To study the short-term outcome of multimodality treatment on morbidity and quality of life in patients with carcinoma oesophagus

Background: Oesophageal cancer is sixth most common cause of cancer related deaths worldwide. Despite complete resections, overall survival remained low. To improve the existing treatment combination of chemotherapy and radiotherapy in both neoadjuvant and adjuvant settings was introduced. Impact of treatment on quality of life, morbidities and toxicities associated with multimodality treatment in patients of carcinoma oesophagus was studied prospectively and retrospectively.Methods: A total of 40 patients histologically proven carcinoma of the oesophagus were enrolled in the study. Study included assessment of clinical features, risk factors, biopsy, multimodality treatment and associated morbidities and toxicities. Quality of Life (QOL) in patients of multimodality treatment assessed using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Core 18 before, immediate post treatment and 6 months after completion of the planned treatment.Results: In 40 patients, male to female ratio was 1.10:1. Dysphagia was the leading complain. 3 patients were treated using neoadjuvant therapy (chemotherapy and radiotherapy followed by surgery) among them 2 patients expired, 1 patient is under regular follow up. 6 patients underwent upfront surgery followed by adjuvant therapy out of which 3 patients expired,15 patients were treated with curative intent by definitive chemotherapy and radiotherapy out of which only 7 patients survived for >1 year. 16 patients were treated with palliative intent (radiotherapy, chemotherapy, oesophageal stenting and feeding procedures) in which only 1 patient survived for 1 year.Conclusions: The present study demonstrates that patients over all QOL was reduced after treatment and in the follow up period which was due to the treatment related toxicities but in contrast symptom improvement was observed simultaneously.

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Prospective Assessment of Quality of Life and Psychological Distress in Patients With Gynecologic Malignancy: A 1-Year Prospective Study

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e3182559c03 ◽

2012 ◽

Vol 22 (6) ◽

pp. 1096-1101 ◽

Cited By ~ 17

Author(s):

Guler Yavas ◽

Nasuh Utku Dogan ◽

Cagdas Yavas ◽

Nilgun Benzer ◽

Deniz Yuce ◽

...

Keyword(s):

Quality Of Life ◽

Body Image ◽

Anxiety And Depression ◽

Life Questionnaire ◽

Gynecologic Malignancy ◽

European Organization ◽

Eortc Qlq C30 ◽

Eortc Qlq

ObjectiveOur aim was to evaluate the health-related quality of life (HRQoL) and psychological distress in patients treated with radiotherapy (RT) for gynecologic malignancy.MethodsFifty-seven women with either cervical or endometrial cancer were prospectively enrolled. We assessed HRQoL at baseline (after surgery before RT), at the end of RT, and during follow-up (every 3 months thereafter) using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 (EORTC QLQ-C30), European Organization for Research and Treatment of Cervical Cancer Quality of Life Questionnaire 24 (EORTC QLQ-CX24), and Hospital Anxiety and Depression Scale.ResultsWe demonstrated changes in appetite loss (P= 0.03), nausea and vomiting (P= 0.02), and role function score (P= 0.003) domains of EORTC QLQ-C30. Only the mean body image score of EORTC QLQ-CX24 was significantly different during follow-up (P= 0.02). Type of surgery, histopathological diagnosis, and the menopausal and marital status of the patients affected baseline body image scores (P= 0.032, 0.004, and 0.019 and 0.005, respectively). Patients who underwent chemotherapy had higher baseline body image scores when compared with patients without any chemotherapy before RT (P= 0.028). All the complaints of patients except body image scores improved during the follow-up period. The baseline and follow-up anxiety and depression scores did not differ significantly.ConclusionsAlthough pelvic RT deteriorated HRQoL in gynecologic cancer, patients’ improvement in HRQoL during follow-up was observed. Patients receiving RT could be reassured about the improvement of acute adverse effects in the course of treatment.

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Quality of Life in Patients With Gastroenteropancreatic Tumors Treated With [177Lu-DOTA0,Tyr3]octreotate

Journal of Clinical Oncology ◽

10.1200/jco.2004.10.016 ◽

2004 ◽

Vol 22 (13) ◽

pp. 2724-2729 ◽

Cited By ~ 142

Author(s):

Jaap J.M. Teunissen ◽

Dik J. Kwekkeboom ◽

Eric P. Krenning

Keyword(s):

Quality Of Life ◽

Global Health ◽

Progressive Disease ◽

Tumor Regression ◽

Somatostatin Receptor ◽

Disease Status ◽

Life Questionnaire ◽

European Organization

Purpose To evaluate the quality of life (QoL) in patients with metastatic somatostatin receptor positive gastroenteropancreatic tumors treated with [177Lu-DOTA0,Tyr3]octreotate (177Lu-octreotate) therapy. Patients and Methods Fifty patients who had been treated with 600 to 800 mCi of 177Lu-octreotate and had a follow-up of at least 3 months were studied. The patients completed the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 before therapy and at follow-up visit 6 weeks after the last cycle. Overall QoL and specific QoL domains of both the total group of patients and subgroups according to treatment outcome were analyzed. Twenty-four patients had regression, 19 had stable disease, six had progressive disease, and one had nonassessable disease status. Analysis of variance was used for statistical comparison. Results A significant improvement in the global health status/QoL scale was observed after therapy with 177Lu-octreotate (P < .01). The score increased significantly six weeks after therapy to a mean of 78.2, up from 69.0 (scale range, 0 to 100). Furthermore, significant improvement was observed in the role, emotional, and social function scales. The symptom scores for fatigue, insomnia, and pain were significantly decreased. Patients with proven tumor regression most frequently had an improvement of QoL domains. Unexpectedly, patients with progressive disease also indicated an improvement in their global health/QoL score. Conclusion 177Lu-octreotate therapy significantly improved the global health/QoL and several function and symptom scales in patients with metastasized gastroenteropancreatic tumors, but especially in those patients with proven tumor regression.

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A prospective comparison of the FACT-e and EORTC-QLQC30 and OG25 questionnaires for evaluating changes in health-related quality of life in patients with esophageal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.4_suppl.130 ◽

2013 ◽

Vol 31 (4_suppl) ◽

pp. 130-130

Author(s):

Gail Darling

Keyword(s):

Quality Of Life ◽

Esophageal Cancer ◽

Repeated Measures ◽

Disease Free Survival ◽

Well Being ◽

Symptom Improvement ◽

Life Questionnaire ◽

European Organization ◽

Over Time

130 Background: The FACT-E (Functional Assessment of Cancer Therapy– Esophageal) and the EORTC QLQ-C30 (European Organization for Research on Treatment of Cancer Quality of Life Questionnaire) and its cancer-specific module (OG25) are two validated instruments used to assess quality-of-life (QOL) in patients with esophageal cancer. This study investigates the differences between these two instruments. Methods: This is a prospective study of 22 consecutive patients treated with chemoradiation followed by surgery. Questionnaires were self-administered at each of the following: baseline (prior to treatment), 6-8 weeks and 12-14 weeks following start of chemoradiation, and 1, 3, 6, 9, 12, and 18 months following esophagectomy. Mixed model regression was applied to model the repeated measures of the two questionnaires to compare slopes. Results: Of the 22 patients, 20 proceeded to surgery. Overall survival and disease-free survival at 18 months were 59% and 55% respectively. Comparison of the QOL domains over time showed good correlation for physical and functional well-being, with an apparent variation in the magnitude of the changes over time for the latter. The questionnaires were discordant with respect to social and total well-being. Social well-being showed a return to baseline by 1 month post-op using the FACT, but never recovered to baseline for the EORTC. FACT Total well-being recovered to baseline by 9 months, while the EORTC only approached baseline values by 18 months. The disease-specific modules showed post-operative symptom improvement with the FACT and a deterioration with the EORTC. There was also discordance in emotional well being. Conclusions: Domain comparisons of the EORTC and FACT questionnaires showed differing results. Discordance was seen for emotional, social and overall QOL, as well as symptomatology. The EORTC total and physical well-being domains showed a similar pattern of change over time. These findings might result from the overall tendency of the EORTC to emphasize physical aspects of QOL. Thus these two instruments appear to measure different aspects of QOL, which may affect their clinical utility.

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Feasibility of Early Application of an Advance Directive at the Time of First-Line Palliative Chemotherapy in Patients With Incurable Cancer: A Prospective Study

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909119839355 ◽

2019 ◽

Vol 36 (10) ◽

pp. 893-899

Author(s):

Eun-Ju ParK ◽

Yeon Jae Lim ◽

Jae-Joon Kim ◽

Sang-Bo Oh ◽

So Yeon Oh ◽

...

Keyword(s):

Quality Of Life ◽

Advance Directive ◽

Palliative Chemotherapy ◽

Life Questionnaire ◽

First Line ◽

European Organization ◽

Before And After ◽

Eortc Qlq

Context:This study aimed to evaluate the feasibility of an advance directive (AD) at the time of starting first-line palliative chemotherapy. We investigated changes in emotional distress, quality of life (QoL), and attitudes toward anticancer treatments between before and after AD.Methods:Patients with advanced cancer who had just started palliative chemotherapy were prospectively enrolled. We assessed attitudes toward chemotherapy, Hospital Anxiety and Depression Scale (HADS), and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ) before conducting the AD and subsequently performed the AD after the first cycle of chemotherapy. Follow-up evaluations using same parameters were performed in the next cycle visit.Results:During the study period, 104 patients started palliative chemotherapy. Among them, 41 patients (11 with cognitive impairment at baseline, 14 with clinical deteriorations after the first cycle of chemotherapy, 6 with follow-up loss, 7 without proxy, 3 with protocol violations) were excluded, and the AD were recommended in the remaining 64 patients (proportion of AD recommendation: 62%). Among the 64 patients, 44 agreed to conduct the AD (proportion of AD consent: 69%). There were no significant changes before and after AD in terms of HADS and EORTC-QLQ. Attitudes regarding chemotherapy were also unchanged ( P = .773). A total of 36 (82%) patients followed physician’s recommendations, with the exception of 8 patients who terminated chemotherapy due to refusal or loss to follow-up.Conclusions:Considering our results showing no significant changes in depression and anxiety scores, QoL, and attitudes toward anticancer treatments after the AD, early integration of the AD at initiation of first-line palliative chemotherapy might be feasible.

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Quality of life improves after palliative placement of percutaneous tunneled drainage catheter for refractory ascites in prospective study of patients with end-stage cancer

Palliative & Supportive Care ◽

10.1017/s1478951519000051 ◽

2019 ◽

Vol 17 (6) ◽

pp. 677-685

Author(s):

Piera Cote Robson ◽

Mithat Gonen ◽

Ai Ni ◽

Lynn Brody ◽

Karen T. Brown ◽

...

Keyword(s):

Quality Of Life ◽

Refractory Ascites ◽

Rank Test ◽

Symptom Improvement ◽

Life Questionnaire ◽

European Organization ◽

Drainage Catheter ◽

End Stage ◽

The Impact

AbstractObjectivePercutaneous tunneled drainage catheter (PTDC) placement is a palliative alternative to serial paracenteses in patients with end-stage cancer and refractory ascites. The impact of PTDC on quality of life (QoL) and long-term outcomes has not been prospectively described. The objective was to evaluate changes in QoL after PTDC.MethodEligible adult patients with end-stage cancer undergoing PTDC placement for refractory ascites completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and McGill Quality of Life instruments before PTDC placement and at 2 to 7 days and 2 to 4 weeks after PTDC. Catheter function, complications, and laboratory values were assessed. Analysis of QoL data was evaluated with a stratified Wilcoxon signed-rank test.ResultFifty patients enrolled. Survey completion ranged from 65% to 100% (median 88%) across timepoints. All patients had a Tenckhoff catheter, with 98% technical success. Median survival after PTDC was 38 days (95% confidence interval = 32, 57 days). European Organization for Research and Treatment of Cancer scores showed improvement in global QoL (p = 0.03) at 1 week postprocedure (PP). Significant symptom improvement was reported for fatigue, nausea/vomiting, pain, dyspnea, insomnia, and appetite at 1 week PP and was sustained at 3 weeks PP for dyspnea (p < 0.01), insomnia (p < 0.01), and appetite loss (p = 0.03). McGill Quality of Life demonstrated overall QoL improvement at 1 (p = 0.03) and 3 weeks (p = 0.04) PP. Decline in sodium and albumin values pre- and post-PTDC slowed significantly (albumin slope –0.43 to –0.26, p = 0.055; sodium slope –2.50 to 1.31, p = 0.04). Creatinine values increased at an accelerated pace post-PTDC (0.040 to 0.21, p < 0.01). Thirty-eight catheter-related complications occurred in 24 of 45 patients (53%).Significance of resultsQoL and symptoms improved after PTDC placement for refractory ascites in patients with end-stage malignancy. Decline in sodium and albumin values slowed postplacement. This study supports the use of a PTDC for palliation of refractory ascites in cancer patients.

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Quality of Life and Sexual Functioning After Vulvar Reconstruction With the Lotus Petal Flap

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001340 ◽

2018 ◽

Vol 28 (9) ◽

pp. 1728-1736 ◽

Cited By ~ 1

Author(s):

Joke Hellinga ◽

Nienke C. te Grootenhuis ◽

Paul M.N. Werker ◽

Geertruida H. de Bock ◽

Ate G.J. van der Zee ◽

...

Keyword(s):

Quality Of Life ◽

Sexual Functioning ◽

Life Questionnaire ◽

European Organization ◽

Healthy Women ◽

Vulvar Reconstruction ◽

Flap Procedure ◽

Lotus Petal Flap

ObjectiveResection of (pre) malignant lesions in the vulvoperineal area may result in large defects that cannot be closed primarily. The lotus petal flap technique is widely used for reconstruction. The aim of this study was to evaluate both quality of life (QoL) and sexual functioning of patients who underwent the lotus petal flap procedure, because no data are available on this topic.MethodsA cross-sectional study was performed on all eligible patients (N = 38) who underwent the lotus petal flap procedure between 2005 and 2016. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, Female Sexual Function Index, and Body Image Scale were used to evaluate QoL and sexual functioning. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Female Sexual Function Index scores were compared with scores of age-matched healthy women.ResultsTwenty-six patients (68%) responded. The mean (SD) age was 65.5 (16.3) years, and the median follow-up time was 38.5 months (range 16–141 months). Quality of life scores were lower compared with healthy women in the domains physical, role, and social functioning. Sexual activity rates were comparable with healthy women; however, sexual functioning was worse. Although patients were satisfied about their sexual life, pain was reported.ConclusionsPatients who underwent vulvar reconstructive surgery with lotus petal flaps seem to have a lower QoL compared with healthy women. Patients report more pain during sexual activity but are satisfied about their sexual functioning. These results should be included in preoperative counseling and follow-up of future patients eligible for vulvar reconstruction with a lotus petal flap.

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Symptoms and their implications on quality of life and psychological distress in sarcoma patients

Future Oncology ◽

10.2217/fon-2020-0572 ◽

2021 ◽

Vol 17 (7) ◽

pp. 817-823

Author(s):

Gabriella Maggi ◽

Irene Terrenato ◽

Luca Giacomelli ◽

Viviana Bifano ◽

Alessandra Gravili ◽

...

Keyword(s):

Quality Of Life ◽

Psychological Distress ◽

Life Questionnaire ◽

European Organization ◽

Quality Of Life Questionnaire ◽

Financial Difficulties ◽

Few Data ◽

Over Time

The aim of this study was to investigate symptoms, their variation over time and their relationship with quality of life (QoL)/psychological distress in sarcoma patients, as few data regarding QoL and psychological distress in this set of patients are currently available. A total of 188 sarcoma patients from an Italian referral center were involved. Symptoms and financial difficulties were evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire from the first treatment and over the follow-up period, up to 6 years. The authors found that patients with sarcoma experience several symptoms, especially fatigue and pain, which may dramatically worsen QoL and psychological distress. In conclusion, patients with sarcoma often experience fatigue, pain and financial difficulties, which negatively impacts QoL and psychological distress. To ameliorate overall QoL, proper control of symptoms is necessary.

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Assessment of quality of life in resectable gastric cancer patients undergoing chemoradiotherapy as adjuvant treatmentLetter to the Editor

South Asian Journal of Cancer ◽

10.4103/sajc.sajc_196_17 ◽

2018 ◽

Vol 07 (01) ◽

pp. 16-20 ◽

Cited By ~ 2

Author(s):

Deep Shankar Pruthi ◽

Mushtaq Ahmad ◽

Meenu Gupta ◽

Saurabh Bansal ◽

Vipul Nautiyal ◽

...

Keyword(s):

Quality Of Life ◽

Adjuvant Treatment ◽

Three Dimensional ◽

Conformal Radiotherapy ◽

Curative Intent ◽

European Organization ◽

Few Data ◽

Gastric Cancer Patients

Abstract Introduction: Quality of life (QOL) is increasingly recognized as an important endpoint in cancer therapies. However, few data are available on QOL in patients who have received radiotherapy as adjuvant treatment for cancer stomach. Methods: Thirty patients who underwent curative resection were enrolled and received chemoradiotherapy (45 Gy in 25 fractions using three-dimensional conformal radiotherapy technique), together with 5-fluorouracil and leucovorin. The European Organization for Research and Treatment of Cancer QOL questionnaire C30 and STO Q22 was assessed at four time points: pre- and postchemoradiotherapy and at 1-month and 6-month follow-up. Results: Mean age of the patients was 54 years. Male:female ratio was 4:1. Stage II and Stage III disease was present in 60% and 30% of patients, respectively. All patients were able to complete the chemoradiotherapy protocol. Our study found out significant impairment in QOL for emotional functioning, fatigue, nausea and vomiting and dyspnea. Results showed that QOL levels decrease postchemoradiotherapy; however, QOL levels returned to baseline at 1-month and 6-month follow-up period. Conclusion: Chemoradiotherapy as adjuvant treatment for cancer stomach patients who have undergone resection with curative intent is a safe and well-tolerated regimen with respect to QOL.

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Cathartic Effect of Suicide Attempts Not Limited to Depression

Crisis ◽

10.1027//0227-5910.24.2.73 ◽

2003 ◽

Vol 24 (2) ◽

pp. 73-78 ◽

Cited By ~ 21

Author(s):

Yves Sarfati ◽

Blandine Bouchaud ◽

Marie-Christine Hardy-Baylé

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Personality Traits ◽

Rating Scales ◽

Suicide Attempts ◽

World Health ◽

Life Questionnaire ◽

Short Term

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.

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