| Summary: | 碩士 === 長庚大學 === 醫務管理學研究所 === 91 === Radiotherapy is a major treatment modality for nasopharyngeal cancer (NPC). The tumor control rate is relatively good among all cancers. Approximately 70% of the NPC patients reach 5-year survival after tumor control. However, radiation-induced complications are not rare, including dry mouth, hearing impairment, and trismus. These complications may affect patients’ life quality as well as their economic status. In this study, we assessed the change of NPC patients’ life quality and economic status, after completion of radiotherapy.
The Functional Assessment of Chronic Illness Therapy for Head and Neck cancer (FACT-H&N) verse 4 was used to assess the life quality and income changes. In the beginning, 34 NPC patients were entered the pilot study to validate the questionnaire. Result showed high reliablity for use in NPC patients.
A total of 153 consequent follow-up NPC patients were interviewed the FACT questionnaire. In these patients, the median age was 46 (ranging from 25 to 79). About 70 % of patients are male. The distributions in different stage of disease severity are even. The income of these patients was slightly higher than the average of national population in Taiwan. The annual income, working hour and job pattern were all recorded according to each patient’s statement. The treatment complications were also recorded according to the information on hospital chart. The score of life quality was calculated according to the FACT manual.
After analysis, results show that the severity of radiation complications, including xerostomia, hearing impairment, trismus, neurological deficits and dysphagia, had significantly related to patients’ life quality. However, patient age, sex, occupation, education level, tumor stage, receiving chemotherapy or not, and the length of follow-up had no effect on life quality. For economic status, 43 patients (28.1%) decreased their annual income after treatment. Only 4 patients (2.6%) increased their income after treatment, and these 4 patients were all students when they received treatment. In additions, the severity of treatment complications was strongly associated to the income change.
Further analysis for the final cause-relationship of the life quality change and income alteration cannot be made because of the limitation of sample size and sample collection process. However, this study shows that the severity of treatment complications will decrease their life quality as well as annual income in NPC patients. Therefore, when assessing treatment cost, the long-term treatment effects of patients’ life quality and economic alteration must take into consideration.
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