Joint modeling of longitudinal health-related quality of life during concurrent chemoradiotherapy period and long-term survival among patients with advanced nasopharyngeal carcinoma.

IF 3.3 2区医学 Q2 ONCOLOGY Radiation Oncology Pub Date : 2024-09-20 DOI:10.1186/s13014-024-02473-y

Ji-Bin Li, Shan-Shan Guo, Ting Liu, Zhuo-Chen Lin, Wei-Jie Gong, Lin-Quan Tang, Ling Guo, Hao-Yuan Mo, Hai-Qiang Mai, Qiu-Yan Chen

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Abstract

Background: To investigate the prognosis of longitudinal health-related quality of life (HRQOL) during concurrent chemoradiotherapy (CCRT) on survival outcomes in patients with advanced nasopharyngeal carcinoma (NPC).

Methods: During 2012-2014, 145 adult NPC patients with stage II-IVb NPC were investigated weekly using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire core 30 (EORCT QLQ-C30) during their CCRT period. The effects of longitudinal trends of HRQOL on survival outcomes were estimated using joint modeling, and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were reported as a 10-point increase in HRQOL scores.

Results: After a median follow-up of 83.4 months, the multivariable models showed significant associations of longitudinal increasing scores in fatigue and appetite loss during the CCRT period with distant metastasis-free survival: 10-point increases in scores of fatigue and appetite loss domains during CCRT period were significantly associated with 75% (HR: 1.75, 95% CI: 1.01, 3.02; p = 0.047) and 59% (HR: 1.59, 95% CI: 1.09, 2.59; p = 0.018) increase in the risk of distant metastasis, respectively. The prognostic effects of the longitudinal HRQOL trend on overall survival and progress-free survival were statistically non-significant.

Conclusion: Increases in fatigue and appetite loss of HRQOL during the CCRT period are significantly associated with high risks of distant metastasis in advanced NPC patients. Nutritional support and psychological intervention are warranted for NPC patients during the treatment period.

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晚期鼻咽癌患者同期化疗放疗期间纵向健康相关生活质量与长期生存的联合建模。

研究背景研究晚期鼻咽癌（NPC）患者在同期化疗放疗（CCRT）期间纵向健康相关生活质量（HRQOL）对生存结果的影响：2012年至2014年期间，145名II-IVb期成年鼻咽癌患者在接受CCRT期间每周使用欧洲癌症研究和治疗组织生活质量问卷核心30（EORCT QLQ-C30）进行调查。采用联合建模法估算了HRQOL纵向趋势对生存结果的影响，并以HRQOL评分每增加10分为单位报告了危险比（HR）和95%置信区间（95% CI）：中位随访83.4个月后，多变量模型显示，CCRT期间疲劳和食欲减退评分的纵向增加与无远处转移生存率显著相关：CCRT期间疲劳和食欲减退领域评分增加10分与75%的无远处转移生存率显著相关（HR：1.75，95% CI：1.01，3.02；P = 0.047）和59%（HR：1.59，95% CI：1.09，2.59；P = 0.018）的远处转移风险增加显著相关。纵向HRQOL趋势对总生存期和无进展生存期的预后影响无统计学意义：结论：晚期鼻咽癌患者在CCRT期间的疲劳和食欲减退与远处转移的高风险显著相关。鼻咽癌患者在治疗期间需要营养支持和心理干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiation Oncology ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

6.50

自引率

2.80%

发文量

181

审稿时长

3-6 weeks

期刊介绍： Radiation Oncology encompasses all aspects of research that impacts on the treatment of cancer using radiation. It publishes findings in molecular and cellular radiation biology, radiation physics, radiation technology, and clinical oncology.