scholarly journals Gross tumor volume determines toxicity and quality of life for patients with nasopharyngeal carcinoma treated by concurrent chemoradiotherapy with simultaneously integrated boost technique

2020 ◽  
Author(s):  
Tai-Lin Huang ◽  
Hui-Ching Chuang ◽  
Chun-Chieh Huang ◽  
Chih-Yen Chien ◽  
Shau-Hsuan Li ◽  
...  

Abstract Background: To evaluate the impact of gross tumor volume (GTV) on toxicities and quality of life (QoL) for patients with nasopharyngeal carcinoma (NPC) treated by concurrent chemoradiotherapy with simultaneously integrated boost technique (chemo-SIB-IMRT). Methods: A total of 278 NPC patients with stage II-IVb treated by chemo-SIB-IMRT were enrolled. Toxicities were evaluated according to CTCAE version 4.03. QoL outcomes (n=219) were measured by using the EORTC QLQ-C30 and HN35 questionnaires at the time point of 12 months after chemo-SIB-IMRT. Results: A higher GTV was observed to be significantly associated with a higher mean or maximal dose in most organs at risk, together with more severe acute (mucositis, dermatitis, weight loss, and use of analgesic) and late toxicities (xerostomia, neck fibrosis, and radiation neuropathy). A linear regression model revealed that a higher GTV was significantly associated with a decline in role functioning and an increment in taste/smell, speech, social eating, opening mouth, dry mouth, and sticky saliva. Conclusion: GTV is the determining factor of some acute and late toxicities and QoL scales for NPC patients treated by chemo-SIB-IMRT.

Head & Neck ◽  
2018 ◽  
Vol 41 (5) ◽  
pp. 1282-1289 ◽  
Author(s):  
Fu‐Min Fang ◽  
Tai‐Lin Huang ◽  
Yun‐Hsuan Lin ◽  
Chih‐Yen Chien ◽  
Hui‐Ching Chuang ◽  
...  

Author(s):  
Albert Tuca Rodríguez ◽  
Miguel Núñez Viejo ◽  
Pablo Maradey ◽  
Jaume Canal-Sotelo ◽  
Plácido Guardia Mancilla ◽  
...  

Abstract Purpose The main aim of the study was to assess the impact of individualized management of breakthrough cancer pain (BTcP) on quality of life (QoL) of patients with advanced cancer in clinical practice. Methods A prospective, observational, multicenter study was conducted in patients with advanced cancer that were assisted by palliative care units. QoL was assessed with the EORTC QLQ-C30 questionnaire at baseline (V0) and after 28 days (V28) of individualized BTcP therapy. Data on background pain, BTcP, comorbidities, and frailty were also recorded. Results Ninety-three patients completed the study. Intensity, duration, and number of BTcP episodes were reduced (p < 0.001) at V28 with individualized therapy. Transmucosal fentanyl was used in 93.8% of patients, mainly by sublingual route. Fentanyl titration was initiated at low doses (78.3% of patients received doses of 67 μg, 100 μg, or 133 μg) according to physician evaluation. At V28, mean perception of global health status had increased from 31.1 to 53.1 (p < 0.001). All scales of EORTC QLQ-C30 significantly improved (p < 0.001) except physical functioning, diarrhea, and financial difficulties. Pain scale improved from 73.6 ± 22.6 to 35.7 ± 22.3 (p < 0.001). Moreover, 85.9% of patients reported pain improvement. Probability of no ≥ 25% improvement in QoL was significantly higher in patients ≥ 65 years old (OR 1.39; 95% CI 1.001–1.079) and patients hospitalized at baseline (OR 4.126; 95% CI 1.227–13.873). Conclusion Individualized BTcP therapy improved QoL of patients with advanced cancer. Transmucosal fentanyl at low doses was the most used drug. Trial registration This study was registered at ClinicalTrials.gov database (NCT02840500) on July 19, 2016.


Author(s):  
Cynthia S. Bonhof ◽  
Lonneke V. van de Poll-Franse ◽  
Dareczka K. Wasowicz ◽  
Laurens V. Beerepoot ◽  
Gerard Vreugdenhil ◽  
...  

Abstract Purpose To gain more insight into the course of chemotherapy-induced peripheral neuropathy (CIPN) and its impact on health-related quality of life (HRQoL) in a population-based sample of colorectal cancer (CRC) patients up to 2 years after diagnosis. Methods All newly diagnosed CRC patients from four hospitals in the Netherlands were eligible for participation in an ongoing prospective cohort study. Patients (n = 340) completed questions on CIPN (EORTC QLQ-CIPN20) and HRQoL (EORTC QLQ-C30) before initial treatment (baseline) and 1 and 2 years after diagnosis. Results Among chemotherapy-treated patients (n = 105), a high sensory peripheral neuropathy (SPN) level was reported by 57% of patients at 1 year, and 47% at 2-year follow-up, whereas a high motor peripheral neuropathy (MPN) level was reported by 47% and 28%, at years 1 and 2, respectively. Linear mixed model analyses showed that SPN and MPN symptoms significantly increased from baseline to 1-year follow-up and did not return to baseline level after 2 years. Patients with a high SPN or MPN level reported a worse global quality of life and a worse physical, role, emotional, cognitive, and social functioning compared with those with a low SPN or MPN level. Conclusions Future studies should focus on understanding the mechanisms underlying CIPN so targeted interventions can be developed to reduce the impact of CIPN on patient’s lives. Implications for cancer survivors Patients need to be informed of both CIPN and the impact on HRQoL.


2004 ◽  
Vol 22 (2) ◽  
pp. 354-360 ◽  
Author(s):  
Philippe Rauch ◽  
Joelle Miny ◽  
Thierry Conroy ◽  
Lionel Neyton ◽  
Francis Guillemin

Purpose To identify factors affecting the quality of life (QoL) of disease-free survivors of rectal cancer. Patients and Methods One hundred twenty-one patients in complete remission more than 2 years after diagnosis were asked to complete three QoL questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30; its colorectal module, QLQ-CR38; and the Duke generic instrument. Results Patients reported less pain (P = .002) than did controls drawn from the general population. EORTC QLQ-C30 physical scores were also higher among rectal cancer survivors than in the general Norwegian or German population (P = .0005 and P = .002, respectively). Unexpectedly, stoma patients reported better social functioning than did nonstoma patients (P = .005), with less anxiety (P = .008) and higher self-esteem (P = .0002). In the present authors' experience, the QLQ-CR38 does not discriminate between these groups. Residual abdominal or pelvic pain and constipation had the most negative influence on QoL. Conclusion QoL is high among rectal cancer survivors, including stoma patients. Simultaneous use of several QoL questionnaires appears to have value in follow-up and in monitoring the effects of therapy. The impact of residual pain and constipation on long-term QoL should be considered when establishing a treatment regimen.


2019 ◽  
Vol 76 (6) ◽  
pp. 598-606
Author(s):  
Jovica Milovanovic ◽  
Dragoslava Andrejic ◽  
Ana Jotic ◽  
Vojko Djukic ◽  
Oliver Toskovic ◽  
...  

Backround/Aim. Considering the distinct increase in the incidence of oropharyngeal cancer over oral cavity cancers and changing epidemiology with human papilloma virus (HPV) infection emerging as an important risk factor, there is a need to establish better treatment choices in specific groups of patients with oropharyngeal cancer. The aim of this study was to assess the quality of life (QOL) and functional performance and the impact of different demographical data, stage of disease, and treatment type on these parameters in patients with oropharyngeal cancer with successfully achieved locoregional control a year after the treatment. Methods. Study included 87 patients who underwent QOL and functional impairment assessment 12 to 14 months after finished oncological treatment with the following questionnaires: the European Organization for Research and Treatment of Cancer Quality-of Life-Questionnaire-C30 (EORTC QLQ-C30), European Organization for Research and Treatment of Cancer Quality of- Life Questionnaire-Head and Neck 35 (EORTC QLQ-H&N35) and The Karnofsky Performance Scale (KPS). Results. Specific groups of patients had significantly different post-treatment QOL scores. The factors associated with the worse QOL scores were female gender, not being in a partnership, level of education and HPV status. Conclusion. Clinicians should consider socioeconomic factors and HPV status in planning the recovery after treatment of patients with oropharyngeal carcinoma. Gender, education level and employment are the variables that form a certain risk profiles associated with the lower QOL.


2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 90-90
Author(s):  
Orazio Caffo ◽  
Teodoro Sava ◽  
Umberto Basso ◽  
Sebastiano Buti ◽  
Giovanni Lo Re ◽  
...  

90 Background: Eight consecutive courses of D are usually considered a standard first line treatment for CRPC pts. The pts quality of life (QL) may be worsened and an I administration could mitigate this effect. We verified if an I therapy may reduce the impact on pts’ QL compared to continuous (C) treatment. Methods: The treatment was D 70 mg/m2IV q 3 wks ± estramustine (E) 280 mg/TID PO for 5 days. Pts were randomized to receive 8 courses D±E continuously (C) or intermittently, with a 3-month rest period after the first 4 courses. QL was evaluated by EORTC QLQ C30 at baseline and every 6 weeks. For the study aim, we considered evaluable for QL pts who received at least 5 D±E courses and filled the QL instruments. Results: 148 CRPC pts were enrolled from 11/06 to 10/10 with 94 pts evaluable for QL (53 and 41 treated with I with C therapy, respectively). No statistically differences were observed between C and I treatments for QL outcomes: the table shows the median value of single EORTC QLQ C30 scales scores at each assessment time-point. Conclusions: The present study failed to demonstrate that I treatment may produce a QL advantage compared to C treatment which remains the reference therapy for first-line of CRPC pts. Clinical trial information: 2006-005728-17. [Table: see text]


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21607-e21607 ◽  
Author(s):  
Michal Chovanec ◽  
Lucia Vasilkova ◽  
Lucia Setteyova ◽  
Katarina Rejlekova ◽  
Jana Obertova ◽  
...  

e21607 Background: Testicular cancer (GCT) survivors are at risk for different types of late treatment sequelae. This study aimed to evaluate long-term quality of life (QOL), sexual (SexF) and cognitive functioning (CogF) issues resulting from cisplatin-based chemotherapy. Methods: QoL, SexF and CogF data were prospectively collected in 83 GCT survivors with median 9 year follow-up (range 5-32). The chemotherapy group (CTG) consisted of 53 and 18 patients receiving a cisplatin cumulative dose of ≤ 400mg/m2 (LCD) and > 400mg/m2 (HCD), respectively. The control group (CG) included 12 patients treated with orchiectomy (6 pts) and adjuvant radiotherapy (6 pts). Data were collected using EORTC QLQ-C30, QLQ-TC26, FACT-Cog and sexual functioning questionnaires and analyzed according to the scoring guidelines. Results:The CTG survivors had significantly (all p < 0.05) more limitations while working or doing daily activities (37% vs 8%), needed to rest more often (61% vs 33%) and feared the disease relapse more often (73% vs 50%) compared to the CG. A subscale for family problems within QLQ-TC26 have shown higher impairment in the CTG vs. CG (mean score ± SEM: 54.2 ± 26.7 vs. 38.8. ± 7.3, P < 0.05). Cognitive abilities were perceived better in CG vs. CTG (mean score 24.5 ± 1.8 vs. 20.5 ± 0.7, P < 0.05). The CG surivors had higher education level and fathered more children compared to the CTG. The CTG felt more unsettled than the CG (all P < 0.05), however the impact of perceived cognitive impairment on their lives did not significantly differ ( P = 0.4). Patients who received HCD have suffered from dyspnea more often than patients treated with LCD (mean dyspnea subscale score ± SEM: 22.2 ± 4.4 vs 8.9 ± 2.6, P < 0.05). The HCD group also reported more difficulties to concentrate while watching television/reading newspaper and struggled to name things during conversation compared with the LCD group ( P < 0.05 for both). No impairment in sexual functioning was reported. Conclusions: Our study shows thatGCT survivors cured with cisplatin-based chemotherapy suffered from QoL issues and their perception of cognitive abilities was altered. The HCD of cisplatin further impaired several QoL and cognitive aspects.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12092-12092
Author(s):  
Nandini Sharrel Menon ◽  
Vanita Noronha ◽  
Amit Joshi ◽  
Vijay Maruti Patil ◽  
Atanu Bhattacharjee ◽  
...  

12092 Background: This trial was conducted to compare the efficacy of low dose once-a-week cisplatin with once-every-3-weeks cisplatin with radiation in locally advanced head and neck squamous cell carcinoma (LAHNSCC). The current analysis focuses on the quality of life (QoL) of patients in this trial. Methods: In this phase III randomized trial, patients with stage III or IV non-metastatic LAHNSCC were randomized to receive cisplatin 30 mg/m2 once a week or cisplatin 100 mg/m2 once every 3 weeks concurrently with curative intent radiotherapy. The primary endpoint was locoregional control. QoL was a key secondary endpoint. QoL was assessed using the EORTC QLQ-C30 (v.3) and EORTC QLQ-H&N35 (v.1). QoL data were assessed at baseline and days 22 and 43 during treatment; at the end of chemoradiation and at each follow-up. The linear mixed effects model was used for longitudinal analysis of QoL domains to determine the impact of treatment (arm) and time on QoL scores. Results: Three hundred patients were enrolled, 150 in each arm. QoL data from 283 patients with at least one assessable questionnaire were analyzed. The pretreatment QoL scores were similar in both the arms in all domains. There was no significant difference in the global health status/QoL with respect to the treatment arm ( P =0.608) or time ( P=0.0544 ). There was no significant difference in the longitudinal QoL scores between the two treatment arms in all domains except the physical function ( P= .0074), constipation ( P= .0326), trouble with social contact ( P= .0321) and sexuality ( P= .0004). There was a decline in the QoL scores in all domains in both arms during treatment. After completion of treatment, the QoL scores started improving steadily up to 1 year and plateaued thereafter in both arms. Conclusions: The use of once-every-three weeks cisplatin significantly improved the locoregional control without adversely impacting the quality of life as compared to once-a-week cisplatin in combination with radical radiotherapy in locally advanced HNSCC. Clinical trial information: CTRI/2012/10/ 003062. .


2017 ◽  
Vol 51 (3) ◽  
pp. 342-350 ◽  
Author(s):  
Vaneja Velenik ◽  
Ajra Secerov-Ermenc ◽  
Jasna But-Hadzic ◽  
Vesna Zadnik

Abstract Background The aim of our study was to obtain reference data of the EORTC QLQ-C30 quality of life dimensions for the general Slovenian population. We intend to provide the researchers and clinicians in our country with the expected mean health-related quality of life (HRQL) scores for distinctive socio-demographic population groups. Methods The EORTC QLQ-C30 questionnaire supplemented by a socio-demographic inquiry was mailed or distributed to 1,685 randomly selected individuals in the Slovenian population aged 18 – 90. Answers from 1,231 subjects representing socio-demographic diversity of the Slovenian population were collected and transformed into EORTC dimensions and symptoms. The impact of socio-demographic features on HRQL scores was assessed by multiple linear regression models. Results Gender, age and self-rated social class are the important confounders in the quality of life scores in our population. Men reported better quality of life on the majority of the specific scales and, at the same time, reported fewer symptoms. There was no gender-specific difference in cognitive functioning. The mean scores were consistently lower with age in both sexes. Conclusions This is the first study to report the normative EORTC QLQ-C30 scores for one of the south-eastern European populations. The reported expected mean scores allow Slovenian oncologists to estimate what the quality of life in cancer patients would be, had they not been ill. As they are derived by common methodology, our results can easily be included in any further international comparisons or in the calculation of European summarized HRQL scores.


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