Improved quality of life in head and neck cancer patients treated with modern arc radiotherapy techniques - A prospective longitudinal analysis.

Autor:	Chuang EY; Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei, Taiwan., Hou PY; Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei, Taiwan.; Department of Computer Science and Engineering, Yuan Ze University, Taoyuan, Taiwan., Shueng PW; Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei, Taiwan.; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan., Lo WC; Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan.; Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan.; Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan., Lin PY; Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan.; Department of Dentistry, Far Eastern Memorial Hospital, New Taipei, Taiwan.; General Education Center, Lunghwa University of Science and Technology, Taoyuan, Taiwan.; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan., Lin SC; Division of Hematology and Oncology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan., Wu PH; Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan.; Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan.; Department of Electrical Engineering, College of Electrical and Communication Engineering, Yuan Ze University, Taoyuan, Taiwan.; Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan., Jiang JG; Division of Hematology and Oncology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan., Chung CS; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan.; College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan., Hsu CX; Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei, Taiwan.; Department of Computer Science and Engineering, Yuan Ze University, Taoyuan, Taiwan., Kuo DY; Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei, Taiwan., Lu YF; Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei, Taiwan., Liao LJ; Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan.; Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan.; Department of Electrical Engineering, College of Electrical and Communication Engineering, Yuan Ze University, Taoyuan, Taiwan., Hsieh CH; Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei, Taiwan.; Department of Computer Science and Engineering, Yuan Ze University, Taoyuan, Taiwan.; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Head and Neck Cancer Surveillance and Research Group, Far Eastern Memorial Hospital, New Taipei, Taiwan.; Institute of Traditional Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2024 Sep 23; Vol. 14, pp. 1424034. Date of Electronic Publication: 2024 Sep 23 (Print Publication: 2024).
DOI:	10.3389/fonc.2024.1424034
Abstrakt:	Purpose: The present longitudinal study aimed to evaluate the potential impact of modern radiotherapy (RT) techniques on quality of life (QOL) in patients with head and neck (HNC) cancer. Materials and Methods: In this single-center prospective study, participants were asked to complete QOL questionnaires that included the EORTC QLQ-C30, QLQ-H&N 35 and utility score by time trade-off (TTO) at three time points (2 weeks, 3 months and 6 months) after completion of RT. All patients were treated by modern RT techniques [volumetric modulated arc therapy (VMAT) or helical tomotherapy (HT)]. Patients who developed recurrence or died before the 6-month follow-up were excluded. Linear mixed models with random intercepts for participants and restricted maximum likelihood estimates were used to assess the effect of our study variables (age, sex, primary site, cancer stage, treatment, radiation dose and radiation method). Overall changes in QOL, utility scores and symptom burdens at different time points were tested using paired t tests. Results: A total of 45 patients were recruited from 2022 to 2023. Those who completed the surveys at 2 weeks with at least 1 follow-up (30 patients, 67%) were enrolled in the final analysis. The majority of these 30 patients were men (76.7%), had oral cancer (40%), had stage III or IV disease (60%), received surgical intervention (63%) and were treated with chemoradiation (80%). A curative total dose of 66 to 70 Gy was delivered to 23 (76.7%) patients, half of whom received HT. Patients who received chemotherapy had significantly lower global QoL scales (mean difference, 27.94; 95% CI, 9.33-46.55; p =0.005). Global QOL, physical function, symptoms of sticky saliva, cough, feelings of illness and weight loss improved significantly between 2 weeks and 3 months. There was no significant difference between 3 and 6 months. Interestingly, improvements in social function, social contact, pain and nutrition reached significance at 6 months. Subgroup analysis revealed greater pain relief over time for patients who underwent HT ( p =0.030). Moreover, patients who participated in swallowing rehabilitation programs had a greater decrease in nausea and vomiting ( p =0.036). Conclusion: HNC patients treated with modern RT techniques experience improved QOL and physical function over time. The most significant improvement occurs between 2 weeks and 3 months, after which the improvement plateaus. However, social function, social contact, pain and nutrition may require longer recovery intervals after treatment. HT with daily image guidance could provide a therapeutic opportunity for improving pain relief in patients with HNC. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Chuang, Hou, Shueng, Lo, Lin, Lin, Wu, Jiang, Chung, Hsu, Kuo, Lu, Liao and Hsieh.)
Databáze:	MEDLINE
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