Laryngorhinootologie 2013; 92(04): 244-250
DOI: 10.1055/s-0032-1330020
Originalie
© Georg Thieme Verlag KG Stuttgart · New York

Posttherapeutische Lebensqualität beim Nasopharynxkarzinom

Analysis of Quality of Life Outcome for Nasopharyngeal Carcinoma Patients After Treatment
M. Jakob
1   ENT – HNO, University Hospital Bonn, Bonn
,
M. Manz
1   ENT – HNO, University Hospital Bonn, Bonn
,
A. Schröck
1   ENT – HNO, University Hospital Bonn, Bonn
,
F. Bootz
1   ENT – HNO, University Hospital Bonn, Bonn
,
K. Eichhorn
1   ENT – HNO, University Hospital Bonn, Bonn
› Institutsangaben
Weitere Informationen

Publikationsverlauf

eingereicht 26. Juli 2012

akzeptiert   04. November 2012

Publikationsdatum:
07. Januar 2013 (online)

Zusammenfassung

Hintergrund:

In der vorliegenden Querschnitts­studie wurden retrospektiv die Patientencharakteristika und die posttherapeutische Lebensqualität (LQ) nach der Behandlung eines Nasopharynxkarzinoms (NPC) erhoben und ausgewertet.

Material und Methoden:

Das Patientenkollektiv umfasst 20 Patienten, die im Zeitraum 2001–2009 aufgrund eines NPC an der Universitätsklinik Bonn mittels Radiotherapie (RT) oder Radiochemotherapie (RCT) behandelt wurden. Die Lebensqualitätsanalyse wurde mit dem Fragebogen FACT-NP (functional assessment of cancer therapy-nasopharyngeal) durchgeführt.

Ergebnisse:

Das mittlere Alter der Patienten war 57±13 Jahre, das Verhältnis Männer zu Frauen betrug 2,33/1. 3 (15%) der Patienten wurden mit einer RT und 17 (85%) mit einer kombinierten RCT behandelt. Die allgemeine posttherapeutische LQ der Patienten war gut. Mundtrockenheit, Geschmacksminderung, der Einfluss der Erkrankung auf das Sexualleben und otologische Symptome waren LQ mindernd. Schmerzen, der Verlust der Arbeitsfähigkeit, seelische oder familiäre Probleme standen nicht im Vordergrund.

Schlussfolgerung:

Die zu erwartenden Funktions- und Lebensqualitätseinbußen bei der Behandlung des NPC müssen dem Patienten ausführlich erläutert werden. Die Einbindung der Familie in das Therapiekonzept, eine antidepressive Therapie oder psychoonkologische Unterstützung kann sinnvoll und notwendig sein.

Abstract

Analysis of Quality of Life Outcome for Nasopharyngeal ­Carcinoma Patients After Treatment

Background:

This retrospective study analysed patient characteristics and quality of live (QoL) for patients with nasopharyngeal carcinoma (NPC) after treatment.

Material and Methods:

A cross-sectional investigation was conducted to assess the QoL of 20 NPC patients with cancer-free survival of more than one year, which were treated with radiotherapy (RT) or chemoradiotherapy (RCT) during the period 2001–2009 at the University Hospital Bonn, Germany. The QoL was assessed by the FACT-NP (functional assessment of cancer therapy-nasopharyngeal) questionnaire.

Results:

The median age of the patients was 57±13 years and the male/female ratio was 2.33/1.3 (15%) patients were treated with RT and 17 (85%) with RCT. The global QoL was good in our patients. Xerostomia, chewing, decrease of gustatory sense, discontent with sexual life and ear problems were of major concern with the majority of patients and affected the QoL negatively. Pain, lost of working ability, emotional distress, or family problems were no significant factors.

Conclusion:

The expected reduction of QoL after treatment must be explained in detail to the NPC patient. The integration of the family and partner, an antidepressant therapy or psycho-oncological support can be useful and necessary.

 
  • Literatur

  • 1 Lang S, Wollenberg B, Dellian M, Steuer-Vogt MK, Schwenzer K, Sautier W, Chucholowski M, Eckel R, Faas I, Wilmes E, Ehrenfeld M, Arnold W, Kastenbauer E, Holzel D. Clinical and epidemiological data of patients with malignomas of the head and neck. Laryngorhinootologie 2002; 81: 499-508
  • 2 Mertens R, Granzen B, Lassay L, Bucsky P, Hundgen M, Stetter G, Heimann G, Weiss C, Hess CF, Gademann G. Treatment of nasopharyngeal carcinoma in children and adolescents: definitive results of a multicenter study (NPC-91-GPOH). Cancer 2005; 104: 1083-1089
  • 3 Chang ET, Adami HO. The enigmatic epidemiology of nasopharyngeal carcinoma. Cancer Epidemiol Biomarkers Prev 2006; 15: 1765-1777
  • 4 Maune S, Geisthoff U. Measuring the world of quality of life. HNO 2009; 57: 882-883
  • 5 Dietz A, Meyer A, Singer S. Measuring quality of life in head and neck cancer. Current status and future needs. HNO 2009; 57: 857-865
  • 6 Tong MC, Lo PS, Wong KH, Yeung RM, van Hasselt CA, Eremenco S, Cella D. Development and validation of the functional assessment of cancer therapy nasopharyngeal cancer subscale. Head Neck 2009; 31: 738-747
  • 7 Münter MW, Stoiber EM, Jensen AD, Debus J. Nasopharyngeal carcinoma. A model for modern radio-oncology. HNO 2007; 55: 927-929
  • 8 Tribius S, Petersen C, Knecht R, Ihloff AS. Radiation therapy in head and neck cancer. Highlights from ASCO 2010. HNO 2010; 58: 1168-1173
  • 9 Fischer M, Pottgen C, Wechsler S, Stuschke M, Jahnke K. Accelerated hyperfractionated radiotherapy with concurrent chemotherapy in locally advanced nasopharyngeal carcinomas. HNO 2007; 55: 950-955
  • 10 Yarney J, Vanderpuye V, Kitcher ED. Treatment outcome of locally advanced nasopharyngeal cancer with concurrent chemoradiotherapy. West Afr J Med 2008; 27: 65-68
  • 11 Singer S, Hofmeister D, Spiegel K, Boehm A. Current developments in measuring quality of life with instruments of the European organisation for research and treatment of cancer (EORTC). Laryngorhinootologie 2011; 90: 591-594
  • 12 Goh J, Lim K. Imaging of nasopharyngeal carcinoma. Ann Acad Med Singapore 2009; 38: 809-816
  • 13 Fang FM, Tsai WL, Lee TF, Liao KC, Chen HC, Hsu HC. Multivariate analysis of quality of life outcome for nasopharyngeal carcinoma patients after treatment. Radiother Oncol 2010; 97: 263-269
  • 14 Fang FM, Tsai WL, Chien CY, Chen HC, Hsu HC, Huang TL, Lee TF, Huang HY, Lee CH. Pretreatment quality of life as a predictor of distant metastasis and survival for patients with nasopharyngeal carcinoma. J Clin Oncol 2010; 28: 4384-4389
  • 15 Raab-Traub N. Epstein-Barr virus in the pathogenesis of NPC. Semin Cancer Biol 2002; 12: 431-441
  • 16 Brennan B. Nasopharyngeal carcinoma. Orphanet J Rare Dis 2006; 1: 23
  • 17 Chu EA, Wu JM, Tunkel DE, Ishman SL. Nasopharyngeal carcinoma: the role of the Epstein-Barr virus. Medscape J Med 2008; 10: 165
  • 18 Chan AT. Nasopharyngeal carcinoma. Ann Oncol. 2010; 21 (Suppl. 07) vii308-vii312
  • 19 Lee AW, Sze WM, Au JS, Leung SF, Leung TW, Chua DT, Zee BC, Law SC, Teo PM, Tung SY, Kwong DL, Lau WH. Treatment results for nasopharyngeal carcinoma in the modern era: the Hong Kong experience. Int J Radiat Oncol Biol Phys 2005; 61: 1107-1116
  • 20 Gunzel T, Schimmer M. Quality of Life after Primary Radiation/Radiochemotherapy vs. Operation Therapy in an Oropharyngeal Cancer. Laryngorhinootologie 2012; 91: 451-459
  • 21 Al-Sarraf M, Leblanc M, Giri PG, Fu KK, Cooper J, Vuong T, Forastiere AA, Adams G, Sakr WA, Schuller DE, Ensley JF. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol 1998; 16: 1310-1317
  • 22 Yang H, Hu W, Wang W, Chen P. SU-E-T-550: Influence of the Clinical Outcome and Quality of Life by Replanning during Intensity-Modulated Radiation Therapy for Nasopharyngeal Carcinoma. Med Phys 2012; 39: 3832
  • 23 Münter MW, Karger CP, Hoffner SG, Hof H, Thilmann C, Rudat V, Nill S, Wannenmacher M, Debus J. Evaluation of salivary gland function after treatment of head-and-neck tumors with intensity-modulated radiotherapy by quantitative pertechnetate scintigraphy. Int J Radiat Oncol Biol Phys 2004; 58: 175-184
  • 24 Münter MW, Hoffner S, Hof H, Herfarth KK, Haberkorn U, Rudat V, Huber P, Debus J, Karger CP. Changes in salivary gland function after radiotherapy of head and neck tumors measured by quantitative pertechnetate scintigraphy: comparison of intensity-modulated radiotherapy and conventional radiation therapy with and without Amifostine. Int J Radiat Oncol Biol Phys 2007; 67: 651-659
  • 25 Fang FM, Chiu HC, Kuo WR, Wang CJ, Leung SW, Chen HC, Sun LM, Hsu HC. Health-related quality of life for nasopharyngeal carcinoma patients with cancer-free survival after treatment. Int J Radiat Oncol Biol Phys 2002; 53: 959-698
  • 26 Chan AT, Leung SF, Ngan RK, Teo PM, Lau WH, Kwan WH, Hui EP, Yiu HY, Yeo W, Cheung FY, Yu KH, Chiu KW, Chan DT, Mok TS, Yau S, Yuen KT, Mo FK, Lai MM, Ma BB, Kam MK, Leung TW, Johnson PJ, Choi PH, Zee BC. Overall survival after concurrent cisplatin-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma. J Natl Cancer Inst 2005; 97: 536-539
  • 27 Wu Y, Hu WH, Xia YF, Ma J, Liu MZ, Cui NJ. Quality of life of nasopharyngeal carcinoma survivors in Mainland China. Qual Life Res 2007; 16: 65-74
  • 28 Oates JE, Clark JR, Read J, Reeves N, Gao K, Jackson M, Boyer M, O’Brien CJ. Prospective evaluation of quality of life and nutrition before and after treatment for nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg 2007; 133: 533-540
  • 29 Sumitsawan Y, Chaiyasate S, Chitapanarux I, Anansuthiwara M, Roongrotwattanasiri K, Vaseenon V, Tooncam H. Late complications of radiotherapy for nasopharyngeal carcinoma. Auris Nasus Larynx 2009; 36: 205-209
  • 30 McMillan AS, Pow EH, Leung WK, Wong MC, Kwong DL. Oral health-related quality of life in southern Chinese following radiotherapy for nasopharyngeal carcinoma 35. J Oral Rehabil 2004; 31: 600-608
  • 31 Pow EH, Kwong DL, Sham JS, Lee VH, Ng SC. Can intensity-modulated radiotherapy preserve oral health-related quality of life of nasopharyngeal carcinoma patients?. Int J Radiat Oncol Biol Phys 2012; 83: e213-e221
  • 32 Lee PW, Kwan TT, Kwong DL, Sham JS, Pow EH, McMillan AS, Au GK. A prospective study of the impact of nasopharyngeal cancer and radiotherapy on the psychosocial condition of Chinese patients. Cancer 2007; 109: 1344-1354
  • 33 Teguh DN, Levendag PC, Noever I, Voet P, van der EH, van RP, Dumans AG, de Boer MF, van der Huls MP, Sterk W, Schmitz PI. Early hyperbaric oxygen therapy for reducing radiotherapy side effects: early results of a randomized trial in oropharyngeal and nasopharyngeal cancer. Int J Radiat Oncol Biol Phys 2009; 75: 711-716
  • 34 Tang Y, Luo D, Rong X, Shi X, Peng Y. Psychological disorders, cognitive dysfunction and quality of life in nasopharyngeal carcinoma patients with radiation-induced brain injury. PLoS One 2012; 7: e36529
  • 35 Bindewald J, Oeken J, Wollbrueck D, Wulke C, Dietz A, Herrmann E, Schwarz R, Singer S. Quality of life correlates after surgery for laryngeal carcinoma. Laryngoscope 2007; 117: 1770-1776
  • 36 Singer S, Kuhnt S, Zwerenz R, Eckert K, Hofmeister D, Dietz A, Giesinger J, Hauss J, Papsdorf K, Briest S, Brown A. Age- and sex-standardised prevalence rates of fatigue in a large hospital-based sample of cancer patients. Br J Cancer 2011; 105: 445-451
  • 37 Singer S, Danker H, Dietz A, Kienast U, Pabst F, Meister EF, Oeken J, Thiele A, Schwarz R. Sexual problems after total or partial laryngectomy. Laryngoscope 2008; 118: 2218-2224