Preservation of quality of life after intensity-modulated radiotherapy for early-stage nasopharyngeal carcinoma: results of a prospective longitudinal study.

Abstract

Xerostomia is a ubiquitous complication after conventional radiotherapy for nasopharyngeal carcinoma (NPC) that seriously impairs patient quality of life (QOL). The effect on QOL of parotid-sparing intensity-modulated radiotherapy (IMRT) for early-stage NPC was assessed prospectively. Thirty-two patients with T1-2,N0-1,M0 NPC received IMRT. Saliva flow was measured, and the Medical Outcomes Short Form 36 (SF-36), European Organization for Research and Treatment of Cancer (EORTC) core, and EORTC head and neck module (QLQ-H&N35) questionnaires were completed at baseline and 2, 6, and 12 months after IMRT. Saliva flow recovered to at least 25% of baseline in most cases after 1 year. Physical function, fatigue, and vitality were problems at 2 months and then resolved (p < or = .002). Global health scales showed continuous improvement in QOL after treatment (p < or = .004). Xerostomia and sticky saliva were problems 2 months after treatment; thereafter, continuous improvement occurred (p < or = .001). Xerostomia scores correlated with general aspects of QOL (p < or = .044). IMRT for early-stage disease preserved key aspects of QOL, and a reduction in xerostomia symptoms enhanced broader aspects of QOL.