The Correlation Study Between Nutritional Status And Quality Of Life With Nasopharyngeal Carcinoma

[Objective]The purpose of this study was to compare the changing tendency of nutrition andquality of life with nasopharyngeal carcinoma (NPC) patients duringintensity-modulated radiation therapy (IMRT), to investigate the correlation betweennutritional status, quality of life (QoL) and acute complications, and to explore theinfluencing factors of the quality of life. To provide an alternative measure fornutritional status so that it is beneficial to improve the quality of life fornasopharyngeal carcinoma.[Methods]Patients who were primarily diagnosed as nasopharyngeal carcinoma and treatedby intensity-modulated radiotherapy were enrolled in this study in theFujianProvincialCancerHospital from March,2012to March,2013. And21of thesepatients who were received percutaneous endoscopic gastrostomy (PEG) before IMRTwere regarded as treatment group.Then21patients (as control group) withoutpercutaneous endoscopic gastrostomy at the same period were matched respectively.Various measuring scales were used in the investigation, which included EORTCQLQ-C30(version3.0), ECOG and self-designed questionnaire that was about basicinformation of patients. These investigations were conducted within48hours afteradmission and at the end of treatment with IMRT. The nutritional index, includingheight, body weight, albumin, prealbumin, total lymphocyte count and hemoglobin,was also evaluated at the two time points. The changing tendency and compare ofnutrition and QoL were analyzed by T test. A nutrition index model was built to assessthe comprehensive nutritional status by principal components analysis at the end oftreatment with IMRT. Correlations between the comprehensive nutritional status and the QoL, the comprehensive nutritional status and acute complications, thecomprehensive nutritional status and performance status were assessed by theCorrelation analysis. Multiple linear stepwise regression was used to analyze thefactors which affected the QoL on patients with NPC after IMRT.[Results]1. A statistically significant downgrade of every nutritional index, includingalbumin, prealbumin, total lymphocyte count, hemoglobin, body mass index (BMI),ideal body weight percentage (IBW%), usual body weight percentage (UBW%), wasobserved during IMRT.2. At the end of IMRT, the QoL scores of the global scale, functional scale,symptom scale and six single items scale were statistically different with those within48hours after admission.3. Compared with the two groups, the comprehensive nutritional status and thescores of the global scale were appeared statistical differences at the end of IMRT.4. Acute oral mucositis and xerostomia had a negative correlation withcomprehensive nutritional status. And the scores of the global scale existed a positivecorrelation with it. But there was no correlation between comprehensive nutritionalstatus and performance status at the end of IMRT.5. Multivariate analysis on quality of life on patients with NPC after IMRTshowed that the QoL of global scale was correlated with comprehensive nutritionalstatus. The physical condition was the influencing factor of functional scale, symptomscale and six single items scale.[Conclusion]Nutritional status and QoL with NPC patients during treatment decreasedobviously. Good nutritional status means low degree of acute complications, and wellQoL at the end of IMRT. Using PEG before IMRT may improve the NPC patients’nutritional status and QoL during radiotherapy and chemotherapy.