Clinical characteristics and changes in living quality of patients with radiation encephalopathy induced by radiation therapy for treating nasopharyngeal carcinoma

Yamei Tang; Yi Li; Fusheng Zhang; Yunlin Liu; Haihong Zhou; Jianhong Ye; Yigang Xing

摘要：BACKGROUND: Radiation encephalopathy (RE) caused by radiation therapy of nasopharyngeal carcinoma severely influences patients' quality of life (QOL). The factors, which influence such patients' QOL, have not been confirmed.OBJECTIVE: To observe the clinical and imageological characteristics of patients with radiation therapy of nasopharyngeal carcinoma-induced RE and the changes in QOL, and analyze QOL influencing factors.DESIGN: Retrospective case analysis.SETTING: Department of Neurology, the Second Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Eighty-nine inpatients or outpatients with RE induced by radiation therapy of nasopharyngeal carcinoma admitted to Sun Yat-sen University Cancer Center and Department of Neurology,the Second Affiliated Hospital of Sun Yat-sen University from March 1994 to August 2004 were involved in this experiment. They all met the diagnosis criteria of RE from MERRITT'S neurology (10th edition).Thirty-three involved patients were randomly chosen as RE group. Another 34 concurrent inpatients or outpatients with nasopharyngeal carcinoma who received radiation therapy but without RE were chosen as control group. Informed consents of detected items were obtained from all the involved subjects.Quality of Life Questionnaire abbreviated version (WHOQOL-BREF) was used for on-the-spot evaluation.High points of WHOQOL-BREF indicated better QOL. The Late Effects on Normal Tissues - Subjective,Objective, Management and Analytic (LENT-SOMA) scale for evaluating radiation injury was used to evaluate headache and neurologic disorder of patients with RE induced by radiation therapy of nasopharyngeal carcinoma. The evaluation was graded into 5 degrees. High degrees indicted severer clinical therapy ending to onset), initial symptoms, common symptoms, imageological characteristics, QOL and other software.MAIN OUTCOME MEASURES: QOL and clinical characteristics of patients with RE induced by radiation therapy of nasopharyngeal carcinoma as well as QOL influencing factors.RE ranged from 0 to 24 years, and 95% confidence interval was 0 to 15 years. There were significant differences in amount of invaded cases between 6 months after one radiation therapy and 6 months after two glossopharyngeal paralysis (52 cases, 58%), limb inertia and sensory disorder (25 cases, 28%) and headache WHOQOL-BREF, of patients in RE group were significantly lower than those in the control group,respectively [ (2.06±0.86) points vs. (2.59±0.66) points; (2.45±0.75) points vs. (2.91 ±0.75) points;(51.67± 15.24) points vs. (59.22±13.03) points, P ＜ 0.05]. Patients undergoing two or more radiation therapies were inferior to those undergoing one radiation therapy in total scores of health, and of daily life,with scores of psychology, total scores of daily life and of health in WHOQOL-BREF (P ＜ 0.05); Head was negatively correlated with scores of psychology in WHOQOL-BREF (P ＜ 0.05); Neurologic deficit was negatively correlated with scores of psychology, and total scores of health in WHOQOL-BREF (P ＜ 0.05).is common in imageology of RE after radiation therapy. The first 3 ones of initial symptoms and common symptoms both are glossopharyngeal paralysis, neurologic deficit and headache, which greatly negatively influence QOL of patients.