Psychological Disorders, Cognitive Dysfunction and Quality of Life in Nasopharyngeal Carcinoma Patients with Radiation-induced Brain Injury

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2012 Jun 16

PMID 22701557

Citations 50

Authors

Yamei Tang

Donghua Luo

Xiaoming Rong

Xiaolei Shi

Ying Peng

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate factors affecting psychology, cognitive function and quality of life (QOL) of nasopharyngeal carcinoma (NPC) patients with radiation-induced brain injury (RI).

Methods And Materials: 46 recurrence-free NPC patients with RI and 46 matched control patients without RI were recruited in our study. Subjective and objective symptoms of RI were evaluated with the LENT/SOMA systems. Psychological assessment was measured with Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). Montreal Cognitive Assessment (MoCA) was carried out in these patients for assessing their cognitive function. QOL was evaluated by means of WHOQOL BREF.

Results: Of the patients with RI, 39(84.8%) had depression and 40(87.0%) had anxiety. The patients with RI got higher scores both in SDS and SAS than those without RI (SDS, 63.48±8.11 vs. 58.67±7.52, p = 0.008; SAS, 67.36±10.41 vs. 60.34±9.76, p = 0.005). Score in MoCA of patients with RI was significantly lower than that of patients without RI (21.32±2.45 vs. 25.98±1.73, p<0.001). SAS was positive correlated with post-radiotherapy interval. Both SAS and SDS had a significantly positive correlation with the rank of SOMA, while MoCA had a significantly negative correlation with SOMA. Chemotherapy was a risk factor for cognitive dysfunction. In addition, patients with RI got significantly lower scores in physical health (16.50±11.05 vs. 35.02±10.43, p<0.001), psychological health (17.70±10.33 vs. 39.48±12.00, p<0.001) and social relationship (48.00±18.65 vs. 67.15±19.70, p<0.001) compared with those in patients without RI. Multiple linear regression analysis revealed that anxiety and cognitive impairment were significant predictors of global QOL.

Conclusions: NPC patients with RI exhibit negative emotions, impaired cognitive function and QOL. The severity of clinical symptoms of RI plays an important role in both emotions and cognitive function. Anxiety and cognitive impairment are associated with decreased QOL.

Citing Articles

The effect of radiation dose to the brain on early self-reported cognitive function in brain and head-and-neck cancer patients.

Vaassen F, Hofstede D, Zegers C, Dijkstra J, Hoeben A, Anten M Clin Transl Radiat Oncol. 2025; 52:100929.

PMID: 40028425 PMC: 11869991. DOI: 10.1016/j.ctro.2025.100929.

Timeline of cognitive impairments after radiotherapy for head and neck cancer: A review.

Wickborn K, van der Weijden C, de Vries E, Meijer T, Kramer M, Spikman J Clin Transl Radiat Oncol. 2025; 52:100890.

PMID: 39991091 PMC: 11847131. DOI: 10.1016/j.ctro.2024.100890.

ROS-regulated SUR1-TRPM4 drives persistent activation of NLRP3 inflammasome in microglia after whole-brain radiation.

Chang Y, He Y, Wang D, Zhang K, Zhang Y, Li Z Acta Neuropathol Commun. 2025; 13(1):16.

PMID: 39871308 PMC: 11771008. DOI: 10.1186/s40478-025-01932-1.

The current research status of the mechanisms and treatment of radioactive brain injury.

Wang Y, Bao X, Zhang Y, Wu Q Am J Cancer Res. 2025; 14(12):5598-5613.

PMID: 39803653 PMC: 11711531. DOI: 10.62347/BEAU4974.

Drug protection against radiation-induced neurological injury: mechanisms and developments.

Wang Q, Guo C, Wang T, Shuai P, Wu W, Huang S Arch Toxicol. 2024; 99(3):851-863.

PMID: 39724149 DOI: 10.1007/s00204-024-03933-w.

References

Chen P, Hsu L, Tu C, Young Y . Radiation-induced oscillopsia in nasopharyngeal carcinoma patients. Int J Radiat Oncol Biol Phys. 2005; 61(2):466-70. DOI: 10.1016/j.ijrobp.2004.05.016. View

Leung S, Lee T, Chien C, Chao P, Tsai W, Fang F . Health-related quality of life in 640 head and neck cancer survivors after radiotherapy using EORTC QLQ-C30 and QLQ-H&N35 questionnaires. BMC Cancer. 2011; 11:128. PMC: 3083374. DOI: 10.1186/1471-2407-11-128. View

Shin H, Masuyer E, Ferlay J, Curado M . Cancer in Asia - Incidence rates based on data in cancer incidence in five continents IX (1998-2002). Asian Pac J Cancer Prev. 2010; 11 Suppl 2:11-6. View

Cheung M, Chan A, Law S, Chan J, Tse V . Impact of radionecrosis on cognitive dysfunction in patients after radiotherapy for nasopharyngeal carcinoma. Cancer. 2003; 97(8):2019-26. DOI: 10.1002/cncr.11295. View

Young Y, Ko J, Sheen T . Postirradiation vertigo in nasopharyngeal carcinoma survivors. Otol Neurotol. 2004; 25(3):366-70. DOI: 10.1097/00129492-200405000-00027. View

Frick E, Tyroller M, Panzer M . Anxiety, depression and quality of life of cancer patients undergoing radiation therapy: a cross-sectional study in a community hospital outpatient centre. Eur J Cancer Care (Engl). 2007; 16(2):130-6. DOI: 10.1111/j.1365-2354.2006.00720.x. View

Sehlen S, Hollenhorst H, Schymura B, Song R, Aydemir U, Steinbuchel Nv N . Radiotherapy: Impact of Quality of Life and Need for Psychological Care: Results of a Longitudinal Study. Onkologie. 2001; 23(6):565-570. DOI: 10.1159/000055007. View

Hsiao K, Yeh S, Chang C, Tsai P, Wu J, Gau J . Cognitive function before and after intensity-modulated radiation therapy in patients with nasopharyngeal carcinoma: a prospective study. Int J Radiat Oncol Biol Phys. 2010; 77(3):722-6. DOI: 10.1016/j.ijrobp.2009.06.080. View

Ku P, Vlantis A, Leung S, Lee K, Cheung D, Abdullah V . Laryngopharyngeal sensory deficits and impaired pharyngeal motor function predict aspiration in patients irradiated for nasopharyngeal carcinoma. Laryngoscope. 2009; 120(2):223-8. DOI: 10.1002/lary.20701. View

10.

Lue B, Huang T, Chen H . Physical distress, emotional status, and quality of life in patients with nasopharyngeal cancer complicated by post-radiotherapy endocrinopathy. Int J Radiat Oncol Biol Phys. 2007; 70(1):28-34. DOI: 10.1016/j.ijrobp.2007.06.053. View

11.

Lam L, Leung S, Chan Y . Progress of memory function after radiation therapy in patients with nasopharyngeal carcinoma. J Neuropsychiatry Clin Neurosci. 2003; 15(1):90-7. DOI: 10.1176/jnp.15.1.90. View

12.

Cheung M, Chan A, Law S, Chan J, Tse V . Cognitive function of patients with nasopharyngeal carcinoma with and without temporal lobe radionecrosis. Arch Neurol. 2000; 57(9):1347-52. DOI: 10.1001/archneur.57.9.1347. View

13.

Mystakidou K, Tsilika E, Parpa E, Katsouda E, Galanos A, Vlahos L . Assessment of anxiety and depression in advanced cancer patients and their relationship with quality of life. Qual Life Res. 2005; 14(8):1825-33. DOI: 10.1007/s11136-005-4324-3. View

14.

Hammerlid E, Silander E, Hornestam L, Sullivan M . Health-related quality of life three years after diagnosis of head and neck cancer--a longitudinal study. Head Neck. 2001; 23(2):113-25. DOI: 10.1002/1097-0347(200102)23:2<113::aid-hed1006>3.0.co;2-w. View

15.

Karasawa K, Horikawa N, Kawase E, Seki K, Kohno M, Shinoda H . Assessment of psychological responses in patients about to receive radiotherapy. Radiat Med. 2006; 23(7):478-84. View

16.

Heinonen H, Aro A, Aalto A, Uutela A . Is the evaluation of the global quality of life determined by emotional status?. Qual Life Res. 2004; 13(8):1347-56. DOI: 10.1023/B:QURE.0000040788.12947.b9. View

17.

Tang Y, Shen Q, Lu K, Wang Y, Peng Y . A randomized prospective study of rehabilitation therapy in the treatment of radiation-induced dysphagia and trismus. Strahlenther Onkol. 2010; 187(1):39-44. DOI: 10.1007/s00066-010-2151-0. View

18.

Fang F, Chiu H, Kuo W, Wang C, Leung S, Chen H . Health-related quality of life for nasopharyngeal carcinoma patients with cancer-free survival after treatment. Int J Radiat Oncol Biol Phys. 2002; 53(4):959-68. DOI: 10.1016/s0360-3016(02)02838-9. View

19.

Routledge J, Burns M, Swindell R, Khoo V, West C, Davidson S . Evaluation of the LENT-SOMA scales for the prospective assessment of treatment morbidity in cervical carcinoma. Int J Radiat Oncol Biol Phys. 2003; 56(2):502-10. DOI: 10.1016/s0360-3016(02)04578-9. View

20.

Behin A, Delattre J . Complications of radiation therapy on the brain and spinal cord. Semin Neurol. 2005; 24(4):405-17. DOI: 10.1055/s-2004-861535. View