| [Objective]To study changes and related determinants of quality of life (QOL) of nasopharyngeal carcinoma (NPC) patients before and after radiotherapy or chemotherapy to provide evidences for improving their quality of life.[Methods]Our sample was consisted of 93 cases who had been diagnosed with nasopharyngeal carcinoma and had receipted the first radiotherapy in Fujian Provincial Tumor Hospital from Oct, 2009 to Dec, 2010. Investigations were conducted before and after radiotherapy or chemotherapy. Various measuring scales were used in the invertigation, which included EORTC QLQ-C30 (version3.0), MFI-20, HADS, MCMQ, ECOG and self-designed questionaire that was about basic information, diseases and therapy conditions of patient. All data were entered by Epidata 3.1 and analyzed by SPSS 13.0. Analysis of variance (ANOVA) was used to analyze the QOL's differences among patients with different psychological states. Spearman correlation analysis was used to analyze the association between fatigue conditions, medical coping modes and the quality of life after radiotherapy or chemotherapy. Linear trend test was used to analyze the association between anxiety, depression, physical conditions, and the quality of life after radiotherapy or chemotherapy. Multiple stepwise regression was used to analyze the factors that affected the quality of life during radiotherapy or chemotherapy.[Results]1. Univariate analysis on quality of life after radiotherapy or chemotherapy showed that the patients with more tiredness, anxiety, depression, coping mode of surrender, worse physical conditons had poorer quality of life.2. Quality of life evaluation and functional scales evaluation after radiotherapy or chemotherapy appeared lower than before. Symptom scales evaluation and single items evaluation were higher than before, with obviously statistic difference (P<0.002), which indicated that quality of life decreased after radiotherapy or chemotherapy.3. Multivariate analysis on quality of life after radiotherapy or chemotherapy treatments showed that quality of life correlated with nursing staff, fatigue, anxiety, depression, physical conditions, medical coping modes and tumor T stage. Based on standardized coefficients, the patients with less intimate relationship with nursing staff, worse fatigue conditions, more anxiety and depression, worse physical conditions, employed negative coping modes, diagnosis of later tumor T stage would related to be poorer quality. 4. Multivariate analysis on quality of life before and after radiotherapy or chemotherapy showed that the change of quality of life correlated with sex, the place of residence, marital status, nursing staff, fatigue, anxiety, depression, medical coping modes, radiation modes and the period of chemotherapy. Based on standardized coefficients, the factors with female patients, rural residents, single, less intimate relationships with nursing staff, worse fatigue condition, more anxiety, and depression, employing negative coping modes, adopting the traditional radiotherapy and longer period of chemotherapy would show poorer quality of life.[Conclusion]1. Quality of life of nasopharyngeal carcinoma patients with radiotherapy or chemotherapy decreased obviously.2. There were several factors that would influence quality of life, the majority included fatigue, phychological situation, medical coping modes, physical conditions, hospital course (tumor T stage, radiation modes and the period of chemotherapy) and general condition (sex, the place of residence, marital status and nursing staff). 3. More attention should be paid on the education of nasopharyngeal carcinoma, radiotherapy and chemotherapy before radiotherapy or chemotherapy. Patients should be encouraged to actively do the rehabilitation exercise to improve their mood, to employ positive coping modes and to improve their nutritional status during radiotherapy or chemotherapy. As well as more attentions should be paid on female and patients with late stages. More social and family supports are also required.
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