Quality of life of patients with recurrent nasopharyngeal carcinoma treated with nasopharyngectomy using the maxillary swing approach

Abstract

Objective: To investigate factors affecting the quality of life (QOL) of patients with recurrent nasopharyngeal carcinoma who underwent a nasopharyngectomy using the maxillary swing approach. Design: Cross-sectional study using self-administered questionnaire data and medical chart review. Setting: Tertiary cancer referral center. Patients: Patients with recurrent nasopharyngeal carcinoma who underwent a nasopharyngectomy using the maxillary swing approach between January 1998 and December 2003, had a minimal follow-up of 3 months, and completed the questionnaire. Interventions: We measured QOL using the validated traditional Chinese version of the European Organization for Research and Treatment of Cancer core questionnaire and head and neck module. Main Outcome Measures: Descriptive analysis of the results and comparison of scores for each QOL domain, stratified by presence of postoperative trismus, presence of postoperative palatal fistula, sex, age (≤45 years and >45 years), duration of treatment (≤1 year and >1 year), and disease status at follow-up, were performed using nonparametric tests. Results: Of the 50 eligible patients, 41 (32 men and 9 women; mean [SD] age, 51.5 [10.4] years) participated in the study. The mean±SD global QOL scale score of the participants was 68.7±24.2. Social functioning score was the lowest (64.6±25.9) of the 5 functioning scales. Fatigue and financial difficulties were the most common general concerns. Dryness of mouth, sticky saliva, and limited mouth opening were the most common head and neck problems. Women were found to have significantly lower QOL scores in the fatigue (P=.03), diarrhea (P=.03), and emotional functioning (P=.05) domains than men. The presence of severe trismus after the maxillary swing approach was significantly associated with a low QOL score in the mouth opening (P=.001), sticky saliva (P=.006), mouth dryness (P=.02), and social eating (P=.05) domains. However, the presence of palatal fistula, age, duration of treatment, and disease status at follow-up did not result in any significant differences on the QOL scores. Conclusions: The QOL of patients treated with nasopharyngectomy using the maxillary swing approach to treat recurrent nasopharyngeal carcinoma was good. Female sex and the presence of postoperative trismus were factors significantly related to some of the QOL domain differences after surgery. ©2006 American Medical Association. All rights reserved.