Abstract
The purpose of this study was to evaluate the prognostic value of quality of life (QOL) scores acquired not only pre-treatment, but also 1 month after treatment for locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) in patients with pharyngeal cancer treated using radiotherapy. Data for 102 patients with naso-, oro-, or hypo-pharyngeal cancer treated between December 2008 and September 2017 were retrospectively analyzed. About 90% of the patients were male. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) was used for QOL assessments. Associations between QLQ-C30 scores before and 1 month after treatment and outcomes including LRC, DMFS, and OS were analyzed using Cox proportional hazard models. Median follow-up was 37 months (range, 5–117 months). Three-year LRC, DMFS, and OS rates were 77.8%, 60.0%, and 66.5%, respectively. Pre-treatment emotional functioning and diarrhea at 1 month after treatment were identified as significant predictors of LRC. Pre-treatment global QOL and diarrhea at 1 month after treatment were detected as significant predictors of DMFS. Pre-treatment emotional functioning, pre-treatment appetite loss, and diarrhea at 1 month after treatment were detected as significant predictors of OS. Diarrhea at 1 month after treatment was the most powerful QOL variable for predicting LRC, DMFS and OS. Our study revealed that several QOL scores not only before treatment but also 1 month after treatment correlated with LRC, DMFS and OS. In particular, the diarrhea domain of QOL at 1 month after treatment offered the most powerful prognosticator for pharyngeal cancer patients treated with radiotherapy.
Highlights
The purpose of this study was to evaluate the prognostic value of quality of life (QOL) scores acquired pre-treatment, and 1 month after treatment for locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) in patients with pharyngeal cancer treated using radiotherapy
Even when limited to patients with head and neck cancer, many studies have revealed that pre-treatment QOL scores correlate with loco-regional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS)[1–22]
The following factors seem to contribute to conflicts and ambiguity in the results: (1) cancers with significantly different prognoses have all been included together; (2) patients treated with surgery, radiotherapy, and chemotherapy have all been included together; and (3) no unified QOL scoring tool has been applied
Summary
The purpose of this study was to evaluate the prognostic value of quality of life (QOL) scores acquired pre-treatment, and 1 month after treatment for locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) in patients with pharyngeal cancer treated using radiotherapy. Abbreviations QOL Quality of life LRC Locoregional control DMFS Distant metastasis-free survival OS Overall survival EORTC The European Organization for Research and Treatment of Cancer QLQ-C30 Quality of Life Questionnaire PS Performance status HR Hazard ratio 3D-CRT 3-Dimensional conformal radiotherapy IMRT Intensity-modulated radiotherapy PTV Planning target volume. Even when limited to patients with head and neck cancer, many studies have revealed that pre-treatment QOL scores correlate with loco-regional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS)[1–22]. Pre-treatment QOL scores do not seem to have been widely used as prognosticators in clinical practice
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