Effect Of High-dose Hypofractionated Radiotherapy On Quality Of Life Of Patients With Pancreatic Cancer

PurposeThe mortality of pancreatic cancer ranks third in all malignant tumor.The annual mortality rate is basically equal to the incidence rate.80 %-85 % of patients have reached the local progression or distant metastasis.The majority of patients have the symptoms of pain,fatigue,loss of appetite,insomnia,anxiety and any others,which is seriously interfere with the quality of life in patients.In recent years the use of high-dose hypofractionated radiotherapy model significantly improve the local control rate.In order to clear the effects of this radiation dose mode on quality of life of patients and more widely application in clinic of high-dose hypofractionated radiotherapy,We intend to use the international general scale to evaluate the effect of high-dose hypofractionation mode radiotherapy on the quality of life of pancreatic cancer patients.MethodThe clinical data were collected prospectively in the patients with pancreatic cancer who were admitted to our hospital.All the patients underwent high-dose hypofractionated helical tomotherapy.We delievered planning target volume(PTV),clinical target volume(CTV)and gross tumor volume(GTV)to 45-50 Gy,55-60 Gy and 65-70 Gy respectively,with 15-20 fractions,5 fractions per week.To compare the differences between pre-,post-,1 month(first follow-up [1FUP])and 3 months(2FUP)after radiotherapy.The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(QLQ-C30)and pancreatic cancer-specific(European Organization for Research and Treatment of Cancer QLQ-PAN26)questionnaires were administered to patients at these four time points.All data were paired and computed using SPSS paired t-test(version 17.0),to compare the differences of quality of life between pre-,post-,and follow-up times.ResultFifty patients were enrolled in this study.The follow-up rate in 1 FUP is 94% and 72% in 2FUP.In QLQ-C30,there was no change in global Qo L from post-to pre-radiotherapy(P = 0.33),but a significant improvement from 1FUP to pre-radiotherapy(P=0.000).Scores were stable in 2FUP.Also there was a significant improvement in all function subscales at 1FUP except role function,especially scores of cognitive and social function were higher than that of pre-radiotherapy(P=0.045?P=0.002).All function subscales at 2FUP were the same as 1FUP but decline in social function(P=0.047).Among symptom subscales of QLQ-C30,fatigue was improved at post-radiotherapy,better in 1FUP and stable in 2FUP(P=0.703).Pain,insomnia,loss of appetite and diarrhea of 1FUP were similar with pre-radiotherapy and better in 1FUP(P=0.001?0.011?0.036?0.007,respectively).A statistical decline in nausea/vomiting were observed in patients at post-radiotherapy(P=0.000),and scores returned to pre-radiotherapy level by 1FUP,meanwhile,there was no change between 2FUP and 1FUP.Financial difficulties in post-and 1-month after radiotherapy got worse than pre-radiotherapy(P=0.046),stable in 1FUP and worse in 2FUP.In QLQ-PAN26,statistical improvements in pancreatic pain(back pain and night pain)(P=0.009?0.000)were observed from post-to pre-radiotherapy.The same were observed at 1FUP.No significant differences were reported between 1FUP and 2FUP.Weight loss in post-radiotherapy was better than that in pre-radiotherapy(P=0.000),also improved in 1FUP(P=0.024)and no significant improvement in 2FUP(P=0.226).ConclusionsHigh-dose hypofractionated radiotherapy mode for pancreatic cancer can experience short-term improvements in global Qo L.Likewise,to some extent function scale and symptom scale were improved.In general,high-dose hypofractionated radiotherapy can improve Global Qo L and provide basis for patients choosing treatment patterns.