Background
Methods
Patients
QoL assessments
Study treatments
RT techniques
Chemotherapy
Follow-up and study endpoints
Statistical methods
Results
Patient characteristics
Variable | Male | Female |
P
|
---|---|---|---|
Median age, years | |||
Range | |||
< 45 | 177(46.6%) | 75(62.0%) | 0.003 |
≥45 | 203(53.4%) | 46(38.0%) | |
Marital status | |||
Married | 17(4.5%) | 6(5.0%) | 0.833 |
Single | 363(95.3%) | 115(95.0%) | |
Education years | |||
No formal education | 6(1.6%) | 7(5.8%) | 0.065 |
Primary level | 49(12.9%) | 20(16.5%) | |
Secondary level | 99(26.1%) | 24(19.8%) | |
High school | 112(29.5%) | 37(30.6%) | |
University | 114(30.0%) | 33(27.3%) | |
Smoking history | |||
Ever | 159(41.8%) | 116(4.1%) | <0.0001 |
Never | 221(58.2%) | 5(95.9%) | |
Alcohol history | <0.0001 | ||
Ever | 53(13.9%) | 0(0) | |
Never | 327(86.1%) | 121(100.0%) | |
ECOG score | 0.174 | ||
0 | 378(99.7%) | 118(99.2%) | |
1 | 0(0) | 1(0.8) | |
2 | 1(0.3%) | 0(0) | |
WHO type | 0.862 | ||
1 | 2(0.5%) | 1(0.8%) | |
2 | 2(0.5%) | 1(0.8%) | |
3 | 375(98.9%) | 117(98.3%) | |
T stage | 0.521 | ||
1 | 19(5.0%) | 3(2.5%) | |
2 | 67(17.6%) | 18(14.9%) | |
3 | 202(53.2%) | 71(58.7%) | |
4 | 92(24.2%) | 29(24.0%) | |
N stage | 0.641 | ||
0 | 50(13.2%) | 11(9.1%) | |
1 | 144(37.9%) | 51(42.1%) | |
2 | 146(38.4%) | 45(37.2%) | |
3 | 40(10.5%) | 14(11.6%) | |
AJCC stage | 0.322 | ||
1 | 7(1.8%) | 2(1.7%) | |
2 | 44(11.6%) | 7(5.8%) | |
3 | 207(54.5%) | 72(59.5%) | |
4 | 122(32.1%) | 40(33.1%) | |
Treatment modality | |||
RT | 27(7.1%) | 9(7.4%) | |
IC + CCRT | 194(51.1%) | 60(49.6%) | |
CCRT | 159(41.8%) | 52(43.0%) | |
Median RT dose, Gy | |||
VCA IgA | 0.188 | ||
< 1:80 | 151(39.7%) | 40(33.1%) | |
≥ 1:80 | 229(60.3%) | 81(66.9%) | |
EA IgA | 0.138 | ||
< 1:10 | 199(52.4%) | 54(44.6%) | |
≥ 1:10 | 181(47.6%) | 67(55.4%) | |
Pre-EBV DNA | 0.526 | ||
≤ 4000 | 201 (52.9%) | 60(49.6%) | |
> 4000 | 179 (47.1%) | 61(50.4%) | |
Post-EBV DNA | 0.780 | ||
negative | 136(35.8%) | 45(37.2%) | |
positive | 244(64.2%) | 76(62.8%) | |
Family history of NPC | 0.252 | ||
yes | 18(4.7%) | 9(7.4%) | |
no | 362 (95.3%) | 112(92.6%) |
Survival outcomes
QoL data
EORTC scale | Mean | SD |
---|---|---|
QLQ-C30 | ||
Global health status/QoL | 69.84 | 22.47 |
Physical functioning | 94.07 | 9.22 |
Role functioning | 93.88 | 14.73 |
Emotional functioning | 84.21 | 16.56 |
Cognitive functioning | 88.39 | 16.02 |
Social functioning | 75.82 | 25.88 |
Fatigue | 17.25 | 17.27 |
Nausea and vomiting | 3.46 | 10.39 |
Pain | 12.28 | 18.43 |
Dyspnoea | 6.72 | 15.10 |
Insomnia | 15.77 | 23.52 |
Appetite loss | 7.12 | 16.74 |
Constipation | 6.65 | 15.78 |
Diarrhea | 3.53 | 10.49 |
Financial difficulties | 31.27 | 31.45 |
QLQ-H&N35 | ||
Pain | 8.13 | 11.20 |
Swallowing | 3.71 | 9.16 |
Senses | 5.76 | 12.72 |
Speech | 5.26 | 12.72 |
Social eating | 4.14 | 9.39 |
Social contact | 3.97 | 8.75 |
Sexuality | 16.43 | 20.42 |
Teeth | 15.90 | 21.45 |
Opening mouth | 6.59 | 16.16 |
Dry mouth | 17.22 | 19.72 |
Sticky saliva | 11.50 | 17.96 |
Coughing | 9.51 | 17.14 |
Felt ill | 24.42 | 26.59 |
Pain killers | 20.96 | 40.74 |
Nutrition supplements | 20.96 | 40.74 |
Feeding tube | 1.20 | 10.89 |
Weight loss | 34.53 | 47.59 |
Weight gain | 7.19 | 25.85 |
Correlation between EBV DNA and QoL
Univariate analysis pretreatment
Multivariate analysis
HR | 95%CI |
P
| |
---|---|---|---|
Age | 1.200 | 0.692–2.079 | 0.516 |
Gender | 0.772 | 0.395–1.510 | 0.450 |
Marriage | 1.470 | 0.458–4.719 | 0.517 |
Education | 1.197 | 0.940–1.525 | 0.145 |
Smoking history | 0.951 | 0.518–1.747 | 0.872 |
Alcohol history | 0.787 | 0.324–1.910 | 0.596 |
T stage | 1.383 | 0.684–2.794 | 0.367 |
N stage | 1.979 | 1.156–3.388 | 0.013 |
Pre-treatment EBV DNA | 1.451 | 0.866–2.431 | 0.157 |
Post-treatment EBV DNA | 3.130 | 1.563–6.267 | 0.001 |
Pain | 1.015 | 0.995–1.035 | 0.146 |
Teeth | 0.984 | 0.971–0.998 | 0.026 |
Felt ill | 1.004 | 1.001–1.007 | 0.012 |
HR | 95%CI |
P
| |
---|---|---|---|
Age | 1.583 | 0.582–4.302 | 0.368 |
Gender | 1.017 | 0.300–3.450 | 0.978 |
Marriage | 0.479 | 0.099–2.320 | 0.360 |
Education | 1.337 | 0.852–2.098 | 0.206 |
Smoking history | 1.455 | 0.512–4.139 | 0.482 |
Alcohol history | 1.086 | 0.480–2.458 | 0.843 |
T stage | 1.267 | 0.361–4.449 | 0.712 |
N stage | 1.604 | 0.616–4.172 | 0.333 |
Pre-treatment EBV DNA | 1.221 | 0.491–3.035 | 0.667 |
Post-treatment EBV DNA | 3.093 | 0.881–10.857 | 0.078 |
Cognitive functioning | 0.971 | 0.951–0.990 | 0.004 |
HR | 95%CI |
P
| |
---|---|---|---|
Age | 1.039 | 0.560–1.927 | 0.904 |
Gender | 0.527 | 0.235–1.183 | 0.121 |
Marriage | 3.217 | 0.669–15.479 | 0.145 |
Education | 1.278 | 0.967–1.689 | 0.085 |
Smoking history | 0.731 | 0.362–1.477 | 0.383 |
Alcohol history | 0.882 | 0.342–2.271 | 0.794 |
T stage | 1.305 | 0.611–2.787 | 0.491 |
N stage | 2.251 | 1.212–4.179 | 0.010 |
Pre-treatment EBV DNA | 1.730 | 0.963–3.109 | 0.067 |
Post-treatment EBV DNA | 2.915 | 1.338–6.350 | 0.007 |
Pain | 1.015 | 0.994–1.038 | 0.169 |
Felt ill | 1.004 | 1.000–1.007 | 0.043 |
HR | 95%CI |
P
| |
---|---|---|---|
Age | 1.329 | 0.516–3.427 | 0.556 |
Gender | 0.493 | 0.136–1.795 | 0.284 |
Marriage | 1.524 | 0.226–10.298 | 0.665 |
Education | 1.145 | 0.763–1.720 | 0.513 |
Smoking history | 1.246 | 0.483–3.216 | 0.650 |
Alcohol history | 0.268 | 0.034–2.125 | 0.213 |
T stage | 2.353 | 0.539–10.275 | 0.255 |
N stage | 1.675 | 0.686–4.090 | 0.257 |
Pre-treatment EBV DNA | 0.816 | 0.342–1.946 | 0.646 |
Post-treatment EBV DNA | 11.202 | 1.473–85.184 | 0.020 |
Pain | 1.028 | 0.996–1.061 | 0.091 |
Swallowing | 1.014 | 0.978–1.050 | 0.458 |