Clinical Study Of Nutrition Status And Quality Of Life Change During Chemo-Radiotherapy For Locoregionally Advanced Nasopharyngeal Carcinoma Patients

Objective:To investigate the change of the nutrition status and quality of life(QoL)of patients suffering locoregionally advanced nasopharyngeal carcinoma during the chemo-radiotherapy.Methods:Forty consecutive initial diagnosed nasopharyngeal carcinoma patients attending the department of radiation oncology in the First Affiliated Hospital of Guangxi Medical University from May 2015 to November 2015 participated. Twenty five patients received neoadjuvant chemotherapy followed by concurrent chemo-radiotherapy were admitted in neoadjuvant chemotherapy+concurrent chemo-radiotherapy group. The other fifteen patients received concurrent chemo-radiotherapy only were admitted in concurrent chemo-radiotherapy group. Weight and nutrition related biochemical indicators(serum albumin, prealbumin, lymphocyte, hemoglobin)were measured,the Nutritional Risk Screening 2002(NRS2002)and Patient-generated Subjective Global Assessment(PG-SGA)were used to evaluate the nutrition status and the EORTC QLQ-C30 and EORTC QLQ-H&N35 were used to assess QoL at different time during the therapy. Data in the same group was compared by analysis of variance(ANOVA) and LSD-t test. Data of different groups was compared by T test and chi square test(X2 test).Results:1.The weight measured at different time of the two groups was significantly different (P<0.05), which was decreasing along with the treatment. The average weight loss of two groups was more than 4kg. No significant difference of weight loss was observed between two groups (P>0.05) 2. In two groups, the nutrition related biochemical indicators measured at different time were significantly different (P<0.05). In contrast to the initial status, the standard of biochemical indicators was lower after the completion of radiotherapy. The standard of hemoglobin of the concurrent chemo-radiotherapy group was significantly higher than that of neoadjuvant chemotherapy+concurrent chemo-radiotherapy group after the completion of radiotherapy (P<0.05) 3.The score of PG-SGA and NRS2002 was rising along with the treatment. After the completion of radiotherapy, PG-SGA score of all the patients in both groups was B-C level(P>0.05), the patients whose NRS 2002 score≥3 in the neoadjuvant chemotherapy+concurrent chemo-radiotherapy group and concurrent chemo-radiotherapy group were respectively 80%(20/25) and 84%(12/15, P>0.05).4.The score of Global quality of life,physical functioning, role functioning, emotion functioning, cognitive functioning, social functioning decreased, and score of pain, fatigue, nausea and vomiting, loss of appetite, swallowing, dry mouth and sticky saliva in the EORTC QLQ-C30 and QLQ-H&N35 scale rose after the completion of radiotherapy (P<0.05).No significant difference of the score of Global quality of life was observed between two groups at the baseline and after the completion of radiotherapy (P>0.05)Conclusions:The patients with locoregionally advanced nasopharyngeal carcinoma suffer weight loss, decline of nutrition related biochemical indicators, worsening of nutrition status and quality of life after chemo-radiotherapy. The use of neoadjuvant chemotherapy won’t improve the weight loss, decline of nutrition related biochemical indicators, worsening of nutrition status and quality of life of the locoregionally advanced nasopharyngeal carcinoma patients.