Trajectories of Quality of Life among Chinese Patients Diagnosed with Nasopharynegeal Cancer

Abstract

ObjectiveThis secondary longitudinal analysis describes distinct quality of life trajectories during eight months of radiation therapy (RT) among patients with nasopharyngeal cancer (NPC) and examines factors differentiating these trajectories.Methods253 Chinese patients with NPC scheduled for RT were assessed at pre-treatment, and 4 months and 8 months later on QoL (Chinese version of the FACT-G), optimism, pain, eating function, and patient satisfaction. Latent growth mixture modelling identified different trajectories within each of four QoL domains: Physical, Emotional, Social/family, and Functional well-being. Multinomial logistic regression compared optimism, pain, eating function, and patient satisfaction by trajectories adjusted for demographic and medical characteristics.ResultsWe identified three distinct trajectories for physical and emotional QoL domains, four trajectories for social/family, and two trajectories for functional domains. Within each domain most patients (physical (77%), emotional (85%), social/family (55%) and functional (63%)) experienced relatively stable high levels of well-being over the 8-month period. Different Physical trajectory patterns were predicted by pain and optimism, whereas for Emotion-domain trajectories pain, optimism, eating enjoyment, patient satisfaction with information, and gender were predictive. Age, appetite, optimism, martial status, and household income predicted Social/family trajectories; household income, eating enjoyment, optimism, and patient satisfaction with information predicted Functional trajectories.ConclusionMost patients with NPC showed high stable QoL during radiotherapy. Optimism predicted good QoL. Symptom impacts varied by QoL domain. Information satisfaction was protective in emotional and functional well-being, reflecting the importance in helping patients to establish a realistic expectation of treatment impacts.

Phenotypic and molecular characteristics associated with various domains of quality of life in oncology patients and their family caregivers

“…In terms of the percentages of participants with consistently higher domain scores, our findings are consistent with previous reports [ [40–42]. Specifically, in two of these studies of breast [40] and nasopharyngeal [41] cancer patients, that used the Medical Outcomes Study 36-item short-form health survey (SF-36) and the Functional Assessment of Cancer Therapy–General (FACT-G) respectively, approximately 43% to 85% of the patients were classified as having high stable trajectories across the physical, psychological, and social QOL domains.…”

“…For example, in the study of patients with breast cancer [40], three latent classes with lower Mental Component Summary scores from the SF-36 were found. In contrast, in the study of patients with nasopharyngeal cancer [41], two classes were identified with lower Emotional Subscale scores on the FACT-G. In both studies, the trajectory of one of the lower latent classes improved and another deteriorated over time.…”

“…In the studies of breast [40] and nasopharyngeal [41] cancer patients, one to three latent classes with lower physical, psychological, and social domain scores were identified. For example, in the study of patients with breast cancer [40], three latent classes with lower Mental Component Summary scores from the SF-36 were found.…”

“…In the two studies that used latent class analysis, younger age was associated with lower psychological [42] and social [41,42] well-being trajectories in oncology patients. While research on the predictors of QOL in FCs has focused primarily on psychological well-being, one review of QOL among FCs of oncology patients identified that younger age was a risk factor for poorer psychological outcomes [23].…”

“…In one [41] of the three previous latent class studies [ [40–42], being female was associated with membership in the lower emotional well-being class. Potential explanations for this finding are that females are more likely to take on too many responsibilities, be more attentive to their own emotions, and use coping strategies associated with negative health outcomes [88].…”