Comparison of quality of life in patients with nasopharyngeal carcinoma receiving conventional external beam radiation therapy versus intensity modulated radiation therapy

Objective: To compare the acute and late adverse events and quality of life (QOL) in patients with nasopharyngeal carcinomas receiving conventional external beam radiation therapy (RT) versus intensity modulated radiation therapy (IMRT). Methods: Ninety-one patients with newly diagnosed nasopharyngeal carcinoma treated in our institution between August 2008 and September 2010 were systemically reviewed, including 35 cases administered with conventional RT (RT group) and 56 cases with IMRT (IMRT group). Conjoint faciocervical fields plus tangential lower neck-supraclavicular field initially, and then shrinking preauricular portals plus electron beams to the neck were adopted in RT groups, with a total dose of 70 Gy/35 fractions.Nine coplanar fields were conducted in IMRT group with a total dose of 69.96 Gy/33 fractions. Acute and late adverse reactions were observed and compared between RT and IMRT groups, including acute reactions as xerostomia, odynophagia, dermatitis/mucositis and late events as dysphagia, trismus, hypothyroidism, optic/acoustic impairments, skin injury, hypodermal fibrosis, spinal myelitis and brain injury. Results: Compared with RT group, IMRT group showed less acute reactions in xerostomia, odynophagia, dysphagia and dermatitis and mucositis (χ²=85.73, 56.03, 26.58, 69.28, 55.99, P<0.05), and less late reactions in xerostomia, dysphagia, trismus, taste loss and skin injury (χ²=37.95, 7.48, 9.49, 9.49, 11.87, P<0.05), whereas the degree of acoustic/optic impairments and brain injury showed no difference in both groups. Conclusions: As compared to conventional RT, IMRT could decrease acute and some late side events, and improve the quality of life in patients with nasopharyngeal carcinoma. (authors)