Prognostic value of quality of life measured after treatment on subsequent survival in patients with nasopharyngeal carcinoma

Purpose Pretreatment quality of life (QoL) has been used to predict survival in cancer patients. In this study, we examined the prognostic value of QoL measured after treatment on subsequent survival in patients with nasopharyngeal carcinoma (NPC). Methods We enrolled 273 patients with NPC who had been curatively treated for more than 1 year. The EORTC QLQ-C30 and HandN35 questionnaires were completed 1 year after radiotherapy. The predictability of QoL variables on disease-specific survival (DSS) and overall survival (OS) was analyzed using Cox's proportional hazards models. Results Twenty-nine (10.6 %) patients developed locoregional relapse and 27 (9.9 %) had distant metastasis after the QoL survey with subsequent 5-year DSS and OS rates of 87.9 % and 84.0 %, respectively. Based on the QLQC30, scales of physical functioning, fatigue, and appetite loss significantly predicted DSS and OS (p\0.05). In the H&N35, only sexuality was significantly correlated with DSS and OS (p\0.05). An increment of 10 points in physical functioning (HR: 0.69; 95 % CI: 0.48-0.90; p = 0.004) or a decline of 10 points in fatigue problems (HR: 1.40; 95 % CI: 1.19-1.61; p = 0.0002), appetite loss (HR: 1.21; 95 % CI: 1.03-1.40; p = 0.02), and sexuality (HR: 1.14; 95 % CI: 1.02-1.25; p = 0.019) was associated with better OS. Conclusion Some QoL variables measured after the treatment provide prognostic value on subsequent survival in patients with NPC.