Discussion On The Effect Of Related Factors Such As Nutrition And Psychology On Quality Of Life In Head And Neck Carcinoma Patients With Radiotherapy

ObjectiveThis paper analyses the change of patients including nutrition, psychology and quality of life before and after radiotherapy in head and neck carcinoma and discussesthe effect of related factors such as nutrition and psychology on quality of life in head and neck carcinoma patients during radiotherapy in order to provide evidences of improving quality of life in head and neck carcinoma patients with radiotherapy.MethodsThe objects of study were 127 patients who had been made as a definite diagnosis of head and neck carcinoma and had receipt radiotherapy in a certain Grade A hospital from Nov. 2008 to Nov. 2009.Investigation was made to patients before and after radiotherapy.Various measuring scales were used in the investigation, which are EORTC QLQ-C30 (version3.0), EORTC QLQ-H&N35 by EORTC,SAS, SDS, and self-designed questionair included patients'basic imformation, disease and therapy conditions, and nutrition status.Paired t test and McNemar's test were used to analyse changes of psychology and nutrition before and after radiotherapy;Paired t testwas used to analyse quality of life before and after radiotherapy. Multiple stepwise regression analyzed factors effecting quality of life during radiotherapy. All data were entered through Epidata 3.1 and analyzed through SPSS 16.0.Results1. Nutrition:malnutrition in head and neck carcinoma patients with radiotherapy was common(1)Significant weight loss:After comparasion the average weight loss was 2.72 kg which accouted for 4.46% of the starting weigh(tt=14.25,P<0.001). 81.1%of the patients lost weight, among which 44.1% lost weight more than 5% of the starting weight, 5.5% lost weight more than 10% of the starting weight.(2)Obvious changes in serum nutrition indicators: After radiotherapy, hemoglobin, Serum prealbumin and serum transferrin assay dicreased obviously(P<0.05).2. Psychology:Anxiety and depression existed in head and neck carcinoma patients with radiotherapy.(1)Occurrence of anxiety and depression was respectively 29.9% and 25.9% before radiotherapy. After radiotherapy, Occurrence of anxiety and depression was respectively 23.6% and 57.5%.(2)The anxiety was not of statistic differenc(eχ2=1.68,P>0.05),but depression was much of statistic difference(χ2 =28.57,P<0.001),which pointed out depression was aggravated seriously.(3)The anxiety and depression were of positive linear correlation,that was, the more the anxiety was,the more the depression was.3. Quality of life: Quality of life in head and neck carcinoma patients decreased obviously after radiotheroy.(1)Quality of life evaluation,functional scales evaluation, Symptom scales evaluation, six single items evaluation,Specific module H&N35 evaluation after radiotherapy appeared higher than before,Obviously statistic difference (P<0.001), which indicated that quality of life decreased after radiotherapy.(2)Multivariate analysis on quality of life before radiotherapy showed that quality oflife had much to do with anxiety,depression,age, marital status, operation history, chemotherapy history.According to standardized coefficients,the patients who had more anxiety and more depression,were older and unmatched, had chemotherapy and operation history had poorer quality of life.(3)Multivariate analysis on quality of life after radiotherapy showed that quality of life had much to do with anxiety, depression,age, chemotherapy history, hospitali- zation costs, monthly income, and nutrition.According to standardized coefficients, the patients who had more anxiety and depression, poorer nutrition, were older and Self-Paying,had lower income and chemotherapy history had poorer quality of life.(4)Multivariate analysis on quality of life before and after radiotherapy showed that quality of life had much to do with anxiety, depression and nutrition.According to standardized coefficients, the patients who had greater change in anxiety, depression,and nutrion changed more of quality of life.Conclusion1. Head and neck carcinoma patients had high risk of anxiety, depression and malnutrition.2. Quality of life in head and neck carcinoma patients with radiotherapy decreased obviously. Many factors influenced quality of life, the major ones were nutrition, psychology,hospital course(operation history, chemotherapy history), general condition(age, income, hospital costs, marital status), among which nutrition and psychology were of most importance.3. Synthetic intervention measures conbining psychology intervention and nutrition intervention should be used to improve quality of life in head and neck carcinomapatients with radiotherapy.