scholarly journals Chronic Lymphocytic Leukemia (CLL) Patients Quality of Life (QoL): A Cross-Sectional Analysis of the Italian Experience in the Choice Study during the First Wave of the COVID-19 Pandemic

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4680-4680
Author(s):  
Alessandra Tedeschi ◽  
Idanna Innocenti ◽  
Francesco Albano ◽  
Alessandro Gozzetti ◽  
Luciano Levato ◽  
...  

Abstract Introduction Although plenty of data exists on efficacy and safety of CLL drugs, their impact on patients' Health-Related Quality of Life (HRQoL) is largely unknown (1-2). Documentation of drug safety via traditional use of adverse events (AE) in hematology is limited if not complemented with Patient-Reported Outcomes (PRO) measures (3-4). Incorporation of HRQoL PROs is now essential to better evaluate risk-benefit of new therapeutic approaches and it is also highly valued by regulatory stakeholders (5). Most PRO data currently available for CLL patients (pts) came from randomized controlled trial settings (6-7), hence limiting generalizability of findings to CLL real-life patients. CHOICE study was designed to investigate CLL patients' QoL and preference towards different treatment profiles through a Discrete Choice Experiment (DCE) methodology in Italy. Due to the timelines of the study, which started in February 2020, the related data offer an insight into patients' perception and worries during the first wave of the COVID-19 pandemic. Methods This cross sectional, multi-center, observational study included CLL patients, treatment naïve during the watch & wait period (W&W) or already TREATED (around 50% each, controlled at site level), who signed the informed consent for study participation. Exclusion criteria were inability to take oral drugs, cognitive disorders that could impair the comprehension of the questionnaires and concomitant treatment for other malignancies. Patients were asked to fill in the following HRQoL questionnaires: EQ-5D-5L, EORTC QLQ-C30 and QLQ CLL-16, as well as a DCE questionnaire, (described elsewhere). Each questionnaire was completed by the patient on a tablet - using an App specifically developed for the study. Results 401 pts were enrolled in Italy in 16 hematology centers (Feb - July 2020); 199 W&W and 196 TREATED pts completed the questionnaires and were included in the evaluable population. Main patients' characteristics are shown in Table 1. 73.7% of TREATED pts were ON-treatment (30.8% were in 1st-line, 69,2% in further lines) and 26.3% were OFF-treatment; the majority of pts (55,6%) were currently treated with a target therapy (Table1). The EQ-5D-5L questionnaire showed no significant differences between groups. In both groups more than 80% of pts reported low values (1 or 2, indicating no or small impact) on all items. Median VAS was 75 for the TREATED group and 80 for the W&W group (0-100; higher scores indicate higher QoL). QLQ C-30 / CLL-16 scores had very similar results between TREATED and W&W pts suggesting a limited impact of CLL on pts QoL. The median (IQR) QoL Scale was 83.3 (67- 83) for TREATED and 83.3 (67- 92) for W&W pts (0-100; all functional scales had high scores, that represent a better level of functioning; all symptoms' scales had low values, representing a less important symptomatology or problem, Figure 1). The main symptoms reported were fatigue, insomnia, pain, and dyspnea, while the main worry was for "future health" (Figure 1). Distribution of data was statistically different between the 2 groups only for the Role functioning Scale (p=0.024) and the Social Functioning Scale (p=0.003) of QLQ-C30 and for the Infection Scale (p<0.001) of QLQ CLL-16, always with slightly but significantly better results for the W&W group. Conclusions CHOICE study helps to understand the CLL patients' mindset and feeling in the light of the COVID-19 pandemic impact on health care for this category of pts, highlighting their preferences and worries in a large cohort of pts in Italy, allowing a comparison between TREATED and W&W pts. The main limitation of the study was its cross-sectional design, which does not allow us to evaluate any change in QoL neither with respect to the impact of the pandemic, nor to the effects of the treatment, if any. CLL pts showed a good QoL, as confirmed by both EQ-5D-5L and EORTC QLQ C-30 / CLL-16 scores, with very similar results between TREATED and W&W pts (although slightly better results in the W&W vs TREATED group). The results of the present study are consistent with previous reports, and fatigue was the most reported symptom, while worry for future health was the most relevant score in CLL-16 questionnaire. Hospital accesses reduction that was detected during the pandemic might have influenced patients' response, as well as the extreme attention towards the danger of infections, and might have impacted patients' perception on future health. Figure 1 Figure 1. Disclosures Tedeschi: Beigene: Honoraria, Speakers Bureau; AstraZeneca: Honoraria, Speakers Bureau; AbbVie: Honoraria, Speakers Bureau; Janssen: Honoraria, Speakers Bureau. Gozzetti: Janssen: Honoraria; AbbVie: Honoraria. Reda: Beigene: Consultancy; Astra Zeneca: Consultancy; Abbvie: Consultancy; Janssen: Consultancy. Gualberti: AbbVie: Current Employment. Malgieri: AbbVie: Current Employment. Finsinger: AbbVie: Current Employment.

2020 ◽  
Vol 11 (2) ◽  
pp. 133-139
Author(s):  
Kristivani Br Ginting ◽  
Muhammad Rizki Yaznil ◽  
M. Oky Prabudi ◽  
Lili Rahmawati

Latar belakang: Kanker ovarium memiliki angka mortalitas yang cukup tinggi dikarenakan gejalanya yang tidak spesifik, sering ditemukan pada stadium lanjut, dan belum adanya metode deteksi dini yang sudah terbukti. Untuk menilai keberhasilan terapi penyintas kanker ovarium, tidak hanya dinilai dari aspek klinis tetapi juga dinilai dari kualitas hidup penyintas kanker ovarium yang penilaiannya berdasarkan skala fungsional dan skala gejala dalam kuesioner EORTC QLQ C30 dan EORTC QLQ OV28. Metode: Penelitian ini menggunakan desain penelitian cross sectional, menggunakan data primer dari hasil wawancara dengan kuesioner EORTC QLQ C30 dan EORTC QLQ OV28 serta data sekunder yang berasal dari rekam medik di RSUP Haji Adam Malik Medan tahun 2017 - 2018. Sampel penelitian dipilih dengan metode total sampling dari seluruh data rekam medik yang memenuhi kriteria penelitian.   Hasil: Hasil penelitian ini didapatkan kualitas hidup global penyintas kanker ovarium 89.36% adalah baik, dan 10.64% adalah sedang serta tidak ada yang memiliki kualitas hidup buruk. Namun, didapatkan adanya gangguan pada skala fungsional berupa: fungsi emosional, fungsi kognitif, fungsi seksual, dan sikap terhadap penyakit, serta adanya permasalahan pada skala gejala berupa: kelelahan, nyeri, neuropati perifer, dan gejala menopause. Didapatkan juga tidak ada hubungan karakteristik usia, jenis histopatologis, stadium, lama terapi dengan kualitas hidup penyintas kanker ovarium, namun terdapat hubungan antara jenis terapi dengan kualitas hidup penyintas kanker ovarium. Kesimpulan: Kualitas hidup penyintas kanker ovarium secara global adalah baik. Kata Kunci: Kualitas Hidup, Penyintas Kanker Ovarium, EORTC QLQ C-30, EORTC QLQ     OV-28   Abstract Background: Ovarian cancer has a high mortality rate due to nonspecific symptoms, often found at an advanced stage, and also the absence of proven early detection methods. To assess the success of ovarian cancer survivors therapy, it is not only assessed from the clinical aspect but also from the quality of life of ovarian cancer survivors which is based on the functional and symptom scale in the EORTC QLQ C30 and EORTC QLQ OV28 questionnaires.  Methods: This study used a cross-sectional study design, using primary data from interviews with the survivors based on the questionnaire EORTC QLQ C30 and EORTC QLQ OV28 as well as secondary data derived from medical records at Haji Adam Malik General Hospital Medan in 2017 - 2018. The research sample was used with a total sampling method from all medical record data that fulfill the research criteria.  Result: The quality of life of ovarian cancer survivors is generally good (89.36%), meanwhile the rest is moderate (10.64%) without the poor quality of life. However, there are disorders on the functional scale in the form of emotional function, cognitive function, sexual function, and attitude toward disease. Likewise on the scale of symptoms, there are problems including: fatigue, pain, peripheral neuropathy, and menopausal symptoms.  Conclusion: The quality of life of ovarian cancer survivors globally is good. Keywords: Quality of Life, Ovarian Cancer Survivors, EORTC QLQ C-30, EORTC QLQ OV-28  


Medicina ◽  
2020 ◽  
Vol 56 (1) ◽  
pp. 45 ◽  
Author(s):  
Rosellina Margherita Mancina ◽  
Raffaele Pagnotta ◽  
Caterina Pagliuso ◽  
Vincenzo Albi ◽  
Daniela Bruno ◽  
...  

Background and Objectives: Nursing management in Inflammatory Bowel Disease (IBD) is focused on global patient care. Starting from basic knowledge of diagnostic and therapeutic management, nurses can assess the impact of IBD on patients’ quality of life not only at the physical level, but also at the psychological, social, and emotional levels. The aim of this study was to evaluate the impact of gastrointestinal symptoms on psychosocial changes in IBD patients in remission through nursing-led Patient-Reported Outcomes. Materials and Methods: We performed a cross-sectional study of 109 IBD patients in clinical and endoscopic remission. Specialist nurses invited patients to complete questionnaires on gastrointestinal symptoms and quality of life through the Patient-Reported Outcomes Measurement Information System (PROMIS). Results: We found that the gastrointestinal symptoms that the patients reported had a significant impact on the analyzed aspects of health. More specifically, belly pain, diarrhea, and bloating were associated with depressive symptoms (p < 0.001), anxiety (p < 0.001), fatigue (p < 0.001), and sleep disturbances (p < 0.001). Moreover, these symptoms also significantly affected patients’ social dimension in terms of satisfaction with participation in social roles (p < 0.001, p < 0.05, and p < 0.001 for belly pain, diarrhea, and bloating, respectively) and physical functions (p < 0.001). The results were virtually the same in a multivariable analysis adjusted by age, gender, body mass index (BMI), and disease duration. Conclusions: Even during remission, gastrointestinal symptoms are the main factors that influence quality of life in IBD patients. This exploratory study highlights the need to adopt validated questionnaires in clinical practice, and demonstrates that PROMIS is a valid, objective, and standardized instrument that can help nursing staff to better define the consequences of the disease in a patient’s daily life.


2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 413-413
Author(s):  
Lauren M. Rosati ◽  
Zhi Cheng ◽  
Scott P. Robertson ◽  
Megan N. Kummerlowe ◽  
Amy Hacker-Prietz ◽  
...  

413 Background: The impact of fractionated stereotactic body radiation therapy (SBRT) on patient-reported quality of life (QOL) and physician-reported toxicity in patients with recurrent or locally advanced pancreatic cancer (PCA) was prospectively evaluated. Methods: Forty-two PCA patients were treated with 25-33 Gy using SBRT in 5 fractions on a single-institution study. Both patient- and physician-reported outcomes were evaluated prior to SBRT and 4-6 weeks post-SBRT. Eight outcomes were consistently evaluated among both groups—performance status, fatigue, pain, anorexia, nausea, vomiting, constipation, and diarrhea. Patient-reported QOL metrics were assessed using a 4-point Likert scale on the EORTC QLQ-C30 and QLQ-PAN26, while physician-reported toxicities were graded using the NCI CTCAE version 4.0. Comparisons between those with paired patient- and physician-reported outcomes collected prior to and 4-6 weeks after SBRT were made using the Wilcoxon signed-rank test. Results: Of the 42 patients currently enrolled onto the study, 29 had both patient- and physician-reported outcomes collected prior to and 4-6 weeks after SBRT. Fifty-five percent were female and 83% were Caucasian. The median age at diagnosis was 65.6 years (range, 40.8-86.6). There was no significant impairment of any of the 8 physician-reported toxicities, nor were significant changes observed in patient-reported overall health (p = 0.66) or QOL (p = 0.18) scores following SBRT. Patients felt less worried about their future health (mean change [mD] = -0.45, p = 0.02), and an improvement in feeling less attractive as a result of disease and treatment reached borderline significance (mD= 0.31, p = 0.09). However, patients felt limited in planning activities in advance (mD= 0.45, p = 0.02) and were more constipated (mD= 0.38, p = 0.01) 4-6 weeks post-SBRT. Conclusions: Although the numbers are small, patients with unresectable or locally recurrent PCA do not appear to suffer any detriment of overall health or QOL after receiving a five-day course of SBRT. Moreover, this regimen may lead to a more optimistic point of view on future health and/or level of physical attraction. Clinical trial information: NCT01781728.


2017 ◽  
Vol 2 (3) ◽  
pp. 57-63 ◽  
Author(s):  
April W. Armstrong ◽  
Jennifer C. Cather ◽  
Carle F. Paul ◽  
Emily Edson-Heredia ◽  
Baojin Zhu ◽  
...  

Background and Objective Previous large studies have highlighted the impact of psoriasis on health-related quality of life (HRQoL) but not on interpersonal touch. This survey assessed the prevalence of touch avoidance among psoriasis patients, and its relationship to clinical characteristics and HRQoL. Methods Using an online, cross-sectional study with a standardized questionnaire, psoriasis patients reported their level of touch avoidance. The relationships between touch avoidance, patient-reported outcome measures, and patient demographics were analyzed using linear models for continuous outcomes and logistic models for categorical outcomes. Results Touch avoidance was reported by 48.2% of participants. Higher levels of touch avoidance were associated with worse HRQoL, depression, and itch outcomes (p<.001 for all). The strongest indicators of touch avoidance were HRQoL score (p<.001) and depression score (p<.001). Conclusion Nearly half of psoriasis patients report avoidance of touch. Those who had worse disease severity, HRQoL, and depression reported higher levels of touch avoidance.


2021 ◽  
Vol 8 (1) ◽  
pp. 23
Author(s):  
Dini Mahrani ◽  
Ahsanudin Attamimi ◽  
Ardhanu Kusumanto

Background: According to data from the "Endometrial Cancer Report" by the World Cancer Research Fund and the American Institute for Cancer Research (WCRFI), endometrial cancer is the sixth most common malignancy in the world and is the largest cancer in female organs, after cervical cancer. This incidence is increasing every year, it is predicted to increase about 5% of new cases each year. The main prognostic factors of endometrial cancer are determined by the histological type, stage, degree, differentiation of the tumor, invasive myometrial level and increase in lympho-vascular invasion. In addition to determining the histopathological factors, the prognosis is also determined from the clinical patient. Several studies have shown certain clinical factors also improve the condition and prognosis of the disease. Prognosis of this disease with the quality of life of patients becomes an interesting topic to discuss. Besides that quality of life is also a measure of therapeutic success. The better the prognosis of a disease, the better the quality of life, the higher the success rate of therapy (Greimel, 2010).Objective: To know correlation between clinicohistopathological and quality of life in patients with endometrial cancer after undergoing surgery at Sardjito Hospital, Yogyakarta.Method: The research is analytic with cross sectional approach. Patients with endometrial cancer who have undergone total hysterectomy and bisalpingoophorectomy surgery are assessed for their quality of life through interviews and filling out questionnaires in the EORTC QLQ-C 30 and QLQ-EN 24 modules.Results and Discussion: This study, most people with endometrial cancer aged 55-65 years were 34 people (42%) and diagnosed after menopause with a range of age >55 years as many as 43 people (53.1%). This study cannot prove the hypothesis that age, parity, body mass index, type of histopathology and KGB involvement have a relationship with the quality of life of cancer patients (p >0.05). But in contrast to the stage of early cancer (OR 3.17, p=0.044 (CI 95% 1.03-9.75)) and good and moderate differentiation (OR 4.471, p=0.023 (CI 95% 1.23-16.24)) have a significant relationship with quality of life.Conclusion: Clinicohistopathological factors (cancer stage and tumor differentiation) have a correlation with the quality of life at patients with postoperative endometrial cancer in  Sardjito Hospital Keywords: Endometrial cancer; clinicohistopathological factors; quality of life


2000 ◽  
Vol 86 (2) ◽  
pp. 134-138 ◽  
Author(s):  
Cinzia Brunelli ◽  
Paola Mosconi ◽  
Paolo Boeri ◽  
Laura Gangeri ◽  
Paolo Pizzetti ◽  
...  

Background In the last 10 years of clinical research there has been increasing interest in the evaluation of quality of life. Several generic and specific instruments have been developed for this purpose. EORTC QLQ C-30 is a cancer-specific questionnaire translated into various languages and validated in several European countries including Italy, where the impact of malignant disease on different areas of quality of life is poorly documented. Methods The EORTC QLQ C-30 was administered to 109 patients referred to the endoscopy division of the Istituto Nazionale Tumori, Milan, for endoscopic palliative treatment of malignant dysphagia to test its characteristics in terms of acceptability and clinical validity. Results In this group of patients the impact of advanced esophageal cancer was highly evident for Emotional and Physical Functioning, Fatigue and Global QoL scales. Dysphagia is a serious problem for many patients; there is a correlation between grade of dysphagia and four QoL dimensions. Conclusions QoL assessment is an important tool to evaluate the adequate management of patients with esophageal cancer. The EORTC QLQ-C30 questionnaire proved to be valid and reliable also in this population.


2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 92-92
Author(s):  
Lauren M. Rosati ◽  
Zhi Cheng ◽  
Scott P. Robertson ◽  
Megan N. Kummerlowe ◽  
Amy Hacker-Prietz ◽  
...  

92 Background: The impact of fractionated stereotactic body radiation therapy (SBRT) on patient-reported quality of life (QOL) and physician-reported toxicity in patients with recurrent or locally advanced pancreatic cancer (PCA) was prospectively evaluated. Methods: Forty-two PCA patients were treated with 25-33 Gy using SBRT in 5 fractions on a single-institution study. Both patient- and physician-reported outcomes were evaluated prior to SBRT and 4-6 weeks post-SBRT. Eight outcomes were consistently evaluated among both groups—performance status, fatigue, pain, anorexia, nausea, vomiting, constipation, and diarrhea. Patient-reported QOL metrics were assessed using a 4-point Likert scale on the EORTC QLQ-C30 and QLQ-PAN26, while physician-reported toxicities were graded using the NCI CTCAE version 4.0. Comparisons between those with paired patient- and physician-reported outcomes collected prior to and 4-6 weeks after SBRT were made using the Wilcoxon signed-rank test. Results: Of the 42 patients currently enrolled onto the study, 29 had both patient- and physician-reported outcomes collected prior to and 4-6 weeks after SBRT. Fifty-five percent were female and 83% were Caucasian. The median age at diagnosis was 65.6 years (range, 40.8-86.6). There was no significant impairment of any of the 8 physician-reported toxicities, nor were significant changes observed in patient-reported overall health (p = 0.66) or QOL (p = 0.18) scores following SBRT. Patients felt less worried about their future health (mean change [mD] = -0.45, p = 0.02), and an improvement in feeling less attractive as a result of disease and treatment reached borderline significance (mD= 0.31, p = 0.09). However, patients felt limited in planning activities in advance (mD= 0.45, p = 0.02) and were more constipated (mD= 0.38, p = 0.01) 4-6 weeks post-SBRT. Conclusions: Although the numbers are small, patients with unresectable or locally recurrent PCA do not appear to suffer any detriment of overall health or QOL after receiving a five-day course of SBRT. Moreover, this regimen may lead to a more optimistic point of view on future health and/or level of physical attraction. Clinical trial information: NCT01781728.


2016 ◽  
Vol 125 (6) ◽  
pp. 1400-1407 ◽  
Author(s):  
Christina Drewes ◽  
Lisa Millgård Sagberg ◽  
Asgeir Store Jakola ◽  
Ole Solheim

OBJECTIVE Traditionally, the dominant (usually left) cerebral hemisphere is regarded as the more important one, and everyday clinical decisions are influenced by this view. However, reported results on the impact of lesion laterality are inconsistent in the scarce literature on quality of life (QOL) in patients with brain tumors. The authors aimed to study which cerebral hemisphere is the most important to patients with intracranial tumors with respect to health-related QOL (HRQOL). METHODS Two hundred forty-eight patients with unilateral, unifocal gliomas or meningiomas scheduled for primary surgery were included in this prospective cohort study. Generic HRQOL was measured using the EQ-5D-3L questionnaire preoperatively and after 4–6 weeks. Cross-sectional and longitudinal analyses of data were performed. RESULTS Tumor volumes were significantly larger in right-sided tumors at diagnosis, and language or speech problems were more common in left-sided lesions. Otherwise, no differences existed in baseline data. The median EQ-5D-3L index was 0.73 (range −0.24 to 1.00) in patients with right-sided tumors and 0.76 (range −0.48 to 1.00) in patients with left-sided tumors (p = 0.709). Due to the difference in tumor volumes at baseline, histopathology and tumor volumes were matched in 198 patients. EQ-5D-3L index scores in this 1:1 matched analysis were 0.74 (range −0.7 to 1.00) for patients with right-sided and 0.76 (range −0.48 to 1.00) for left-sided lesions (p = 0.342). In the analysis of longitudinal data, no association was found between tumor laterality and postoperative EQ-5D-3L index scores (p = 0.957) or clinically significant change in HRQOL following surgery (p = 0.793). CONCLUSIONS In an overall patient-reported QOL perspective, tumor laterality does not appear to be of significant importance for generic HRQOL in patients with intracranial tumors. This may imply that right-sided cerebral functions are underestimated by clinicians.


Author(s):  
Suwendar Suwendar ◽  
Achmad Fudholi ◽  
Tri Murti Andayani ◽  
Herri S. Sastramihardja

Cervical cancer is one type of cancer with a high prevalence in women. Quality of life of someone with cervical cancer will decrease. Quality of life can also decrease because of chemotherapy regimens. The purpose of this study was to evaluate the impact of cisplatin-vincristine-bleomycin and carboplatin-paclitaxel regimens on the quality of life of patients. Through this research how the difference in quality of life of patients with cervical cancer before and after chemotherapy could be known. Additionally, the  differences impact on the quality of life of the two regimens also were observed.  The study was conducted by using cross sectional design in hospitalization patients. Data were taken prospectively by conducting field observations. Measuring the quality of life was done using the EORTC QLQ-C30 questionnaire. Differences of domain values before and after chemotherapy in each regimen were analyzed by paired t-test (p <0.05). Quality of life difference between two regimens were analyzed by unpaired t test (p<0.05). The results showed that there was an increasing trend of the value of the functional domain, impairment of symptoms domain and an increase in the value of global health status domain after three cycles of chemotherapy of two regimens, except the symptoms of nausea and vomiting and loss of appetite that showed an increasing trend. Patients who received cisplatin-vincristine-bleomycin regimen showed a significant increasing (p = 0.009) in decreased of appetite symptom’s scores. No significant differences in the quality of life of patients who delivered chemotherapy regimen of cisplatin-vincristine-bleomycin compared to carboplatin-paclitaxel regimen.


Author(s):  
Anjan Sreeranga ◽  
P. Pavithra ◽  
Anand D. Meundi

Background: With the availability of highly effective antiretroviral treatment, HIV is transforming into a chronic condition, whose management is now experiencing problems of other chronic diseases, where quality of life (QOL) has become an important component of overall assessment of health care and management. This study was conducted with the objective of assessing the QOL and factors influencing it in HIV infected people on antiretroviral therapy (ART).Methods: A cross-sectional study was conducted at district ART center, Hassan. Purposive sampling was used to identify 148 HIV infected people on antiretroviral therapy, who were interviewed using a pretested questionnaire, assessing QOL with the World Health Organization (WHOQOL) HIV‑BREF.Results: The average age of the study population was 37.69 years. Majority of them were males 54.7% compared to 45.3% of females. Most of them resided in rural areas (87.8%). The educational status of the subjects was poor with 33.8% of them being illiterates. The mean score was highest for spirituality and social relationships domain and least for psychological domain. Age, education and socioeconomic status did not have any influence on the QOL. There was significant difference between QOL scores and clinical stages. Individuals in stage I and II had better scores compared to stage 3 and 4. QOL scores decreased with decreasing CD4 count.Conclusions: Our findings suggest that patient-reported measures of health status and related concepts may help provide a feasible, reliable and valid method to assess the impact of HIV/AIDS improve patient outcomes. 


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