with post-radiotherapy interval. Both SAS and SDS had a significantly positive correlation with the rank of SOMA, while MoCA had a significantly negative correlation with SOMA. Chemotherapy was a risk factor for cognitive dysfunction. In addition, patients with RI got significantly lower scores in physical health (16.50±11.05 vs. 35.02±10.43, p<0.001), psychological health (17.70±10.33 vs. 39.48±12.00, p<0.001) and social relationship (48.00±18.65 vs. 67.15±19.70, p<0.001) compared with those in patients without RI. Multiple linear regression analysis revealed that anxiety and cognitive impairment were significant predictors of global QOL.ConclusionsNPC patients with RI exhibit negative emotions, impaired cognitive function and QOL. The severity of clinical symptoms of RI plays an important role in both emotions and cognitive function. Anxiety and cognitive impairment are associated with decreased QOL.
Highlights
Nasopharyngeal carcinoma (NPC) is known as the high incidence cancer in China [1], especially in Guangdong Province
The severity of clinical symptoms of radiation-induced brain injury (RI) plays an important role in both emotions and cognitive function
Late Effects of Normal Tissue (LENT)/SOMA scale was used to evaluate the severity of clinical symptoms of RI
Summary
Nasopharyngeal carcinoma (NPC) is known as the high incidence cancer in China [1], especially in Guangdong Province. Radiotherapy (RT) is a long-standing mainstay of NPC treatment. There have been some reports [4,5]about psychological disorders, cognitive dysfunction and QOL of NPC patients following RT, most of them focused on the effects of therapies and with a relatively limited postradiotherapy interval. The psychological disorders and QOL of patients with a long post- RT interval, especially of patients with RI are seldom addressed. Whether psychological disorders are the complications of RI or just frequently observed in patients following RT is still poorly known. For these reasons, we undertook a psychological study (including SAS and SDS), cognitive (MoCA) and QOL (WHOQOL BREF) assessment in NPC patients with RI. The results were compared with those of a matching post-radiotherapy (post-RT) NPC patients without RI
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