Quality of Life in Patients with Primary CNS Lymphoma - a Pooled Analysis from Three Prospective Multicentre Trials

Abstract Background Primary CNS lymphoma (PCNSL) is a rare extra nodal non-Hodgkin lymphoma. High-dose methotrexate (HD-MTX) based treatment has improved prognosis, but little is known about the development of quality of life (QoL) during treatment and follow-up from prospective trials. Methods We pooled data from three prospective trials including 225 immunocompetent patients with PCNSL (186 [83%] with newly diagnosed and 39 [17%] with relapsed disease) - all received HD-MTX based polychemotherapy with rituximab. QoL was a pre-specified secondary endpoint in all trials and evaluated using the EORTC QLQ-C30 and EORTC QLQ-BN20 questionnaire at start of treatment, after completion of treatment and during follow-up. We used descriptive statistics to summarize QoL over time. To investigate the development of QoL over time adjusted for age and Karnofsky performance status (KPS), we used multivariable linear regression models with a random effect to account for repeat measurements. We also did two separate analyses for patients with newly diagnosed PCNSL and relapsed disease. Multiple imputations were applied for missing values within a questionnaire, but we did not impute values of questionnaires that were missing completely. We herein report results on the global health status (GHS, item 30 of EORTC QLQ-C30, higher values represent better QoL) and the predominant item of the EORTC QLQ-BN20 (future uncertainty, higher values represent worse QoL). A change of 10% on the respective scale was considered as a clinically meaningful difference (Osoba et al, Eur J Cancer. 2005 Jan;41(2):280-7 and Maringwa et al, Ann Oncol. 2011 Sep;22(9):2107-12). Results The median age and KPS was 62 years (range 20 to 85) and 80% (30% to 100%), respectively, 119 (52%) were female. Before treatment, the median GHS of the EORTC QLQ-C30 was 50 (interquartile range [IQR] 33 to 67) reflecting substantial impaired QoL. After completion of treatment, the median GHS significantly increased by 17 points to a median of 67 (IQR 50 to 71) (P<0.001), which reflects a clinically meaningful difference. This positive effect was consistent in multivariable analysis (beta coefficient 0.37, p<0.001). Patient with a better KPS before starting treatment had a higher chance that their QoL improved over time (beta coefficient 0.26, p=0.0029). There was no difference regarding GHS between patients with newly diagnosed PCNSL or patients with relapsed disease before starting treatment (median GHS both 50). However, in patients with relapsed disease, numerical increase of GHS over time did not reach statistical significance (beta coefficient 0.36, p=0.2185) likely to limited power in the multivariable analysis. The overall development of GHS over time is shown in Figure 1. The dip at months 17 and 18 area is associated with disease relapse. Regarding the EORTC QLQ-BN20 questionnaire, the predominant issue for patients was future uncertainty (median 42, IQR 17 to 67) before starting treatment, which significantly improved after treatment to 25 (IQR 8 to 33) (p<0.001). In multivariable analysis, future uncertainty also improved significantly in separate analyses for patients with newly diagnosed PCNSL (beta coefficient -0.45, p=0.005) and relapsed disease (beta coefficient -0.89, p=0.0049). The overall development of future uncertainty over time is shown in Figure 2. The increase at months 17 and 18 area is associated with disease relapse. Conclusions Patients with newly diagnosed or relapsed PCNSL reported substantial impaired QoL before starting treatment. However, after treatment with HD-MTX based chemotherapy, QoL significantly improved over time and patients were also more confident regarding their future. Results from our analyses provide a reference for future studies on this important issue in the care of patients with PCNSL. At the meeting we will present further analyses and results from all domains of the EORTC QLQ-C30 and EORTC QLQ-BN20 questionnaires. Figure 1 Global Health Status development from the EORTC QLQ-C30 questionnaire (higher values denote better quality of life) Figure 1. Global Health Status development from the EORTC QLQ-C30 questionnaire (higher values denote better quality of life) Figure 2 Future uncertainty from the EORTC QLQ-BN20 questionnaire (lower values denote better quality of life) Figure 2. Future uncertainty from the EORTC QLQ-BN20 questionnaire (lower values denote better quality of life) Disclosures Kasenda: Riemser: Other: Travel Support. Illerhaus:Riemser, Amgen: Honoraria.

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FOENIX-CCA2 quality of life data for futibatinib-treated intrahepatic cholangiocarcinoma (iCCA) patients with FGFR2 fusions/rearrangements.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.4097 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 4097-4097

Author(s):

Juan W. Valle ◽

Antoine Hollebecque ◽

Junji Furuse ◽

Lipika Goyal ◽

Funda Meric-Bernstam ◽

...

Keyword(s):

Quality Of Life ◽

Health Status ◽

Global Health ◽

Global Health Status ◽

Phase 2 ◽

Life Data ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

Eq Vas

4097 Background: In FOENIX-CCA2 (NCT02052778), a pivotal phase 2 study among iCCA patients (pts) with FGFR2 fusions/rearrangements, the highly selective, irreversible FGFR1–4 inhibitor futibatinib demonstrated a confirmed objective response rate of 41.7%, with a 9.7-month median duration of response. Adverse events were manageable with dosing modifications that did not adversely impact on response. We report outcomes for the preplanned analysis of Patient-Reported Outcomes (PROs) during futibatinib treatment as a secondary objective of FOENIX-CCA2. Methods: Pts enrolled in FOENIX-CCA2 had locally advanced/metastatic unresectable iCCA with FGFR2 fusions/rearrangements, ≥1 prior line of therapy (including gemcitabine/cisplatin) and ECOG PS 0-1. Pts received oral futibatinib 20 mg continuous QD dosing per 21-day cycle. PRO measures included EORTC-QLQ-C30 (1 global health, 5 functional, 9 symptom scales), EQ-5D-3L, and EQ visual analogue scale (VAS). PROs were collected at screening, cycles 2 and 4, every 3 cycles thereafter, and end of treatment. PRO data were evaluated up to cycle 13, the last visit before data were missing for >50% of the PRO population (PRO primary assessment time point). Results: 92/103 (89.3%) pts enrolled had PRO completion data at baseline and a minimum of 1 follow-up assessment (median age 58 y, 56.5% female), with 48 pts having PRO data at cycle 13. At baseline, mean (SD) EORTC QLQ-C30 global health status score was 70.1 (19.4) and EQ VAS score 71.7 (20.3). Mean EORTC QLQ-C30 global health status scores were maintained from baseline to cycle 13, corresponding to 9.0 months on treatment, with no clinically meaningful (≥10-point) changes in individual functional measures (Table). EORTC QLQ-C30 scores across individual symptom measures were also stable from baseline through cycle 13; only constipation showed an average of 10.0-point worsening at only cycle 4. Mean EQ VAS scores were sustained from baseline to cycle 13 (mean change ranging -1.8 to +4.8 across cycles), with values maintained within the population norm range from across 20 countries. Conclusions: Quality of life data from the phase 2 FOENIX-CCA2 trial show that physical, cognitive and emotional functioning, and overall health status were maintained among pts with advanced iCCA receiving futibatinib. Clinical trial information: NCT02052778. [Table: see text]

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Real-World Health-Related Quality of Life in Patients with Diffuse Large B-Cell Lymphoma: Comparisons with Reference Populations and By Line of Therapy

Blood ◽

10.1182/blood-2021-152798 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 4111-4111

Author(s):

Qiufei Ma ◽

Abigail Bailey ◽

Neil Milloy ◽

Jake Butcher ◽

Ruben G.W Quek ◽

...

Keyword(s):

Quality Of Life ◽

Health Status ◽

Global Health ◽

Reference Values ◽

Real World ◽

Role Functioning ◽

Functional Scores ◽

Eortc Qlq C30 ◽

Eortc Qlq

Abstract Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most common type of aggressive non-Hodgkin's lymphoma (NHL) constituting 30-58% of all NHL (Tilly et al, 2015; Thieblemont et al, 2020). Treatment can include intensive multiagent chemotherapy and other novel therapies which carries risk for toxicities. Despite this, we lack data comprehensively depicting the quality of life of real-world patients with DLBCL, particularly in the modern era with novel therapies. Therefore, we aimed to compare Quality of Life (QoL) to reference populations and assess real-world DLBCL patients across multiple countries and lines of therapy. Methods: Real-world data were drawn from the Adelphi DLBCL Disease Specific Programme™ (DSP), a point-in-time survey of hematologists, hemato-oncologists, oncologists and their patients with DLBCL conducted in France (FR), Germany (DE), Italy (IT), Spain (SP), the United Kingdom (UK) and the United States of America (US) between Jan-May 2021. Patients were asked to voluntarily complete a patient self-completion form (PSC) capturing demographics and QoL data through the use of patient-reported outcome instruments: the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30), EuroQol 5-dimension 5-level questionnaire (EQ-5D-5L), EQ-5D-5L Visual Analogue Scale and Work Productivity and Activity Impairment questionnaire. Bivariate analysis was conducted to compare all cancer and NHL-specific reference values from the EORTC QLQ-C30 manual (Scott et al, 2008) to DLBCL DSP data, and to review QoL across lines of therapy, defined as first line and second line (1L+2L) and third line and above (3L+). Statistical significance level was set at p<.05. If functional scores were lower, when compared to reference values, within the DSP, this was indicative of a worse QoL in patients with DLBCL. For symptomatic scores the opposite was true; should the DSP value be higher, this was indicative of a worse QoL in patients with DLBCL. Results: Data analysis was conducted on 441 patients with DLBCL who completed a PSC (FR: n=80, DE: n=150, IT: n=54, SP: n=43, UK: n=34, US: n=80); at data collection, mean (standard deviation) age was 64.6 (12.39) years, 36% of patients were female, 19% working full- or part-time and 80% were relapsed/refractory, 29% were 3L+. 8%, 24%, 28% and 40% were at Ann Arbor disease stage I, II, III and IV respectively at the time of data collection. When comparing DLBCL DSP values to EORTC QLQ-C30 all cancer reference values for functional scores (Table 1), global health status, physical functioning, role functioning, emotional functioning, cognitive functioning and social functioning were significantly worse than all cancer reference values. In terms of symptoms, DSP values for fatigue, nausea and vomiting, dyspnea, appetite loss and diarrhea were significantly worse than all cancer reference values (Table 2). Results were mixed when comparing with EORTC QLQ-C30 NHL-specific reference values (Table 1) for functional scores; global health status was significantly worse for the DLBCL DSP population, whilst role functioning, cognitive functioning and social functioning were significantly better than NHL reference values. Significantly worse symptom scores were observed in the DLBCL DSP population (Table 2) for nausea and vomiting, pain, dyspnea and diarrhea when compared with the reference values. Functioning scores were significantly worse in 3L+ patients vs 1L+2L for global health status, physical functioning, role functioning, cognitive functioning and social functioning (Table 3). Fatigue, dyspnea and diarrhea symptomatic scores were significantly worse in 3L+ vs 1L+2L patients. Symptom burden was high across all lines of therapy (Table 4). Conclusion: Real-world patients with DLBCL demonstrated significantly worse QoL when compared with a general cancer reference population with respect to all functional scores, as well as fatigue, nausea and vomiting, dyspnea, appetite loss and diarrhea, underscoring the high symptom burden experienced by patients with DLBCL. Patients with DLBCL on 3L+ had significantly worse QoL than those on earlier lines of therapy with respect to global health status, physical functioning, role functioning, cognitive functioning and social functioning, fatigue, dyspnea and diarrhea indicating an unmet need in novel treatment options to help improve QoL in later lines. Figure 1 Figure 1. Disclosures Ma: Regeneron Pharmaceuticals Inc.: Current Employment, Current holder of individual stocks in a privately-held company. Quek: Regeneron Pharmaceuticals Inc.: Current Employment, Current holder of individual stocks in a privately-held company.

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Mid-Upper Arm Circumference as an Indicator of Quality of Life of Patients with Advanced Cancer

10.21203/rs.3.rs-1005909/v1 ◽

2021 ◽

Author(s):

Seon-Hye Won ◽

Yusuke Hiratsuka ◽

Sang-Yeon Suh ◽

Hayoung Bae ◽

Sung-Eun Choi ◽

...

Keyword(s):

Quality Of Life ◽

Health Status ◽

Advanced Cancer ◽

Summary Score ◽

Upper Arm ◽

Arm Circumference ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

Mid Upper Arm Circumference

Abstract Purpose Mid-upper arm circumference (MUAC) has been used to assess malnutrition and health status across various disease groups. However, it is unclear whether MUAC is associated with quality of life (QOL) of patients with advanced cancer. Our goal was to investigate the relationship between MUAC and QOL in ambulatory out-patients with advanced cancer. Method This was a cross-sectional study conducted in a tertiary cancer center in South Korea. A total of 200 patients with advanced cancer at oncology clinics of Seoul National University Bundang Hospital from March 2016 to January 2019 were enrolled. Out-patients with advanced cancer whose survival was expected to be less than one year by their oncologists were enrolled. QOL of patients was evaluated using the European Organization for Research and Treatment of Cancer quality of life questionnaire core 30 (EORTC QLQ-C30). Associations of QOL with MUAC and nutritional parameters were examined with generalized linear models. Results The most common cancer sites were the lung, colon or rectum, and genitourinary tract. In univariate analyses, significant factors associated with higher summary score of EORTC QLQ-C30 were higher MUAC (≥ 26.5 cm, p < 0.001), higher body mass index (BMI) (≥ 22 kg/m2, p < 0.001), higher serum albumin (≥ 3.7 g/dL, p = 0.004), higher creatinine (≥ 0.8 mg/dL, p = 0.023), and higher uric acid (≥ 5 mg/dL, p = 0.001). In multivariate analysis, higher serum albumin (≥ 3.7 g/dL, p < 0.01) and higher MUAC (≥ 26.5 cm, p = 0.03) were independently associated with better summary score of EORTC QLQ-C-30. Conclusion MUAC was highly associated with QOL in terms of summary score and overall health status. Thus, MUAC, with its simplicity, can be a useful tool to reflect QOL in patients with advanced cancer.

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The Malay Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ C30): Reliability and Validity Study

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v9i2.720 ◽

2020 ◽

Vol 9 (2) ◽

Author(s):

Yusoff N ◽

Low WY ◽

Yip CH

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Health Status ◽

Intraclass Correlation ◽

Life Questionnaire ◽

European Organization ◽

Quality Of Life Questionnaire ◽

Eortc Qlq C30 ◽

Eortc Qlq

Introduction: The Malay Version of EORTC-QLQ C30 was validated among Malaysian women who had undergone breast cancer surgery. Materials and Methods: Test-retest evaluation (i.e. three weeks and ten weeks following surgery) was carried out to examine the validity and reliability of the scale. The Cronbach’s alpha value was used to determine the internal consistency, meanwhile, test-retest Intraclass Correlation Coefficients (ICC) indicates the reliability of the scale. Effect Size Index and Mean Differences interpret the sensitivity of the scale. Discriminant validity was evaluated by comparing two groups i.e. women who had mastectomy and women who had lumpectomy. Results: Internal consistencies are acceptable for Global Health Status (0.91), Functional domains (ranging from 0.50-0.89) and Symptomatology domains (ranging from 0.75-0.99). Intraclass Correlation Coefficient (ICC) ranged from 0.05 to 0.99 for Global Health Status and Functional domains, and ranged from 0.13 to 1.00 for Symptomatology domains. Sensitivity of the scale was observed in nearly all of the domains. Conclusion: The Malay Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ C30) is a suitable tool to measure the quality of life of women with breast cancer.

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The Impact of Chemotherapy on the EORTC QLQ-C30 and LC-13 Quality of Life Scales in Patients with Lung Cancer

The Journal of Tepecik Education and Research Hospital ◽

10.5222/terh.2021.73626 ◽

2021 ◽

Author(s):

Müge Güvençli ◽

Enver Yalnız ◽

Berna Kömürcüoğlu ◽

Ahmet Emin Erbaycu ◽

Gamze Karakurt

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Health Status ◽

Economic Status ◽

Social Functions ◽

Lung Cancer Patients ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

Overall Health Status

Objective: The concept of quality of life (QoL) in lung cancer includes many physical, psychological and social components. We aimed to assess the effect of chemotherapy (CT) on QoL of lung cancer patients using QoL scales. Methods: Fifty inoperable lung cancer patients who were newly diagnosed and taken into a CT plan were included. Patients were followed in terms of responsiveness and toxicity. Turkish versions of the EORTC QLQ-C30 and LC13 scales were used before every cycles. Results: The average age was 60.1 years. There was no difference between QoL and age/income levels. The assessment of physical, social and occupational functions and overall health status of the male patients was better than female. Overall health status without comorbidity was better in the first cycle CT. Chemotherapy led to deterioration in social functions and economic status together with increase in neuropathy, constipation and hair loss. Patients with complete or partial response to treatment were observed to have better physical, occupational, emotional, cognitive and social functions, economic status and overall health; less fatigue, pain, shortness of breath, neuropathy and better appetite. Toxicities were found to affect the QLQ C30 and LC13 scales adversely. Conclusion: Presence of comorbidity, low education levels, socioeconomic status and CT induced hematologic/gastrointestinal toxicities are the major parameters affect QOL in lung cancer. Chemotherapy leads to deterioration in social functions, increase in adverse events as well as worsening in economic status. Radiologic complete or partial response and small cell carcinoma are states in which parameters of QoL are affected positively by chemotherapy.

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Does change in health-related quality of life (HRQoL) score predict survival? Analysis of a lung cancer RCT.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.7607 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 7607-7607

Author(s):

Divine Ewane Ediebah ◽

Corneel Coens ◽

Efstathios Zikos ◽

Chantal Quinten ◽

Jolie Ringash ◽

...

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Performance Status ◽

Health Related Quality ◽

Related Quality ◽

Eortc Qlq C30 ◽

Health Related ◽

Eortc Qlq ◽

Over Time

7607 Background: Over 60 cancer clinical trials have shown that baseline health-related quality of life (HRQoL) scores are prognostic for patient survival. Few studies have investigated the added value of change in HRQoL scores. Our aim was to investigate if change in HRQoL scores from baseline over time is also associated with survival. Methods: We analyzed data from an EORTC 3-arm randomized clinical trial (RCT) in advanced non-small-cell lung cancer (NSCLC) patients, comparing gemcitabine+cisplatin, versus paclitaxel+gemcitabine, versus standard arm paclitaxel+cisplatin. HRQoL was measured in 394 patients using the EORTC QLQ-C30 at baseline and after each chemotherapy cycle. The prognostic significance of sex, age and WHO performance status (0-1 vs. 2) and the 15 QLQ-C30 subscales were assessed with Cox proportional hazard models stratified for treatment (level of significance 0.05). Changes in HRQoL scores from baseline to each chemotherapy cycle assessment were categorized as “improved”, “stable” and “worsened” using a threshold of 10 points difference. Due to expected attrition, the analysis was limited to changes from baseline up to cycle 3. Results: There were 248 patients in cycle 1, 212 in cycle 2 and 196 in cycle 3. We performed analyses separately using data at cycle 1, cycle 2, and cycle 3. In all analyses, HRQoL in various subscales and socio-demographic and clinical variables (physical functioning (hazard ratio [HR] 0.91, 95% CI 0.85-0.98; p=0.0103), pain (1.11, 1.05-1.17; p= 0.0004), age (0.98, 0.97-1.00, p=0.0413) and WHO performance status (1.77, 1.09-2.89; p=0.0218) at cycle 1; pain (1.11, 1.03-1.20; p=0.0016), age (0.98, 0.96-1.00; p=0.0217) and sex (0.63, 0.42-0.95; p=0.0081) at cycle 2; and role functioning (0.93, 0.88-1.00; p=0.0128) and age (0.98, 0.96-1.00; p=0.0081) at cycle 3) predicted survival; however, change in HRQoL was only an independent predictor for improvement at cycle 1. Conclusions: Our findings suggest that change from baseline over time in HRQoL, as measured on subscales of the EORTC QLQ-C30, contains added prognostic value for survival independent of baseline HRQoL scores. Further work is needed to assess the robustness and sensitivity of these findings.

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An Evaluation of Half-Body Irradiation in the Treatment of Widespread, Painful Metastatic Bone Disease

Tumori Journal ◽

10.1177/030089160809400607 ◽

2008 ◽

Vol 94 (6) ◽

pp. 813-821 ◽

Cited By ~ 7

Author(s):

Leszek Miszczyk ◽

Andrzej Tukiendorf ◽

Aleksandra Gaborek ◽

Jerzy Wydmański

Keyword(s):

Quality Of Life ◽

Health Status ◽

Global Health ◽

Pain Intensity ◽

Observation Time ◽

Global Health Status ◽

Pain Level ◽

Eortc Qlq C30 ◽

Eortc Qlq

Aims Evaluation of analgesic uptake, pain intensity, and quality-of-life changes after half-body irradiation of patients with bone metastases. Material and Methods Ninety-five patients (97 irradiations) were treated with single half-body irradiation fraction (3–8 Gy). Thirty-three patients had upper-half-body irradiation, 55 lower-half-body irradiation and 9 middle-half-body irradiation. The patients were examined on the day of irradiation, 2 and 4 weeks later, and then once a month. The intake of analgesics, pain level (from 0 to 10), and the quality of life (EORTC QLQ-C30) were evaluated. The fluctuations of pain levels and the particular scaling values of QLQ-C30 during a one-year period were analyzed (Kendall t correlation). Results Over the course of 5 months, the incidence of patients using strong opioids decreased from 43.8% to 33.3%, and the incidence of patients who did not need to resort to analgesics increased from 6.7% to 25%. The mean pain level decreased from 6.1 points (half-body irradiation) to 3.1 points 2 weeks later. An inverse correlation between pain level readings and time was statistically significant. An increase was observed in the values of the five functional scales as reflected on the EORTC QLQ-C30 questionnaire (four of which correlated significantly with the observation time). A similar situation prevailed with respect to global health status. A decrease was observed in most of the values on the symptoms scales; 6 saw a significant decrease, in correlation with the follow-up. Correlations were also found between pain intensity and functionality, and between symptoms scales readings and global health status. Conclusions Half-body irradiation of cancer patients suffering from painful multiple bone dissemination is an effective and simple treatment modality that affords significant quality-of-life improvement and pain relief, thus allowing for a reduction in the use of strong analgesics.

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COMPARATIVE ASSESSMENT OF THE QUALITY OF LIFE OF PATIENTS WITH KIDNEY CANCER AFTER SURGICAL TREATMENT

Bulletin physiology and pathology of respiration ◽

10.12737/article_5a24b1918ee2a4.73477487 ◽

2017 ◽

Vol 1 (66) ◽

pp. 77-82 ◽

Cited By ~ 1

Author(s):

Галина Алексеева ◽

Galina Alekseeva ◽

Павел Кику ◽

Pavel Kiku ◽

Сергей Юдин ◽

...

Keyword(s):

Quality Of Life ◽

Health Status ◽

Open Access ◽

Kidney Cancer ◽

General Health ◽

General Health Status ◽

Social Functions ◽

Eortc Qlq C30 ◽

Eortc Qlq

In the study using the questionnaire EORTC-QLQ C30 there was done a comparative analysis of the quality of life of 35 patients with renal cancer (stage T1-2N0M0) who underwent organ-preserving surgery or open access radical nephrectomy. The initial parameters of quality of life of patients with kidney cancer were higher under organ-preserving surgery; important advantages covered general health status, role and social functions, fatigue and reduced appetite and sleep disorders. In the postoperative period in patients after organ-preserving surgery there remained higher general health status, physical and emotional functions, while the use of open access lowered the quality of life in both groups in functional scales due to the severity of pain and the reduction of social functions. The widespread introduction of endoscopic organ-preserving surgery for kidney cancer can improve the quality of life and contributes to rapid rehabilitation.

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The Effect of Chemotherapy on Quality of Life of the Patients with Metastatic Gastric and Colorectal Cancer

The Journal of Tepecik Education and Research Hospital ◽

10.5222/terh.2021.77598 ◽

2021 ◽

Author(s):

Selda Çakın Ünnü ◽

Ilkay Tugba Unek ◽

Ömercan Topaloğlu

Keyword(s):

Quality Of Life ◽

Colorectal Cancer ◽

Health Status ◽

Global Health ◽

Palliative Chemotherapy ◽

Global Health Status ◽

Symptom Scores ◽

Eortc Qlq C30 ◽

Eortc Qlq

Objective: The self-administered questionnaires by the patients are among the most important methods to evaluate the patient’s health related quality of life. The objective of the study was to evaluate the effect of chemotherapy on quality of life of the patients receiving palliative chemotherapy with the diagnosis of metastatic gastric and colorectal cancer by using EORTC QLQ-C30. Methods: This study included 100 patients who were treated with palliative chemotherapy for the diagnosis of metastatic gastric or colorectal cancer in İzmir Tepecik Education and Research Hospital Department of Medical Oncology between 2011-2012. The EORTC QLQ-C30 questionnaire was filled twice by the patients before chemoterapy started and after chemotherapy completed. Results: When the two questionnaires were compared, it was found that global health status and physical functioning did not change after the chemotherapy. Role functioning, cognitive functioning, and social functioning impaired but emotional functioning improved (p<0.05). After the chemoterapy, scores of fatigue and constipation decreased but financial difficulties increased (p<0.05). The symptom scores of nausea-vomitting, pain, dyspnea, insomnia, anorexia, diarrhea did not change. Conclusion: The results of this study suggested that a quality of life assessment with the EORTC QLQ-C30 questionnaire would be beneficial in patients with metastatic gastric and colorectal cancer. In this way, impairments in functional scores, global health status and symptom scores that may occur after chemotherapy can be detected, clinicians can be helped to decide on the switch to chemotherapy regimens that are similar in effectiveness but have different side effects profile, the patients’ quality of life can be improved as a result of the application of the necessary palliative treatments.

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Health-Related Quality of Life in Waldenstrom Macroglobulinemia (WM) and IgM Monoclonal Gammopathy of Undeterminated Significance (IgM-MGUS)

Blood ◽

10.1182/blood-2018-99-111444 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 3593-3593

Author(s):

Anna Maria Frustaci ◽

Michele Nichelatti ◽

Marina Deodato ◽

Maddalena Mazzucchelli ◽

Marco Montillo ◽

...

Keyword(s):

Quality Of Life ◽

Health Status ◽

Global Health ◽

Global Health Status ◽

Emotional Function ◽

Vas Score ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

The Impact

Abstract The clinical course of WM widely differs among patients, with some manifesting symptoms as a consequence of the monoclonal IgM component or lymphoma infiltration. IgM-MGUS is generally asymptomatic while, in some cases, paraprotein-related manifestations may occur. Patients with IgM-MGUS should perform a regular follow-up as they are at risk of developing WM or other B-cell lymphoproliferative disorders (1.5-2% per year). Although WM typically afflicts the elderly, there are no studies addressing the impact of ECOG performance status and comorbidities on patients' outcome. Furthermore, to our knowledge health-related quality of life (HRQOL) has never been evaluated in this category. The aim of this study is to analyze the impact of diagnosis and patients' characteristics on quality of life. From October 2017, HRQOL was assessed in 103 patients (37 WM with previous or ongoing treatment [tWM]; 29 asymptomatic MW [aWM]; 37 IgM-MGUS) by the administration of EORTC QLQ-C30, HADS, FACT-GOG neurotoxicity and EQ-5D-5L questionnaires. Demographic anamnestic and disease-related data were also collected for each patient. The same questionnaires continue to be administered every 6 months for 3 years, in order to capture changes in HRQOL over time. Patients features are reported in table 1. No significant differences in terms of age, sex distribution, age at diagnosis, months from diagnosis, ECOG performance status, CIRS or number of concomitant medications, were detected among the 3 groups (table 1). As regards CIRS, the organ systems mainly involved resulted: vascular and genitourinary for tWM, genitourinary for aWM and vascular, respiratory and genitourinary for IgM-MGUS. Among the 3 groups no statistical differences were reported when analyzing: EORTC QLQ-C30 global health status, functional scales (physical, role, emotional, cognitive and social functioning) and symptoms scale, EQ-5D VAS score, HADS anxiety and depression scores or FACT-GOG neurotoxicity score. Males had higher global health status and emotional function when compared to females both in IgM-MGUS and WM patients. Higher CIRS score and ECOG status negatively impacted on global health status, physical function, EQ-5D VAS score and anxiety both in WM and IgM-MGUS. WM patients with longer time from diagnosis showed a significantly worse emotional function. Patients-reported symptoms that could be referred to peripheral neuropathy (PN, 39 patients) resulted the only significant parameter negatively impacting on HRQOL (global health status, functional and symptoms scales according to EORTC QLQ-C30 and EQ-5D VAS score) and also affecting HADS anxiety score. The diagnosis of PN was confirmed by neurologic tests only in 16/39 subjects that, compared with the rest of the population, showed older age (p .019), older age at diagnosis (p . 015) and higher ECOG status (p .005). In these patients, EORTC QLQ-C30 detected a reduced cognitive function (p .0031), while HADS a greater perception of anxiety (p .0015). No differences were recorded for EQ-5D VAS score or HADS depression scale. In conclusion, in our series diagnosis per se didn't seem to affect HRQOL which was negatively influenced by high ECOG status and comorbidities. Emotional function meaningfully deteriorated as the time lapse from diagnosis became longer. Quality of life was significantly altered in patients reporting symptoms of PN and this was confirmed by all the questionnaires. Longer follow up is needed to confirm these preliminary data. Disclosures Montillo: Roche: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Honoraria; AbbVie: Consultancy, Honoraria, Speakers Bureau; Gilead: Consultancy, Honoraria, Speakers Bureau. Tedeschi:Janssen: Consultancy, Speakers Bureau; AbbVie: Consultancy; Gilead: Consultancy.

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