부산대학교 도서관

Simple Summary: Intensity-modulated proton therapy (IMPT) has proven to be more effective in minimizing radiation exposure to normal organs when compared to photon-based volumetric modulated arc therapy (VMAT) in patients diagnosed with nasopharyngeal cancer (NPC). This retrospective cohort study represents the first quantitative assessment of the longitudinal impact on the quality of life (QoL) outcomes in NPC patients undergoing treatment with IMPT (n = 41) as opposed to VMAT (n = 246). We gathered data on global QoL, functional QoL, C30 symptoms, and HN35 symptoms using the EORTC QLQ-C30 and QLQ-HN35 questionnaires at four time points: pre radiotherapy (RT), during RT, 3 months post RT, and 12 months post RT. IMPT demonstrated superior mean dose reductions in 12 of the 16 organs at risk compared to VMAT. This reduction in radiation dose, attributed to the IMPT technique, appears to be associated with positive outcomes in functional QoL, reflecting a noteworthy increase of 7.5 points and a decrease of 10.7 points in HN35 symptoms. However, this effect is time dependent and exclusively observed at the time point of during RT. Purpose: This retrospective cohort study aims to compare the quality of life (QoL) in patients with nasopharyngeal cancer (NPC) treated with intensity-modulated proton therapy (IMPT) versus volumetric modulated arc therapy (VMAT) at different time points. Materials and Methods: We conducted a longitudinal assessment of QoL on 287 newly diagnosed NPC patients (IMPT: 41 and VMAT: 246). We collected outcomes of global QoL, functional QoL, C30 symptoms, and HN35 symptoms from EORTC QLQ-C30 and QLQ-HN35 questionnaires at pre-radiotherapy, during radiotherapy (around 40 Gy), 3 months post radiotherapy, and 12-months post radiotherapy (RT). The generalized estimating equation was utilized to interpret the group effect, originating from inherent group differences; time effect, attributed to RT effects over time; and interaction of the group and time effect. Results: IMPT demonstrated superior mean dose reductions in 12 of the 16 organs at risk compared to VMAT, including a significant (>50%) reduction in the oral cavity and larynx. Both groups exhibited improved scores of global QoL, functional QoL, and C30 symptoms at 12 months post RT compared to the pre-RT status. Regarding global QoL and C30 symptoms, there was no interaction effect of group over time. In contrast, significant interaction effects were observed on functional QoL (p = 0.040) and HN35 symptoms (p = 0.004) during RT, where IMPT created an average of 7.5 points higher functional QoL and 10.7 points lower HN35 symptoms than VMAT. Conclusions: Compared to VMAT, dose reduction attributed to IMPT could translate into better functional QoL and HN35 symptoms, but the effect is time dependent and exclusively observed during the RT phase. [ABSTRACT FROM AUTHOR]