Distress and health-related quality of life in post-treatment nasopharyngeal carcinoma patients: a two-centre cross-sectional study

Nasopharyngeal carcinoma (NPC) patients often face significant physical and psychological challenges. While disease control remains a clinical priority, the impact on distress and health-related quality of life (HRQOL) is often overlooked. This study will assess distress and the HRQOL prevalence, severity, and relationship among post-treatment nasopharyngeal carcinoma (NPC) patients and investigate its associated factors.

A cross-sectional study at Hospital Melaka (HM) and Hospital Canselor Tuanku Muhriz (HCTM) involved post-treatment NPC patients with at least six months of follow-up. Distress was assessed using the Distress Thermometer (DT). Quality of life (QoL) and symptomatology were assessed with the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) and EORTC Head and Neck Module (QLQ-H&N 35). We conducted statistical analyses using Kruskal–Wallis and Mann–Whitney U tests for comparisons and Spearman Correlation for analyzing relationships.

One hundred forty-four patients with a median age of 60.5 years (range 18–92) were recruited and completed the questionnaires. The median NPC surveillance follow-up time was seven years (6 months to 36 years). 84% of the patients received concurrent chemoradiotherapy. The majority of the patients were in late stage 57.6% (Stage III, n = 51[35.4%]; Stage IV, n = 32 [22.2%]). The median distress score is 4 (range, 1–8), and the median HRQOL score is 75 (range of 50–100). A significant negative correlation was found between distress and the HRQOL score. (r = -0.53, p < 0.01). Factors influencing distress and HRQOL scores were sticky saliva, dry mouth, fatigue, and less sexuality, with a significance of P < 0.01.

Overall distress and HRQOL scores among post-treatment NPC patients were good. Factors such as sticky saliva, dry mouth, fatigue, and decreased sexuality substantially impacted distress and HRQOL. Addressing these factors alongside cancer treatment may enhance HRQOL outcomes.