Effect of high-dose hypofractionated radiotherapy on quality of life of patients with pancreatic cancer / 中华放射肿瘤学杂志

ABSTRACT

Objective To evaluate the effect of high-dose hypofractionated radiotherapy upon the quality of life (QOL) of patients diagnosed with pancreatic cancer. Methods In this prospective study, 50 patients with pancreatic cancer admitted to our hospital between 2016 and 2017 were recruited. All patients underwent high-dose hypofractionated helical tomotherapy. The prescription doses for PTV, CTV, and GTV were 50, 60, and 70 Gy in 15-20 fractions, 5 times per week. The QOL was evaluated by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) and pancreatic cancer-specific (European Organization for Research and Treatment of Cancer QLQ-PAN26) questionnaires before, after, 1-month and 3-month after the radiotherapy to statistically compare the QOL changes before and after radiotherapy and subsequent follow-up. Results A total of 50 patients with pancreatic cancer were included. At the end of radiotherapy, the overall QLQ-C30 score did not differ from that before radiotherapy (P＝0. 330). At 1 month after radiotherapy, the overall QLQ-C30 score was significantly higher than that before radiotherapy (P＝0. 000). The overall QLQ-C30 scores did not significantly differ at 1-and 3-month after radiotherapy ( P＝0. 665). At 3 months after radiotherapy, social function score was considerably decreased (P＝0. 047), and the remaining function scores were equal to those at 1 month post-radiotherapy. The symptoms of fatigue in the QLQ-C30 questionnaire were slightly improved at the end of radiotherapy, which were mitigated at 1-month after radiotherapy and became stable at 3-month following radiotherapy. Pain, insomnia, loss of appetite and diarrhea did not significantly change at the end of radiotherapy, whereas were improved at 1 month after radiotherapy. Nausea and vomiting were aggravated at the end of radiotherapy ( both P＝0. 000), restored to the level before radiotherapy at 1 month after radiotherapy, and the symptoms were similar at 1-and 3-month after radiotherapy. Financial difficulty was worsened at the end of radiotherapy (P＝0. 046), acceptable at 1 month after radiotherapy and worsened at 3 months following radiotherapy. In the QLQ-PAN26 questionnaire, the symptoms of pancreatic pain (backache, nocturnal pain) were mitigated at the end of radiotherapy (P＝0. 009, P＝0. 000), and further alleviated at 1 month after radiotherapy. No significant difference was noted at 1-and 3-month after radiotherapy. The body weight loss was slightly mitigated compared with that before radiotherapy ( P＝ 0. 000 ), and further improved at 1 month after radiotherapy ( P＝0. 024). No significant difference was noted at 1-and 3-month after radiotherapy ( P＝0. 226). Conclusion High-dose hypofractionated radiotherapy can significantly enhance quality of life of pancreatic cancer patients at 1- and 3- month following radiotherapy.This study further demonstrated the clinical value of high-dose hypofractionated radiotherapy in improving the quality of life on the basis of previous studies showing that high-dose hypofractionated radiotherapy can significantly improve the local control rate and survival rate of pancreatic cancer.