[an error occurred while processing this directive] | [an error occurred while processing this directive]
Quality of life in patients with early‐stage extra‐nodal NK/T cell lymphoma of nasal type after definitive radiation therapy
Li Yimin1,2, Zhang Yujing2, Li Yiyang2,3, Ye Yuming4, Zhang Yuetong2, Wang Jijin2, Wang Hanyu2
1Department of Radiation Oncology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China; 2Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Collaborative Innovation, Sun Yat‐sen University Cancer Center, Guangzhou 510000, China; 3Department of Oncology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510000, China; 4Department of Pneumology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China
AbstractObjective To investigate the quality of life in patients with early‐stage extra‐nodal NK/T cell lymphoma of nasal type (ENKTL) arising from the upper aerodigestive tract, who had remained progression‐free survival (PFS) for over 3 months after definitive intensity‐modulated radiation therapy (IMRT), and to analyze the factors related to main adverse symptoms. Methods 276 patients who received IMRT from March, 2012 to June, 2021 were included. There were 201 males and 75 females with a median age of 41.5 years (range: 13‐81 years) upon diagnosis. Consistent target delineation schemes and similar dose gradients were adopted for IMRT, with a median prescribed dose of 54.6 Gy/26F. Cross‐sectional investigation was performed with a modified EORTC QLQ‐H&N35 questionnaire, the incidence and severity of adverse symptoms, severity of disease and their influencing factors at each time‐point during their survival were statistically analyzed. Results The median age of patients at the investigation was 46.2 years, and the median PFS after IMRT was 47.2 months (range: 3.1‐115.7 months). The most common adverse symptoms included nasal symptoms (incidence rate 63.8%), dry mouth (50%), tooth diseases (47.1%), smell and taste alteration, and sexual apathy, etc. Most symptoms were mild (the average standardized score was 5.50, the full score of 100 indicating the most severe), and could be relieved remarkably over survival time, but some symptoms, such as tooth diseases and sexual apathy, were more obvious and recurred for several years. Age and anti‐PD‐1 immune therapy influenced the symptom scores, and tooth diseases were closely correlated with dry mouth. Conclusion The quality of life in patients with early‐stage ENKTL after definitive IMRT is high, and the most significant symptoms include nasal symptoms, tooth diseases, and sexual apathy, etc. , which need to be mitigated with more studies.
Li Yimin,Zhang Yujing,Li Yiyang et al. Quality of life in patients with early‐stage extra‐nodal NK/T cell lymphoma of nasal type after definitive radiation therapy[J]. Chinese Journal of Radiation Oncology, 2022, 31(9): 798-804.
Li Yimin,Zhang Yujing,Li Yiyang et al. Quality of life in patients with early‐stage extra‐nodal NK/T cell lymphoma of nasal type after definitive radiation therapy[J]. Chinese Journal of Radiation Oncology, 2022, 31(9): 798-804.
[1] Li YX, Yao B, Jin J, et al. Radiotherapy as primary treatment for stage IE and IIE nasal natural killer/T‐cell lymphoma[J]. J Clin Oncol, 2006,24(1):181‐189. DOI: 10.1200/JCO.2005.03.2573. [2] Li YY, Lin HQ, Zhang LL, et al. Intensity‐modulated radiotherapy has superior outcomes to three‐dimensional conformal radiotherapy in patients with stage IE‐IIE extranodal nasal‐type natural killer/T‐cell lymphoma[J]. Oncotarget, 2017,8(36):60504‐60513. DOI: 10.18632/oncotarget.16138. [3] Qi SN, Yang Y, Zhang YJ, et al. Risk‐based, response‐adapted therapy for early‐stage extranodal nasal‐type NK/T‐cell lymphoma in the modern chemotherapy era: a China Lymphoma Collaborative Group study[J]. Am J Hematol, 2020,95(9):1047‐1056. DOI: 10.1002/ajh.25878. [4] Wang HY, Niu SQ, Yang YY, et al. Promising clinical outcomes of sequential and "Sandwich" chemotherapy and extended involved‐field intensity‐modulated radiotherapy in patients with stage I(E) /II(E) extranodal natural killer/T‐cell lymphoma[J]. Cancer Med, 2018,7(12):5863‐5869. DOI: 10.1002/cam4.1755. [5] Niu SQ, Yang Y, Li YY, et al.Primary site and regional lymph node involvement are independent prognostic factors for early‐stage extranodal nasal‐type natural killer/T cell lymphoma[J]. Chin J Cancer, 2016,35:34. DOI: 10.1186/s40880‐016‐0096‐0. [6] Bjordal K, Hammerlid E, Ahlner‐Elmqvist M, et al. Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire‐H&N35[J]. J Clin Oncol, 1999,17(3):1008‐1019. DOI: 10.1200/JCO.1999.17.3.1008. [7] Huang TL, Tsai MH, Chuang HC, et al.Quality of life and survival outcome for patients with nasopharyngeal carcinoma treated by volumetric‐modulated arc therapy versus intensity‐modulated radiotherapy[J]. Radiat Oncol, 2020,15(1):84. DOI: 10.1186/s13014‐020‐01532‐4. [8] van der Laan HP, Van den Bosch L, Schuit E, et al. Impact of radiation‐induced toxicities on quality of life of patients treated for head and neck cancer[J]. Radiother Oncol, 2021,160:47‐53. DOI: 10.1016/j.radonc.2021.04.011. [9] 牛绍清,张玉晶,温戈,等.早期原发鼻腔NK/T细胞淋巴瘤局部扩大野IMRT前瞻性Ⅱ期研究的初步结果[J].中华放射肿瘤学杂志, 2015,24(4):377‐381. DOI: 10.3760/cma.j.issn 1004‐4221.2015.04.006. Niu SQ, Zhang YJ, Wen G, et al. Preliminary results of a phaseⅡprospective clinical study of early s stage nasal NK/T cell lymphoma with extended involved‐field intensity‐modulated radiotherapy[J]. Chin J Radiat Oncol, 2015,24(4):377‐381. DOI: 10.3760/cma.j.issn.1004‐4221.2015.04.006. [10] Shen Q, Ma X, Hu W, et al.Intensity‐modulated radiotherapy versus three‐dimensional conformal radiotherapy for stage I‐II natural killer/T‐cell lymphoma nasal type: dosimetric and clinical results[J]. Radiat Oncol, 2013,8:152. DOI: 10.1186/1748‐717X‐8‐152. [11] 张伟军,王继群,王兆武,等.鼻咽癌放疗后继发性鼻窦炎影响因素的分析[J].中华放射医学与防护杂志, 2003,23(1):33‐35. DOI: 10.3760/cma. j. issn. 0254‐5098.2003.01.012. Zhang WJ, Wang JQ, Wang ZW, et al. Analysis risk factors of nasosinusitis after radiotherapy of nasopharyngeal carcinoma[J].Chin J Radiol Med Prot, 2003,23(1):33‐35. DOI: 10.3760/cma. j. issn. 0254‐5098.2003.01.012. [12] Moore C, McLister C, Cardwell C, et al. Dental caries following radiotherapy for head and neck cancer: a systematic review[J]. Oral Oncol, 2020,100:104484. DOI: 10.1016/j.oraloncology.2019.104484. [13] 刘杨, 马婕, 杨云莉, 等. 鼻咽癌放射性口干症与腮腺受照射体积相关性研究[J].中华放射肿瘤学杂志, 2018,27(3):235‐239. DOI: 10.3760/cma.j.issn.1004‐4221.2018.03.002. Liu Y, Ma J, Yang YL, et al. Relationship between radiation‐induced xerostomia and the volume of parotid glands exposed in radiotherapy for nasopharyngeal carcinoma[J].Chin J Radiat Oncol, 2018,27(3):235‐239. DOI: 10.3760/cma.j.issn.1004‐4221.2018.03.002. [14] Vissink A, Burlage FR, Spijkervet FK, et al. Prevention and treatment of the consequences of head and neck radiotherapy[J]. Crit Rev Oral Biol Med, 2003,14(3):213‐225. DOI: 10.1177/154411130301400306. [15] 林志雄, 李德锐, 陈世坚, 等.鼻咽癌患者放射治疗后性功能减退吗[J].中华放射肿瘤学杂志, 2003,12(z1): 52‐55. DOI: 10.3760/j.issn:1004‐221.2003.z1.005. Lin ZX, Li DR, Chen SJ, et al. Is there a sexual function decline in nasopharyngeal carcinoma survivors treated with radiotherapy[J]. Chin J Radiat Oncol, 2003,12(z1): 52‐55. DOI: 10.3760/j. issn: 1004‐221.2003.z1.005.
2022, Vol. 31 
