401
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Granger CL, Holland AE, Gordon IR, Denehy L. Minimal important difference of the 6-minute walk distance in lung cancer. Chron Respir Dis 2015; 12:146-54. [DOI: 10.1177/1479972315575715] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The 6-minute walk distance (6MWD) is one of the most commonly used measures of functional capacity in lung cancer, however, the minimal important difference (MID) has not been established. The aims of this exploratory study are, in lung cancer, to estimate (1) the MID of the 6MWD and (2) relationship between 6MWD, demographic and disease-related factors. Fifty-six participants with stage I–IV lung cancer completed the 6MWD prior to treatment and 10 weeks later. No exercise intervention occurred. Additional measures included European Organization for Research and Treatment of Cancer questionnaire (EORTC-QLQ-C30) and questionnaires assessing function, physical activity and symptoms. MID was calculated using anchor- and distribution-based methods. The mean 6MWD decline in participants classed as deteriorated was 60 m compared with 16 m in participants classed as not-deteriorated ( p = 0.01). The receiver operating curve indicated a cut-off value for clinically relevant change to be 42 m (95% confidence interval (CI) 6–75) (area under curve = 0.66, 95% CI 0.51–0.81) or a 9.5% change. Distribution-based methods indicated an MID between 22 m (95% CI 18–26) and 32 m (95% CI 20–42). Higher 6MWD correlated with better function ( r = −0.42, p = 0.001), physical activity ( r = 0.56, p < 0.005) and dyspnoea ( r = −0.44, p = 0.001). The MID for deterioration of the 6MWD in lung cancer is estimated to be between 22 m and 42 m or a change of 9.5%.
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Affiliation(s)
- Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia
- Department of Physiotherapy, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Institute for Breathing and Sleep, Austin Hospital, Heidelberg, Victoria, Australia
| | - Anne E Holland
- Institute for Breathing and Sleep, Austin Hospital, Heidelberg, Victoria, Australia
- Department of Physiotherapy, La Trobe University, Melbourne, Victoria, Australia
- Department of Physiotherapy, Alfred Hospital, Prahran, Victoria, Australia
| | - Ian R Gordon
- Statistical Consulting Centre, The University of Melbourne, Parkville, Victoria, Australia
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia
- Institute for Breathing and Sleep, Austin Hospital, Heidelberg, Victoria, Australia
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402
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Kirchheiner K, Nout RA, Czajka-Pepl A, Ponocny-Seliger E, Sturdza AE, Dimopoulos JC, Dörr W, Pötter R. Health related quality of life and patient reported symptoms before and during definitive radio(chemo)therapy using image-guided adaptive brachytherapy for locally advanced cervical cancer and early recovery — A mono-institutional prospective study. Gynecol Oncol 2015; 136:415-23. [DOI: 10.1016/j.ygyno.2014.10.031] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/17/2014] [Accepted: 10/28/2014] [Indexed: 01/22/2023]
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403
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Klafke N, Mahler C, von Hagens C, Rochon J, Schneeweiss A, Müller A, Salize HJ, Joos S. A complex nursing intervention of complementary and alternative medicine (CAM) to increase quality of life in patients with breast and gynecologic cancer undergoing chemotherapy: study protocol for a partially randomized patient preference trial. Trials 2015; 16:51. [PMID: 25887713 PMCID: PMC4337273 DOI: 10.1186/s13063-014-0538-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 12/19/2014] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) is most adversely affected in cancer patients between diagnosis and the end of chemotherapy. The aim of the Complementary Nursing in Gynecologic Oncology (CONGO) study is to assess the effectiveness of a complex nursing care intervention of CAM to increase HRQoL in cancer patients undergoing chemotherapy. METHODS/DESIGN CONGO is a prospective partially randomized patient preference (PRPP) trial including adult women diagnosed with breast and gynecologic cancer starting a new chemotherapy regimen. Patients without strong preferences for CAM will be randomized to usual nursing care or complex nursing care; those patients with strong preferences will be allowed their choice. The intervention consists of three interacting and intertwined elements: CAM nursing intervention packet, counseling on CAM using a resource-oriented approach and evidence-based informational material on CAM. Primary outcome data on participants' HRQoL will be collected from baseline until the end of treatment and long-term follow-up using the EORTC-QLQ-C30. Secondary outcomes include nausea, fatigue, pain, anxiety/depression, social support, self-efficacy, patient competence, spiritual wellbeing, and satisfaction with care. Accompanying research on economic outcomes as well as a mixed-methods process evaluation will be conducted. A total of 590 patients (236 patients in the randomized part of the study and 354 patients in the observational part of the study) will be recruited in the two outpatient clinics. The first analysis step will be the intention-to-treat (ITT) analysis of the randomized part of the trial. A linear mixed model will be used to compare the continuous primary endpoint between the intervention and control arm of the randomized group. The observational part of the trial will be analyzed descriptively. External validity will be assessed by comparing randomized with nonrandomized patients. DISCUSSION Cancer patients are increasingly using CAM as supportive cancer care, however, a patient-centered model of care that includes CAM for the patient during chemotherapy still needs to be evaluated. This protocol has been designed to test if the effects of the intervention go beyond potential benefits in quality-of-life outcomes. TRIAL REGISTRATION German Clinical Trials Register (DRKS), DRKS00006056 (15 April 2014).
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Affiliation(s)
- Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Voßstr. 2, D-69115, Heidelberg, Germany.
| | - Cornelia Mahler
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Voßstr. 2, D-69115, Heidelberg, Germany.
| | - Cornelia von Hagens
- Department of Gynaecological Endocrinology and Reproductive Medicine, University Women's Hospital Heidelberg, Im Neuenheimer Feld 440, D-69120, Heidelberg, Germany.
| | - Justine Rochon
- Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, D-69120, Heidelberg, Germany.
| | - Andreas Schneeweiss
- National Center for Tumor Diseases, University Hospital, Im Neuenheimer Feld 460, D-69120, Heidelberg, Germany.
| | - Andreas Müller
- Community Hospital Karlsruhe, Moltkestraße 90, D-76133, Karlsruhe, Germany.
| | - Hans-Joachim Salize
- Central Institute of Mental Health, Mental Health Services Research Group, Medical Faculty Mannheim/Heidelberg University, Mannheim, D-68159, Germany.
| | - Stefanie Joos
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Voßstr. 2, D-69115, Heidelberg, Germany. .,Institute of General Practice, University Hospital Tuebingen, Oesterbergstr. 9, D-72074, Tuebingen, Germany.
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404
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Eckhoff L, Knoop AS, Jensen MB, Ewertz M. Persistence of docetaxel-induced neuropathy and impact on quality of life among breast cancer survivors. Eur J Cancer 2015; 51:292-300. [DOI: 10.1016/j.ejca.2014.11.024] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 10/15/2014] [Accepted: 11/27/2014] [Indexed: 01/17/2023]
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405
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The impact of age on changes in quality of life among breast cancer survivors treated with breast-conserving surgery and radiotherapy. Br J Cancer 2015; 112:636-43. [PMID: 25602967 PMCID: PMC4333491 DOI: 10.1038/bjc.2014.632] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 11/13/2014] [Accepted: 11/30/2014] [Indexed: 11/12/2022] Open
Abstract
Background: The purpose of the study was to determine the impact of young age on health-related quality of life (HRQoL) by comparing HRQoL of younger and older breast cancer patients, corrected for confounding, and of young patients and a general Dutch population. Methods: The population consisted of breast cancer survivors (stage 0-III) after breast-conserving surgery and radiotherapy. Health-related quality of life was prospectively assessed using the EORTC QLQ-C30 and QLQ-BR23 questionnaires. The association between age (⩽50; 51–70; ⩾70 years) and HRQoL over time was analysed with mixed modelling. The clinical relevance of differences between/within age groups was estimated with Cohen's D and consensus-based guidelines. The HRQoL data from the young patient cohort were compared with Dutch reference data at 3 years after radiotherapy. Results: A total of 1420 patients completed 3200 questionnaires. Median follow-up was 34 (range 6–70) months. Median age was 59 (range 28–85) years. Compared with older subjects, young women reported worse HRQoL in the first year after radiotherapy, but clinical relevance was limited. Three years after radiotherapy, HRQoL values in the younger group were equal to those in the reference population. Pain and fatigue after radiotherapy improved, with medium clinical relevance. Conclusions: Three years after radiotherapy for breast cancer, young age was not a risk factor for decreased HRQoL.
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406
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Psychological distress, quality of life, symptoms and unmet needs of colorectal cancer survivors near the end of treatment. J Cancer Surviv 2015; 9:462-70. [DOI: 10.1007/s11764-014-0422-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 12/17/2014] [Indexed: 01/05/2023]
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407
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Husson O, Mols F, Ezendam NPM, Schep G, van de Poll-Franse LV. Health-related quality of life is associated with physical activity levels among colorectal cancer survivors: a longitudinal, 3-year study of the PROFILES registry. J Cancer Surviv 2015; 9:472-80. [DOI: 10.1007/s11764-014-0423-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 12/17/2014] [Indexed: 12/26/2022]
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408
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Stewart AK, Rajkumar SV, Dimopoulos MA, Masszi T, Špička I, Oriol A, Hájek R, Rosiñol L, Siegel DS, Mihaylov GG, Goranova-Marinova V, Rajnics P, Suvorov A, Niesvizky R, Jakubowiak AJ, San-Miguel JF, Ludwig H, Wang M, Maisnar V, Minarik J, Bensinger WI, Mateos MV, Ben-Yehuda D, Kukreti V, Zojwalla N, Tonda ME, Yang X, Xing B, Moreau P, Palumbo A. Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma. N Engl J Med 2015; 372:142-52. [PMID: 25482145 DOI: 10.1056/nejmoa1411321] [Citation(s) in RCA: 996] [Impact Index Per Article: 110.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Lenalidomide plus dexamethasone is a reference treatment for relapsed multiple myeloma. The combination of the proteasome inhibitor carfilzomib with lenalidomide and dexamethasone has shown efficacy in a phase 1 and 2 study in relapsed multiple myeloma. METHODS We randomly assigned 792 patients with relapsed multiple myeloma to carfilzomib with lenalidomide and dexamethasone (carfilzomib group) or lenalidomide and dexamethasone alone (control group). The primary end point was progression-free survival. RESULTS Progression-free survival was significantly improved with carfilzomib (median, 26.3 months, vs. 17.6 months in the control group; hazard ratio for progression or death, 0.69; 95% confidence interval [CI], 0.57 to 0.83; P=0.0001). The median overall survival was not reached in either group at the interim analysis. The Kaplan-Meier 24-month overall survival rates were 73.3% and 65.0% in the carfilzomib and control groups, respectively (hazard ratio for death, 0.79; 95% CI, 0.63 to 0.99; P=0.04). The rates of overall response (partial response or better) were 87.1% and 66.7% in the carfilzomib and control groups, respectively (P<0.001; 31.8% and 9.3% of patients in the respective groups had a complete response or better; 14.1% and 4.3% had a stringent complete response). Adverse events of grade 3 or higher were reported in 83.7% and 80.7% of patients in the carfilzomib and control groups, respectively; 15.3% and 17.7% of patients discontinued treatment owing to adverse events. Patients in the carfilzomib group reported superior health-related quality of life. CONCLUSIONS In patients with relapsed multiple myeloma, the addition of carfilzomib to lenalidomide and dexamethasone resulted in significantly improved progression-free survival at the interim analysis and had a favorable risk-benefit profile. (Funded by Onyx Pharmaceuticals; ClinicalTrials.gov number, NCT01080391.).
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409
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Eyles C, Leydon GM, Hoffman CJ, Copson ER, Prescott P, Chorozoglou M, Lewith G. Mindfulness for the self-management of fatigue, anxiety, and depression in women with metastatic breast cancer: a mixed methods feasibility study. Integr Cancer Ther 2015; 14:42-56. [PMID: 25161198 PMCID: PMC4390604 DOI: 10.1177/1534735414546567] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The impact of living with metastatic breast cancer (MBC) is considerable and psychosocial support can be beneficial. Mindfulness-based stress reduction (MBSR) can help self-management of anxiety, depression, quality of life (QoL), and fatigue and has been evaluated in early-stage breast cancer but not MBC. This study investigated the acceptability and feasibility of providing MBSR for women with MBC and of introducing MBSR into a National Health Service (NHS) setting. A mixed methods convergent design was used. Eligible women with MBC, an Eastern Cooperative Oncology Group (ECOG) score of 0 to 2, stable disease, and life expectancy of at least 6 months were invited to attend (by their oncologist) an 8-week MBSR course. Qualitative interviews with patients, a focus group, and interview with NHS staff were held to explore acceptability and feasibility of MBSR. Questionnaires at baseline, during (weeks 4, 8), and after (weeks 16, 24) the course measured fatigue, anxiety and depression, mindfulness, disease-specific QoL, and generic preference based QoL. Of 100 women approached, 20 joined the study. One woman dropped out prior to the intervention due to illness progression. Nineteen women took part in 3 MBSR courses. Recruitment to 2 of the 3 courses was slow. Commitment to 8 weeks was a reason for non-participation, and proved challenging to participants during the course. Participants found the course acceptable and reported many cumulative and ongoing benefits. These included feeling less reactive to emotional distress and more accepting of the disruption to life that occurs with living with MBC. There was high attendance, completion of course sessions, adherence to home practice, excellent follow-up rates, and high questionnaire return rates. MBSR was acceptable to MBC patients, who perceived benefits such as improved anxiety and QoL; but the MBSR course requires a considerable time commitment. There is scope to tailor the intervention so that it is less intensive.
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410
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Schmidt ME, Wiskemann J, Armbrust P, Schneeweiss A, Ulrich CM, Steindorf K. Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: A randomized controlled trial. Int J Cancer 2014; 137:471-80. [DOI: 10.1002/ijc.29383] [Citation(s) in RCA: 150] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 11/24/2014] [Indexed: 12/27/2022]
Affiliation(s)
- Martina E. Schmidt
- Division of Preventive Oncology; National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Joachim Wiskemann
- Division of Medical Oncology; National Center for Tumor Diseases (NCT) and University Hospital Heidelberg; Heidelberg Germany
| | - Petra Armbrust
- Division of Medical Oncology; National Center for Tumor Diseases (NCT) and University Hospital Heidelberg; Heidelberg Germany
| | - Andreas Schneeweiss
- Division of Medical Oncology; National Center for Tumor Diseases (NCT) and University Hospital Heidelberg; Heidelberg Germany
| | - Cornelia M. Ulrich
- Division of Preventive Oncology; National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Karen Steindorf
- Division of Preventive Oncology; National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ); Heidelberg Germany
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411
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van der Poel MWM, Oerlemans S, Schouten HC, van de Poll-Franse LV. Elderly multiple myeloma patients experience less deterioration in health-related quality of life than younger patients compared to a normative population: a study from the population-based PROFILES registry. Ann Hematol 2014; 94:651-61. [DOI: 10.1007/s00277-014-2264-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 11/22/2014] [Indexed: 01/25/2023]
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412
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Griebsch I, Palmer M, Fayers PM, Ellis S. Is progression-free survival associated with a better health-related quality of life in patients with lung cancer? Evidence from two randomised trials with afatinib. BMJ Open 2014; 4:e005762. [PMID: 25361836 PMCID: PMC4216861 DOI: 10.1136/bmjopen-2014-005762] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Progression-free survival (PFS) is frequently used as an efficacy end point in oncology clinical trials. However, there is limited evidence to support a positive association between improvement in PFS and improvement in health-related quality of life (HRQoL). The association between PFS and HRQoL was evaluated in two randomised trials. MATERIALS AND METHODS Data from two randomised controlled trials in patients with non-small cell lung cancer (NSCLC; LUX-Lung 1 and LUX-Lung 3) were used to investigate HRQoL in patients to determine whether tumour progression is accompanied by worsening HRQoL. HRQoL was assessed using the cancer-specific European Organization for Research and Treatment of Cancer (EORTC) core questionnaire QLQ-C30, the EuroQol EQ-5D overall utility and EuroQol EQ visual analogue scale. In both studies, progression was evaluated by independent review using RECIST criteria (primary end point) and also by investigator assessment. The relationship between tumour progression and HRQoL was evaluated using analysis of covariance and a longitudinal model. RESULTS Compliance with HRQoL questionnaire completion was high. In both studies, patients with progression consistently experienced numerically poorer HRQoL at the time of progression than patients without progression. Differences in mean scores were statistically significant (p<0.05) between patients with and without progression at week 4 in all analyses in LUX-Lung 1 and at multiple time points in LUX-Lung 3. Results from the longitudinal analysis showed that progression (by independent review and investigator assessment) appears to have consistent negative impact on all three HRQoL measures (all p<0.0001). CONCLUSIONS Tumour progression in patients with NSCLC was associated with statistically significant worsening in HRQoL. These findings confirm the value of PFS as a patient-relevant end point.
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Affiliation(s)
| | | | - Peter M Fayers
- Institute of Applied Health Sciences, University of Aberdeen, Scotland, UK
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Stuart Ellis
- Independent Statistical Consultant, Cheshire, UK
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413
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Adamson D, Blazeby J, Nelson A, Hurt C, Nixon L, Fitzgibbon J, Crosby T, Staffurth J, Evans M, Kelly NH, Cohen D, Griffiths G, Byrne A. Palliative radiotherapy in addition to self-expanding metal stent for improving dysphagia and survival in advanced oesophageal cancer (ROCS: Radiotherapy after Oesophageal Cancer Stenting): study protocol for a randomized controlled trial. Trials 2014; 15:402. [PMID: 25336193 PMCID: PMC4223756 DOI: 10.1186/1745-6215-15-402] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 10/01/2014] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The single most distressing symptom for patients with advanced esophageal cancer is dysphagia. Amongst the more effective treatments for relief of dysphagia is insertion of a self-expanding metal stent (SEMS). It is possible that the addition of a palliative dose of external beam radiotherapy may prolong the relief of dysphagia and provide additional survival benefit. The ROCS trial will assess the effect of adding palliative radiotherapy after esophageal stent insertion. METHODS/DESIGN The study is a randomized multicenter phase III trial, with an internal pilot phase, comparing stent alone versus stent plus palliative radiotherapy in patients with incurable esophageal cancer. Eligible participants are those with advanced esophageal cancer who are in need of stent insertion for primary management of dysphagia. Radiotherapy will be administered as 20 Gray (Gy) in five fractions over one week or 30 Gy in 10 fractions over two weeks, within four weeks of stent insertion. The internal pilot will assess rates and methods of recruitment; pre-agreed criteria will determine progression to the main trial. In total, 496 patients will be randomized in a 1:1 ratio with follow up until death. The primary outcome is time to progression of patient-reported dysphagia. Secondary outcomes include survival, toxicity, health resource utilization, and quality of life. An embedded qualitative study will explore the feasibility of patient recruitment by examining patients' motivations for involvement and their experiences of consent and recruitment, including reasons for not consenting. It will also explore patients' experiences of each trial arm. DISCUSSION The ROCS study will be a challenging trial studying palliation in patients with a poor prognosis. The internal pilot design will optimize methods for recruitment and data collection to ensure that the main trial is completed on time. As a pragmatic trial, study strengths include collection of all follow-up data in the usual place of care, and a focus on patient-reported, rather than disease-orientated, outcomes. Exploration of patient experience and health economic analyses will be integral to the assessment of benefit for patients and the NHS. TRIAL REGISTRATION The trial was registered with Current Controlled Trials (registration number: ISRCTN12376468) on 10 July 2012.
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Affiliation(s)
- Douglas Adamson
- />Tayside Cancer Centre, Ward 32, Ninewells Hospital, Dundee, DD1 9SY UK
| | - Jane Blazeby
- />School of Social & Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| | - Annmarie Nelson
- />Marie Curie Palliative Care Research Centre, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, 1st Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Chris Hurt
- />Wales Cancer Trials Unit, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, 6th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Lisette Nixon
- />Wales Cancer Trials Unit, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, 6th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Jim Fitzgibbon
- />Wales Cancer Trials Unit, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, 6th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Tom Crosby
- />Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, CF14 2TL UK
| | - John Staffurth
- />Institute of Cancer and Genetics, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, CF14 4XW UK
| | - Mim Evans
- />National Institute for Social Care and Health Research (NISCHR), Clinical Research Centre, 3rd Floor 12 Cathedral Road, Cardiff, CF11 9LJ UK
| | - Noreen Hopewell Kelly
- />Marie Curie Palliative Care Research Centre, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, 1st Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - David Cohen
- />NISCHR Welsh Health Economics Support Service, University of South Wales, Pontypridd, CF37 1DL UK
| | - Gareth Griffiths
- />University of Southampton Clinical Trials Unit, MP 131, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UK
| | - Anthony Byrne
- />Marie Curie Palliative Care Research Centre, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, 1st Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
- />Wales Cancer Trials Unit, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, 6th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
- />Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, CF14 2TL UK
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414
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The relationship between economic characteristics and health-related quality of life in newly diagnosed cancer patients in Southeast Asia: results from an observational study. Qual Life Res 2014; 24:937-49. [DOI: 10.1007/s11136-014-0828-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2014] [Indexed: 12/01/2022]
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415
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Efficace F, Mandelli F, Avvisati G, Cottone F, Ferrara F, Di Bona E, Specchia G, Breccia M, Levis A, Sica S, Finizio O, Kropp MG, Fioritoni G, Cerqui E, Vignetti M, Amadori S, Schlenk RF, Platzbecker U, Lo-Coco F. Randomized Phase III Trial of Retinoic Acid and Arsenic Trioxide Versus Retinoic Acid and Chemotherapy in Patients With Acute Promyelocytic Leukemia: Health-Related Quality-of-Life Outcomes. J Clin Oncol 2014; 32:3406-12. [DOI: 10.1200/jco.2014.55.3453] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose A randomized clinical trial compared efficacy and toxicity of standard all-trans-retinoic acid (ATRA) plus chemotherapy versus ATRA plus arsenic trioxide in patients with newly diagnosed, low- or intermediate-risk acute promyelocytic leukemia (APL). Here, we report health-related quality-of-life (HRQOL) results. Patients and Methods HRQOL was a secondary end point of this trial. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 was used to assess HRQOL at end of induction and after consolidation therapy. All analyses were based on 156 patients who received at least one dose of treatment, with groups defined according to randomly assigned treatment. Primary analysis was performed, estimating mean HRQOL score over time and differences between treatment arms using a linear mixed model. Results Overall, 162 patients age 18 to 70 years were enrolled. Of these, 150 and 142 patients were evaluable for HRQOL after induction therapy and third consolidation course, respectively. Overall compliance with HRQOL forms was 80.1%. The largest difference, favoring patients treated with ATRA plus arsenic trioxide, was found for fatigue severity (mean score difference, −9.3; 95% CI, −17.8 to −0.7; P = .034) at end of induction therapy. This difference was also clinically relevant. HRQOL differences between treatment arms at end of consolidation showed that for several scales, differences between treatment arms were marginal. Conclusion Overall, current HRQOL findings further support the use of ATRA plus arsenic trioxide as preferred first-line treatment in patients with low- or intermediate-risk APL.
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Affiliation(s)
- Fabio Efficace
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Franco Mandelli
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Giuseppe Avvisati
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Francesco Cottone
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Felicetto Ferrara
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Eros Di Bona
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Giorgina Specchia
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Massimo Breccia
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Alessandro Levis
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Simona Sica
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Olimpia Finizio
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Maria Grazia Kropp
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Giuseppe Fioritoni
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Elisa Cerqui
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Marco Vignetti
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Sergio Amadori
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Richard F. Schlenk
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Uwe Platzbecker
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
| | - Francesco Lo-Coco
- Fabio Efficace, Franco Mandelli, Francesco Cottone, and Marco Vignetti, Gruppo Italiano Malattie Ematologiche dell'Adulto; Giuseppe Avvisati, Università Campus Biomedico; Massimo Breccia, Università “La Sapienza,”; Simona Sica, Università Cattolica Sacro Cuore; Sergio Amadori and Francesco Lo-Coco, Università Tor Vergata; Francesco Lo-Coco, Fondazione Santa Lucia, Roma; Felicetto Ferrara, Ospedale Cardarelli; Olimpia Finizio, Ospedale Cardarelli, Napoli; Eros Di Bona, Ospedale San Bortolo, Vicenza
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416
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Ezendam NPM, Pijlman B, Bhugwandass C, Pruijt JFM, Mols F, Vos MC, Pijnenborg JMA, van de Poll-Franse LV. Chemotherapy-induced peripheral neuropathy and its impact on health-related quality of life among ovarian cancer survivors: results from the population-based PROFILES registry. Gynecol Oncol 2014; 135:510-7. [PMID: 25281491 DOI: 10.1016/j.ygyno.2014.09.016] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/19/2014] [Accepted: 09/25/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study assessed the prevalence and risk factors of chemotherapy-induced peripheral neuropathy, and its impact on health-related quality of life among ovarian cancer survivors, 2-12 years after diagnosis. METHODS Women (n=348) diagnosed with ovarian cancer between 2000 and 2010, as registered by the Dutch population-based Eindhoven Cancer Registry, were eligible for participation. A questionnaire, including the EORTC QLQ-C30 and EORTC QLQ-OV28 measures, containing 3 items about neuropathy, was returned by 191 women (55%). Recurrence and chemotherapy data were obtained from medical records. RESULTS Of all 191 women, the 129 women who received chemotherapy more often reported having tingling hands/feet and feeling numbness in fingers/toes, specifically 51% reported "a little" to "very much" of these symptoms vs. about 27% who did not receive chemotherapy. Women reporting more neuropathy symptoms reported lower levels of functioning and overall quality of life. They also reported more symptoms of fatigue, nausea/vomiting, pain, dyspnea, insomnia, appetite loss, and financial problems. Moreover, women reporting more neuropathy symptoms had experienced the disease and treatment more often as being a burden and were more worried about their health, had more gastrointestinal and hormonal symptoms, hair loss and more other chemotherapy side effects. Linear regression analyses showed that more cycles of chemotherapy, more recurrences and a shorter period since last treatment were associated with a higher neuropathy score. CONCLUSION Neuropathy symptoms were experienced by 51% of women with ovarian cancer who received chemotherapy even up to 12 years after the end of treatment, and this seriously affected their HRQoL.
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Affiliation(s)
- Nicole P M Ezendam
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands; Eindhoven Cancer Registry, Comprehensive Cancer Center the Netherlands, The Netherlands.
| | - Brenda Pijlman
- Department of Obstetrics and Gynecology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
| | - Celine Bhugwandass
- Department of Obstetrics and Gynecology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
| | - Johannes F M Pruijt
- Department of Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
| | - Floortje Mols
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands; Eindhoven Cancer Registry, Comprehensive Cancer Center the Netherlands, The Netherlands.
| | - M Caroline Vos
- Department of Obstetrics and Gynecology, Elisabeth Tweesteden Hospital, Tilburg and Waalwijk, The Netherlands.
| | - Johanna M A Pijnenborg
- Department of Obstetrics and Gynecology, Elisabeth Tweesteden Hospital, Tilburg and Waalwijk, The Netherlands.
| | - Lonneke V van de Poll-Franse
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands; Eindhoven Cancer Registry, Comprehensive Cancer Center the Netherlands, The Netherlands.
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417
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Husson O, Mols F, Fransen MP, van de Poll-Franse LV, Ezendam NPM. Low subjective health literacy is associated with adverse health behaviors and worse health-related quality of life among colorectal cancer survivors: results from the profiles registry. Psychooncology 2014; 24:478-86. [DOI: 10.1002/pon.3678] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 08/12/2014] [Accepted: 08/18/2014] [Indexed: 01/10/2023]
Affiliation(s)
- O. Husson
- CoRPS-Center of Research on Psychology in Somatic diseases; Department of Medical and Clinical Psychology; Tilburg University; Tilburg the Netherlands
- Comprehensive Cancer Centre Netherlands South; Eindhoven Cancer Registry; Eindhoven the Netherlands
| | - F. Mols
- CoRPS-Center of Research on Psychology in Somatic diseases; Department of Medical and Clinical Psychology; Tilburg University; Tilburg the Netherlands
- Comprehensive Cancer Centre Netherlands South; Eindhoven Cancer Registry; Eindhoven the Netherlands
| | - M. P. Fransen
- Department of Public Health; Academic Medical Centre; University of Amsterdam; Amsterdam the Netherlands
| | - L. V. van de Poll-Franse
- CoRPS-Center of Research on Psychology in Somatic diseases; Department of Medical and Clinical Psychology; Tilburg University; Tilburg the Netherlands
- Comprehensive Cancer Centre Netherlands South; Eindhoven Cancer Registry; Eindhoven the Netherlands
| | - N. P. M. Ezendam
- CoRPS-Center of Research on Psychology in Somatic diseases; Department of Medical and Clinical Psychology; Tilburg University; Tilburg the Netherlands
- Comprehensive Cancer Centre Netherlands South; Eindhoven Cancer Registry; Eindhoven the Netherlands
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418
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Daniëls LA, Krol SD, de Graaf MA, Scholte AJ, van ’t Veer MB, Putter H, de Roos A, Schalij MJ, van de Poll-Franse LV, Creutzberg CL. Impact of Cardiovascular Counseling and Screening in Hodgkin Lymphoma Survivors. Int J Radiat Oncol Biol Phys 2014; 90:164-71. [DOI: 10.1016/j.ijrobp.2014.05.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/30/2014] [Accepted: 05/05/2014] [Indexed: 11/24/2022]
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419
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Impact of active surveillance, chlorambucil, and other therapy on health-related quality of life in patients with CLL/SLL in the Netherlands. Ann Hematol 2014; 94:45-56. [PMID: 25038918 DOI: 10.1007/s00277-014-2161-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 07/02/2014] [Indexed: 11/12/2022]
Abstract
As survival of patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) increases and the number of patients who live long rises, health-related quality of life (HRQoL) becomes a relevant endpoint. Few studies investigated this, mainly as a secondary endpoint in randomized clinical trials where patients with early stage CLL/SLL, and elderly/frail patients were underrepresented. The aim of our study was to assess HRQoL in a population-based setting, including these previously underrepresented patients. Out of 175 patients diagnosed with CLL/SLL between 2004 and 2011, 136 (78 %) returned the HRQoL questionnaire. The outcomes were compared to an age- and sex-matched norm population. Detailed data on stage and treatment were extracted from a population-based hematological registry (PHAROS). Patients ever treated for CLL/SLL reported significantly poorer HRQoL than the norm population (p < 0.01 with large clinically important differences. Interestingly, no differences were observed between the norm population and patients under active surveillance. In contrast to our hypothesis, patients treated with chlorambucil reported the lowest HRQoL scores. Drastic, long-lasting negative effects of starting treatment on HRQoL cannot be excluded, whereas active surveillance does not seem to provoke worrying, anxiety, or depressive symptoms. Further elaborate research into the impact of starting therapy on HRQoL is needed, especially in patients that are underrepresented in most clinical trials, and thoroughly consider its results during revision of treatment guidelines.
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420
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Husson O, Oerlemans S, Mols F, Smeets REH, Poortmans PM, van de Poll-Franse LV. Satisfaction with information provision is associated with baseline but not with follow-up quality of life among lymphoma patients: Results from the PROFILES registry. Acta Oncol 2014; 53:917-26. [PMID: 24456497 DOI: 10.3109/0284186x.2013.879201] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Appropriate information provision is an important determinant of patient satisfaction and might also affect health-related quality of life (HRQoL) of cancer patients. The aim of this study was to examine the relationship between perceived information provision at baseline and HRQoL, anxiety and depression among lymphoma patients two years later. MATERIAL AND METHODS This study is part of a longitudinal, population-based survey among all lymphoma patients diagnosed between 1999 and 2009 as registered in the Eindhoven Cancer Registry (southern part of The Netherlands). Patients between six months and 10 years after diagnoses received the first questionnaire including the EORTC QLQ-INFO25, EORTC QLQ-C30 and HADS at baseline (T1) and the second two years later (T2). All analyses are stratified for time since diagnosis (< 2 and ≥ 2 years since diagnosis). RESULTS At baseline 69% of the patients (n = 1186) responded, at T2 355 (30%) patients responded. For patients < 2 years since diagnosis, receiving more medical test information was associated with higher levels of cognitive functioning (ß = 0.46; p = 0.04) and lower levels of anxiety (ß = -0.41; p = 0.04) at baseline, no prospective relationships were found. For patients ≥ 2 years since diagnosis, receiving more medical test information (ß = 0.20; p = 0.03) was associated with better emotional functioning, while receiving more treatment information was associated with worse emotional functioning (ß = -0.21; p = 0.04). Among this group, satisfaction with the received information was associated with better functioning (ß ranging from -0.15 to -0.33; all p < 0.05) at baseline, and these relationships remained significant prospectively for physical (ß = -0.13; p = 0.02) and emotional functioning (ß = -0.13; p = 0.04) only. Stability of satisfaction with received information over time was associated with better emotional (ß = -0.13) and better cognitive functioning (ß = -0.09; p < 0.05) at T2. CONCLUSION The present study showed that satisfaction with received information among lymphoma patients was associated with better HRQoL at baseline (only for patients ≥ 2 years since diagnosis), but not at follow-up when corrected for baseline HRQoL.
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Affiliation(s)
- O Husson
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University , The Netherlands
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421
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Thaysen HV, Jess P, Rasmussen PC, Nielsen MB, Laurberg S. Health-related quality of life after surgery for advanced and recurrent rectal cancer: a nationwide prospective study. Colorectal Dis 2014; 16:O223-33. [PMID: 24373460 DOI: 10.1111/codi.12551] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 12/07/2013] [Indexed: 12/12/2022]
Abstract
AIM Advances in the treatment of rectal cancer have made it possible to perform complex rectal cancer surgery (COMP-RCS) in patients with primary advanced rectal cancer penetrating beyond the total mesorectal excision planes and in patients with locally recurrent rectal cancer. The aim of this study was to examine health-related quality of life (HRQoL) before and during the first 2 years after COMP-RCS. METHOD Between 2001 and 2008, 180 patients were treated with COMP-RCS at Aarhus University Hospital. HRQoL was assessed preoperatively and 3, 6, 12, 18 and 24 months after surgery using three questionnaires. The results were compared with those for patients treated with standard rectal cancer surgery (STAN-RCS) and with data from the general Danish population (NORM-data). RESULTS One hundred and twenty-two (68%) patients responded to the questionnaires. Of these 80 (66%) with disease-free survival for 2 years after surgery were included in the main analysis. The lowest level of functioning and the highest degree of symptoms were reported preoperatively. The majority of the HRQoL scales improved or remained stable during the first postoperative year; a decrease was observed for body image only. One year after surgery, HRQoL in patients treated with COMP-RSC was comparable to that for patients treated with STAN-RCS. Lower levels were found for physical and emotional role functioning, compared with NORM-data. CONCLUSION Patients treated with COMP-RCS experienced improvement in HRQoL in the first year after surgery. One year after surgery, HRQoL was similar to that of patients treated with STAN-RCS. Compared with NORM-data, lower levels were found for physical and emotional role functioning.
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Affiliation(s)
- H V Thaysen
- Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark
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422
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The individual and combined effect of colorectal cancer and diabetes on health-related quality of life and sexual functioning: results from the PROFILES registry. Support Care Cancer 2014; 22:3071-9. [PMID: 24947055 DOI: 10.1007/s00520-014-2292-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 05/15/2014] [Indexed: 01/10/2023]
Abstract
PURPOSE This study examined the individual and combined effect of having colorectal cancer (CRC) and diabetes mellitus (DM) on health-related quality of life (HRQoL) and sexual functioning. METHODS Data from questionnaires collected in 2010 among CRC patients and a sample of the general Dutch population were used. All persons older than 60 years were included in this study. DM prevalence among the CRC sample as well as the sample of the general population was self-reported. HRQoL was measured using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire version 3.0 (QLQ-C30), and sexual functioning was assessed with four scales from the EORTC-QLQ-CR38. RESULTS In total 624 persons without CRC and DM, 78 persons with DM only, 1,731 with CRC only, and 328 with both CRC and DM were included. Having both CRC and DM did not result in lower HRQoL and sexual functioning than the sum of the individual effects of both diseases. CRC, irrespective of having DM, was associated with lower scores on most EORTC-QLQ-C30 subscales, except global health, pain, and appetite loss. CRC was also independently associated with more erection problems among males. DM, irrespective of having CRC, was associated with lower physical functioning and more symptoms of dyspnea. CONCLUSIONS Having both CRC and DM did not result in lower HRQoL and sexual functioning than the sum of the individual effects of both diseases. As CRC was found to be consistently associated with lower functioning and more symptoms, CRC and its treatment seem to contribute stronger to lower HRQoL and sexual functioning compared with DM.
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423
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Can quality of life assessments differentiate heterogeneous cancer patients? PLoS One 2014; 9:e99445. [PMID: 24919068 PMCID: PMC4053440 DOI: 10.1371/journal.pone.0099445] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 05/15/2014] [Indexed: 01/05/2023] Open
Abstract
Purpose This research conducted a face validation study of patient responses to the application of an HRQOL assessment research tool in a comprehensive community cancer program setting across a heterogeneous cohort of cancer patients throughout the natural history of diagnosed malignant disease, many of whom would not be considered candidates for clinical research trial participation. Methods Cancer registries at two regional cancer treatment centers identified 11072 cancer patients over a period of nine years. The EORTC QLQ-C30 was administered to patients at the time of their initial clinical presentation to these centers. To determine the significance of differences between patient subgroups, two analytic criteria were used. The Mann-Whitney test was used to determine statistical significance; clinical relevance defined a range of point differences that could be perceived by patients with different health states. Results Univariate analyses were conducted across stratification variables for population, disease severity and demographic characteristics. The largest differences were associated with cancer diagnosis and recurrence of disease. Large differences were also found for site of origin, mortality and stage; minimal differences were observed for gender and age. Consistently sensitive QoL scales were appetite loss, fatigue and pain symptoms, and role (work-related), social and physical functions. Conclusions 1) The EORTC QLQ-C30 collected meaningful patient health assessments in the context of non-research based clinical care, 2) patient assessment differences are manifested disparately across 15 QoL domains, and 3) in addition to indicating how a patient may feel at a point in time, QoL indicators may also reveal information about underlying biological responses to disease progression, treatments, and prospective survival.
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424
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Hellstadius Y, Lagergren P, Lagergren J, Johar A, Hultman CM, Wikman A. Aspects of emotional functioning following oesophageal cancer surgery in a population-based cohort study. Psychooncology 2014; 24:47-53. [PMID: 24895142 DOI: 10.1002/pon.3583] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/31/2014] [Accepted: 05/04/2014] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to establish the proportion of patients reporting emotional problems following oesophagectomy for cancer and identify the risk characteristics for emotional problems. METHODS A Swedish population-based cohort study of patients with surgically treated oesophageal cancer was used. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 was used to assess tension, worry, irritation and depressed mood at 6 months and 5 years after surgery. Potential risk characteristics were retrieved from medical notes and data linkages to Swedish health registries. Multivariable logistic regression analyses were performed to examine risk characteristics for poor emotional recovery. RESULTS Of 401 patients included at 6 months, 49% reported problems with tension, 61% worry, 62% irritation and 63% depressed mood. Of the 140 (35%) patients who completed the 5-year follow-up, 39% reported problems with tension and about half of the patients reported problems with worry, irritation, and depressed mood (49, 45 and 52%, respectively). Squamous cell carcinoma was identified as a risk characteristic for tension (OR 2.15, 95% CI 1.30-3.55), worry (OR 2.02, 95% CI 1.19-3.40) and depressed mood (OR 1.71, 95% CI 1.01-2.90) at 6 months compared with adenocarcinoma. Compared with higher education, lower education was associated with tension (upper secondary schooling: OR 1.97, 95% CI 1.02-3.79 and 9-year compulsory: OR 2.46, 95% CI 1.28-4.74), while non-cohabitating patients were less likely to report problems with worry at 6 months (OR 0.53, 95% CI 0.34-0.84) compared with cohabitating patients. CONCLUSIONS A substantial proportion of patients reports emotional problems following oesophagectomy, and risk characteristics include squamous cell carcinoma histology and low educational level.
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Affiliation(s)
- Ylva Hellstadius
- Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Lebret T, Culine S, Davin JL, Hennequin C, Mignard JP, Moreau JL, Rossi D, Zerbib M, Mahmoudi A, Latorzeff I. Quality of life of 1276 elderly patients with prostate cancer, starting treatment with a gonadotropin-releasing hormone agonist: results of a French observational study. Aging Male 2014; 17:87-93. [PMID: 24576298 DOI: 10.3109/13685538.2014.891013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This French observational, longitudinal, prospective study described the health-related quality of life (HRQoL) of elderly men (≥75 years old) with prostate cancer after initiating gonadotropin-releasing hormone (GnRH) agonist therapy. At baseline and 3-6 months after baseline, European Organisation for Research and Treatment of Cancer quality of life questionnaire-core 30 (QLQ-C30) and prostate-specific (QLQ-PR25) questionnaires were completed by patients. Data from 1276 patients were analyzed. At baseline, mean (±SD) age was 80 (±4.1) years, 29.1% of patients had Gleason scores ≥8 and 24.9% had metastases. At baseline, increasing age, presence of metastasis and presence of comorbidity had a negative impact on QLQ-C30 and QLQ-PR25 scores. At follow-up, improvement in emotional-functioning (2.8; p < 0.001), social-functioning (1.7; p = 0.011), global HRQoL (1.6; p = 0.029), sleep-disturbance (-2.1; p = 0.011), appetite-loss (-4.0; p < 0.001) and pain (-4.1; p < 0.001) QLQ-C30 scores were observed. In addition, there was a worsening in treatment-related symptom (8.6; p < 0.001), sexual-activity (-5.5; p < 0.001) and sexual-functioning (-22.6; p < 0.001) QLQ-PR25 scores, and an improvement in urinary symptoms (-3.7; p < 0.001) and incontinence aid (-2.9; p = 0.023) QLQ-PR25 scores. This study shows that, apart from the expected impact on sexual functioning domains, HRQoL is not adversely affected by 3-6 months of GnRH agonist therapy in older men with prostate cancer.
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426
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Which quality of life instruments are preferred by cancer patients in Japan? Comparison of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 and the Functional Assessment of Cancer Therapy-General. Support Care Cancer 2014; 22:3135-41. [PMID: 24865876 DOI: 10.1007/s00520-014-2287-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 05/12/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE We compared two health-related quality of life (HRQOL) instruments used for cancer patients [the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) and the Functional Assessment of Cancer Therapy-General (FACT-G)] to identify which instrument cancer patients most preferred. METHODS Adult cancer patients who had received cancer treatments within the previous 2 years (n = 395) completed both surveys; participants assessed the importance, necessity, and appropriateness of each as an indicator of their quality of life. RESULTS The patients significantly preferred the FACT-G over the EORTC QLQ-C30 as a more important (effect size (ES) = 0.37, P < 0.001), necessary (ES = 0.18, P < 0.001), and appropriate questionnaire (ES = 0.14, P = 0.005). The subgroups of patients with good performance status, and those who reported low levels of work disruption, significantly preferred the FACT-G more than the other. The corresponding correlation coefficients were the following: physical functioning and well-being subscale, r = 0.65; emotional functioning and well-being subscale, r = 0.60; social functioning and social/family well-being subscale, r = 0.00; and role functioning and functional well-being subscale, r = 0.41. CONCLUSIONS We recommend using the FACT-G if the performance status of the subject is good, e.g., in outpatient or cancer survivor surveys, based on the observed patient preferences. When performance status is not good, an instrument should be chosen after considering the differences between their scale structures and social domains and based on the availability of disease-specific modules.
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427
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The course of anxiety and depression for patients with Hodgkin’s lymphoma or diffuse large B cell lymphoma: a longitudinal study of the PROFILES registry. J Cancer Surviv 2014; 8:555-64. [DOI: 10.1007/s11764-014-0367-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 04/28/2014] [Indexed: 12/22/2022]
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428
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Health-related quality of life and persistent symptoms in relation to (R-)CHOP14, (R-)CHOP21, and other therapies among patients with diffuse large B-cell lymphoma: results of the population-based PHAROS-registry. Ann Hematol 2014; 93:1705-15. [DOI: 10.1007/s00277-014-2099-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 04/28/2014] [Indexed: 12/22/2022]
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429
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Hislop J, Adewuyi TE, Vale LD, Harrild K, Fraser C, Gurung T, Altman DG, Briggs AH, Fayers P, Ramsay CR, Norrie JD, Harvey IM, Buckley B, Cook JA. Methods for specifying the target difference in a randomised controlled trial: the Difference ELicitation in TriAls (DELTA) systematic review. PLoS Med 2014; 11:e1001645. [PMID: 24824338 PMCID: PMC4019477 DOI: 10.1371/journal.pmed.1001645] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 04/04/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Randomised controlled trials (RCTs) are widely accepted as the preferred study design for evaluating healthcare interventions. When the sample size is determined, a (target) difference is typically specified that the RCT is designed to detect. This provides reassurance that the study will be informative, i.e., should such a difference exist, it is likely to be detected with the required statistical precision. The aim of this review was to identify potential methods for specifying the target difference in an RCT sample size calculation. METHODS AND FINDINGS A comprehensive systematic review of medical and non-medical literature was carried out for methods that could be used to specify the target difference for an RCT sample size calculation. The databases searched were MEDLINE, MEDLINE In-Process, EMBASE, the Cochrane Central Register of Controlled Trials, the Cochrane Methodology Register, PsycINFO, Science Citation Index, EconLit, the Education Resources Information Center (ERIC), and Scopus (for in-press publications); the search period was from 1966 or the earliest date covered, to between November 2010 and January 2011. Additionally, textbooks addressing the methodology of clinical trials and International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) tripartite guidelines for clinical trials were also consulted. A narrative synthesis of methods was produced. Studies that described a method that could be used for specifying an important and/or realistic difference were included. The search identified 11,485 potentially relevant articles from the databases searched. Of these, 1,434 were selected for full-text assessment, and a further nine were identified from other sources. Fifteen clinical trial textbooks and the ICH tripartite guidelines were also reviewed. In total, 777 studies were included, and within them, seven methods were identified-anchor, distribution, health economic, opinion-seeking, pilot study, review of the evidence base, and standardised effect size. CONCLUSIONS A variety of methods are available that researchers can use for specifying the target difference in an RCT sample size calculation. Appropriate methods may vary depending on the aim (e.g., specifying an important difference versus a realistic difference), context (e.g., research question and availability of data), and underlying framework adopted (e.g., Bayesian versus conventional statistical approach). Guidance on the use of each method is given. No single method provides a perfect solution for all contexts.
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Affiliation(s)
- Jenni Hislop
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - Luke D. Vale
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Kirsten Harrild
- Population Health, University of Aberdeen, Aberdeen, United Kingdom
| | - Cynthia Fraser
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Tara Gurung
- Warwick Evidence, University of Warwick, Coventry, United Kingdom
| | - Douglas G. Altman
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Andrew H. Briggs
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Peter Fayers
- Population Health, University of Aberdeen, Aberdeen, United Kingdom
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Craig R. Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - John D. Norrie
- Centre for Healthcare Randomised Trials, University of Aberdeen, Aberdeen, United Kingdom
| | - Ian M. Harvey
- Faculty of Health, University of East Anglia, Norwich, United Kingdom
| | | | - Jonathan A. Cook
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
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430
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Oerlemans S, Issa DE, van den Broek EC, Nijziel MR, Coebergh JWW, Mols F, van de Poll-Franse LV. Impact of therapy and disease-related symptoms on health-related quality of life in patients with follicular lymphoma: results of the population-based PHAROS-registry. Eur J Haematol 2014; 93:229-38. [PMID: 24702126 DOI: 10.1111/ejh.12335] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The increasing number of longer living patients with follicular lymphoma (FL) and serious side effects of treatment urged us to study the health-related quality of life (HRQoL) and persistent (treatment-related) symptoms in unselected patients after different treatment modalities and compare HRQoL of patients with a normative population. METHODS The population-based Eindhoven Cancer Registry was used to select patients diagnosed with FL during 2004-2010. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) was completed twice, with a 1-yr interval. This questionnaire was also completed by an age- and sex-matched normative population (N = 580). Detailed data on treatment were extracted from the cancer registry and Population-based HAematological Registry for Observational Studies (PHAROS). RESULTS Of the 181 patients who were invited, 148 responded (82%, T1). Patients treated with immunochemotherapy reported clinically relevant higher mean fatigue scores than those who underwent radiotherapy (P = 0.02). No differences were observed on the other HRQoL scales between treatment groups. Mean HRQoL scores were worse for FL patients treated with immunochemotherapy compared with a normative population (P < 0.01). A quarter to 50% of patients persistently reported to be slowed down, lethargic, or persistently worried about future health or was limited in social activities. Subsequently, patients reporting these symptoms/worries had a lower global health status/HRQoL. CONCLUSION Alertness for persistent symptoms that occur during and after treatment of FL patients is needed and may help to avoid lasting negative influence on their HRQoL.
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Affiliation(s)
- Simone Oerlemans
- Comprehensive Cancer Centre Netherlands, Eindhoven Cancer Registry, Eindhoven, The Netherlands; Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
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431
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Arias F, Arraras JI, Asin G, Uzcanga MI, Maraví E, Chicata V, Eito C, Zarandona U, Mora I, Vila M, Domínguez MA. Quality of life and voice assessment in patients with early-stage glottic cancer. Head Neck 2014; 37:340-6. [DOI: 10.1002/hed.23603] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 11/05/2013] [Accepted: 01/07/2014] [Indexed: 11/08/2022] Open
Affiliation(s)
- Fernando Arias
- Department of Radiation Oncology; Complejo Hospitalario de Navarra; Navarra Spain
| | - Juan Ignacio Arraras
- Department of Radiation Oncology; Complejo Hospitalario de Navarra; Navarra Spain
| | - Gemma Asin
- Department of Radiation Oncology; Complejo Hospitalario de Navarra; Navarra Spain
| | - María Itziar Uzcanga
- Department of Otorhinolaryngology; Complejo Hospitalario de Navarra; Navarra Spain
| | - Enrique Maraví
- Department of Otorhinolaryngology; Complejo Hospitalario de Navarra; Navarra Spain
| | - Volker Chicata
- Department of Radiation Oncology; Complejo Hospitalario de Navarra; Navarra Spain
| | - Clara Eito
- Department of Radiation Oncology; Complejo Hospitalario de Navarra; Navarra Spain
| | - Uxue Zarandona
- Department of Radiation Oncology; Complejo Hospitalario de Navarra; Navarra Spain
| | - Itxaso Mora
- Department of Radiation Oncology; Complejo Hospitalario de Navarra; Navarra Spain
| | - Meritxell Vila
- Department of Radiation Oncology; Complejo Hospitalario de Navarra; Navarra Spain
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Hung YC, Bauer JD, Horsely P, Coll J, Bashford J, Isenring EA. Telephone-delivered nutrition and exercise counselling after auto-SCT: a pilot, randomised controlled trial. Bone Marrow Transplant 2014; 49:786-92. [PMID: 24710562 DOI: 10.1038/bmt.2014.52] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 01/24/2014] [Accepted: 01/29/2014] [Indexed: 01/11/2023]
Abstract
Adverse changes in nutrition-related outcomes including quality of life (QoL) occur after PBSC transplantation. This randomised controlled trial aims to evaluate the impact of nutrition and exercise counselling provided at hospital discharge on nutritional status, body composition and QoL post transplantation. Usual care (UC) (n=19) received no intervention after discharge; extended care (EC) (n=18) received fortnightly telephone counselling from a dietitian and exercise physiologist up to 100 days post transplantation. Nutritional status (patient-generated subjective global assessment, and diet history), QoL (EORTC QLQ-C30 version 3) and body composition (air displacement plethysmography) were assessed at pre-admission, discharge and 100 days post transplantation. Intervention groups were compared using two-sample t-tests of changes in the outcomes; results were adjusted using analysis of covariance. EC exhibited clinically important but not statistically significant increases in protein intake (14.7 g; confidence interval (CI) 95% -6.5, 35.9, P=0.165), cognitive functioning (7.2; CI 95% -7.9, 22.2, P=0.337) and social functioning (16.5; CI 95% -7.3, 40.3, P=0.165) compared with UC. Relative to pre-admission, EC experienced less weight loss than UC (-3.3 kg; CI 95% -6.7, 0.2, P=0.062). Physical activity was not significantly different between the groups. Ongoing nutrition and exercise counselling may prevent further weight loss and improve dietary intake and certain QoL components in autologous PBSC transplantation patients following hospitalisation.
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Affiliation(s)
- Y-C Hung
- Centre for Dietetics Research, School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia
| | - J D Bauer
- 1] Centre for Dietetics Research, School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia [2] The Wesley Research Institute, Brisbane, Queensland, Australia
| | - P Horsely
- The Wesley Research Institute, Brisbane, Queensland, Australia
| | - J Coll
- The Wesley Research Institute, Brisbane, Queensland, Australia
| | - J Bashford
- Haematology & Oncology Clinics of Australia, The Wesley Medical Centre, Brisbane, Queensland, Australia
| | - E A Isenring
- 1] Centre for Dietetics Research, School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia [2] Department of Nutrition & Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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Daniëls LA, Krol ADG, de Graaf MA, Scholte AJHA, Van't Veer MB, Putter H, de Roos A, Schalij MJ, Creutzberg CL. Screening for coronary artery disease after mediastinal irradiation in Hodgkin lymphoma survivors: phase II study of indication and acceptance†. Ann Oncol 2014; 25:1198-203. [PMID: 24692582 DOI: 10.1093/annonc/mdu130] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Cardiovascular diseases are the most common nonmalignant cause of death in Hodgkin lymphoma (HL) survivors, especially after mediastinal irradiation. We investigated the role of computed tomographic coronary angiography (CTA) as a screening tool for coronary artery disease (CAD) in asymptomatic HL survivors, and related CTA findings to exercise testing and subsequent interventions. PATIENTS AND METHODS Patients were eligible for this phase II study if at least 10 years disease-free and treated with mediastinal radiotherapy. Screening consisted of electrocardiogram, exercise testing and CTA. Primary end point was significant CAD (stenosis >50%) on CTA. CTA screening was considered to be indicated for testing in a larger population if ≥6 of 50 CTA scanned patients (12%) would need revascularization. Screening was evaluated with a questionnaire before and after screening. RESULTS Fifty-two patients were included, and 48 patients underwent CTA. Median age was 47 years, time since HL diagnosis 21 years. There were 45 evaluable scans. Significant CAD on CTA was found in 20% (N = 9), significantly increased compared with the 7% expected abnormalities (P = 0.01, 95% confidence interval 8.3% to 31.7%). In 11% (N = 5), significant stenosis was confirmed at coronary angiography, and revascularization was carried out. Additionally, two patients were treated with optimal medical therapy. Ninety percent of patients were content with screening, regardless whether the CTA showed abnormalities. CONCLUSIONS Prevalence of significant CAD among HL survivors is high, while asymptomatic even in the presence of life-threatening CAD. This might justify screening by CTA in asymptomatic HL survivors who had mediastinal radiotherapy, but needs to be evaluated in a larger cohort. The trial protocol was approved by the Ethics Committee of the LUMC and registered with ClinicalTrials.gov, NCT01271127.
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Affiliation(s)
| | | | - M A de Graaf
- Department of Cardiology The Interuniversity Cardiology Institute of The Netherlands, Utrecht, The Netherlands
| | | | | | - H Putter
- Department of Medical Statistics and Bio-informatics
| | - A de Roos
- Radiology, Leiden University Medical Center, Leiden
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434
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Im MH, Kim JW, Kim WS, Kim JH, Youn YH, Park H, Choi SH. The impact of esophageal reflux-induced symptoms on quality of life after gastrectomy in patients with gastric cancer. J Gastric Cancer 2014; 14:15-22. [PMID: 24765533 PMCID: PMC3996245 DOI: 10.5230/jgc.2014.14.1.15] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 02/22/2014] [Accepted: 02/24/2014] [Indexed: 12/13/2022] Open
Abstract
Purpose To evaluate the prevalence of esophageal reflux-induced symptoms after gastrectomy owing to gastric cancer and assess the relationship between esophageal reflux-induced symptoms and quality of life. Materials and Methods From January 2012 to May 2012, 332 patients were enrolled in this cross-sectional study. The patients had a history of curative resection for gastric cancer at least 6 months previously without recurrence, other malignancy, or ongoing chemotherapy. Esophageal reflux-induced symptoms were evaluated with the GerdQ questionnaire. The quality of life was evaluated with the European Organization for Research and Treatment QLQ-C30 and STO22 questionnaires. Results Of the 332 patients, 275 had undergone subtotal gastrectomy and 57 had undergone total gastrectomy. The number of GerdQ(+) patients was 58 (21.1%) after subtotal gastrectomy, and 7 (12.3%) after total gastrectomy (P=0.127). GerdQ(+) patients showed significantly worse scores compared to those for GerdQ(-) patients in nearly all functional and symptom QLQ-C30 scales, with the difference in the mean score of global health status/quality of life and diarrhea symptoms being higher than in the minimal important difference. Additionally, in the QLQ STO22, GerdQ(+) patients had significantly worse scores in every symptom scale. The GerdQ score was negatively correlated with the global quality of life score (r=-0.170, P=0.002). Conclusions Esophageal reflux-induced symptoms may develop at a similar rate or more frequently after subtotal gastrectomy compared to that after total gastrectomy, and decrease quality of life in gastric cancer patients. To improve quality of life after gastrectomy, new strategies are required to prevent or reduce esophageal reflux.
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Affiliation(s)
- Min Hye Im
- Gangnam Severance Cancer Hospital, Seoul, Korea
| | - Jong Won Kim
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Whan Sik Kim
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jie-Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Hoon Youn
- Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyojin Park
- Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Ho Choi
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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435
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Mols F, Lemmens V, Bosscha K, van den Broek W, Thong MSY. Living with the physical and mental consequences of an ostomy: a study among 1-10-year rectal cancer survivors from the population-based PROFILES registry. Psychooncology 2014; 23:998-1004. [PMID: 24664891 DOI: 10.1002/pon.3517] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 02/12/2014] [Accepted: 02/13/2014] [Indexed: 11/12/2022]
Abstract
BACKGROUND This study examined the physical and mental consequences of an ostomy among 1-10-year rectal cancer survivors. METHODS Patients with rectal cancer diagnosed from 2000 to 2009, as registered in the population-based Eindhoven Cancer Registry, received a questionnaire on quality of life (QOL; EORTC QLQ-C30), disease-specific health status (EORTC QLQ-CR38), depression and anxiety (HADS), illness perceptions (Brief Illness Perception Questionnaire), and health care utilization; 76% (n = 1019) responded. RESULTS A total of 408 (43%) rectal cancer survivors had an ostomy at survey and they reported a statistically significant and clinically relevant lower physical, role, and social functioning, and global health status/QOL but fewer problems with constipation and diarrhea compared with those without an ostomy. Also, they had a significantly worse body image, more male sexual problems, and fewer gastrointestinal problems although these differences were not clinically relevant. No differences regarding the prevalence of symptoms of anxiety and depression were found. Survivors with an ostomy believed that their illness have significantly more serious consequences, will last longer (clinically relevant), and were more concerned about their illness compared with those without an ostomy. Survivors with an ostomy visited their medical specialist, but not their general practitioner, significantly more often. Also, they more often received additional support after cancer treatment. CONCLUSIONS Rectal cancer survivors with an ostomy have a lower QOL, worse illness perceptions, and a higher health care consumption compared with those without an ostomy 1-10 years after diagnosis.
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Affiliation(s)
- Floortje Mols
- Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands; Comprehensive Cancer Centre South (CCCS), Eindhoven Cancer Registry, Eindhoven, The Netherlands
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de Wreede LC, Watson M, van Os M, Milligan D, van Gelder M, Michallet M, Dreger P, Dearden CE, Homewood J, Dupuis J, Leporrier M, Karas M, Corront B, Baerlocher GM, Herr W, Choquet S, Niederwieser DW, Sutton L, Kröger N, de Witte TM, Schetelig J. Improved relapse-free survival after autologous stem cell transplantation does not translate into better quality of life in chronic lymphocytic leukemia: lessons from the randomized European Society for Blood and Marrow Transplantation-Intergroup study. Am J Hematol 2014; 89:174-80. [PMID: 24123244 DOI: 10.1002/ajh.23610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 10/02/2013] [Accepted: 10/03/2013] [Indexed: 12/21/2022]
Abstract
In chronic lymphocytic leukemia (CLL) medical progress is driven by clinical studies with relapse-free survival (RFS) as the primary endpoint. The randomized EBMT-Intergroup trial compared high-dose therapy and autologous stem cell transplantation (ASCT) to observation and demonstrated a substantial improvement of RFS without showing improved overall survival for the transplant arm. Here we report quality of life (QoL) information of the first 3 years following randomization from that study. The main objective was to assess the impact of treatment on QoL over time. Two secondary analyses were performed to further investigate the impact of ASCT and relapse on QoL. In the primary analysis, we demonstrate an adverse impact of ASCT on QoL which was largest at 4 months and continued throughout the first year after randomization. Further, we demonstrated a sustained adverse impact of relapse on QoL which worsened over time. Despite better disease control by ASCT the side effects thus turned the net effect towards inferior QoL in the first year and comparable QoL in the following 2 years after randomization. This study emphasizes the importance of information concerning QoL impacts when patients are counseled about treatments aimed at improving RFS in the absence of a survival benefit.
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Affiliation(s)
| | | | - Marleen van Os
- EBMT/Dept of Medical Statistics & Bioinformatics LUMC; Leiden The Netherlands
| | | | | | | | | | | | - Janis Homewood
- Institute of Cancer Research / Royal Marsden Hospital; Sutton United Kingdom
| | - Jehan Dupuis
- CHU Henri Mondor Assistance Publique-Hôpitaux de Paris; Creteil France
| | - Michel Leporrier
- Université de Caen Basse-Normandie & UMR 6301 ISTCT, LDM-TEP, GIP Cyceron; France
| | - Michal Karas
- Charles University Hospital; Pilsen Czech Republic
| | | | | | | | | | | | | | | | - Theo M. de Witte
- Radboud University Nijmegen Medical Center; Nijmegen The Netherlands
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Canevari S, Raspagliesi F, Lorusso D. Bevacizumab treatment and quality of life in advanced ovarian cancer. Future Oncol 2014; 9:951-4. [PMID: 23837758 DOI: 10.2217/fon.13.77] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Despite improvements in surgery and chemotherapy treatments, the 5-year survival of ovarian cancer patients is far below 50%. As angiogenesis contributes to tumor growth and metastasis, bevacizumab, an antiangiogenetic monoclonal antibody, was studied in many solid cancers for which evidence of efficacy has been shown in several trials. The ICON7 randomized Phase III trial was designed to evaluate the addition of bevacizumab to standard chemotherapy in ovarian cancer. The ICON7 study demonstrated for patients receiving bevacizumab: a progression-free survival advantage of 2.4 months; an overall survival benefit of 8 months in patients with high risk of progression; and a less than 10-point difference in quality of life (QoL) between the two groups. A detailed assessment of ICON7 QoL confirmed that bevacizumab continuation treatment seems to be associated with a small but clinically significant decrement in QoL. As development of existing and new antiangiogenesis drugs is mainly based on continuation schedules, studies taking into account the evolving interpretation of QoL data are needed.
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Affiliation(s)
- Silvana Canevari
- Molecular Therapies, Department of Experimental Oncology & Molecular Medicine, Ondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, 20133 Milan, Italy
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438
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Daniëls LA, Oerlemans S, Krol ADG, Creutzberg CL, van de Poll-Franse LV. Chronic fatigue in Hodgkin lymphoma survivors and associations with anxiety, depression and comorbidity. Br J Cancer 2014; 110:868-74. [PMID: 24434433 PMCID: PMC3929869 DOI: 10.1038/bjc.2013.779] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 11/06/2013] [Accepted: 11/18/2013] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Fatigue is a frequent and persistent problem among Hodgkin lymphoma (HL) survivors. We investigated the prevalence of clinically relevant fatigue in HL survivors and the relation between fatigue and anxiety and depression. METHODS Fatigue was measured through the generic European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) and Fatigue Assessment Scale (FAS). Anxiety and depression were measured with the Hospital Anxiety and Depression Scale. Questionnaires were mailed to 267 HL survivors. Results were compared with a Dutch age-matched normative population. RESULTS Response rate was 68% (median age 46 years, mean time since diagnosis 4.6 years). Prevalence of fatigue was significantly higher among HL survivors than in the norm population (FAS 41% vs 23%, QLQ-C30 43% vs 28%), as were fatigue levels. There was a significant association between fatigue, anxiety and depression. Of the HL survivors with high symptom levels of depression, 97% also reported fatigue. In multivariate analysis, depression was strongly associated with high levels of fatigue and, to a lesser extent, anxiety and comorbidity. CONCLUSIONS Prevalence rates of fatigue are significantly higher in HL survivors than in the general population and differences are clinically relevant. Depression and anxiety were strongly associated with high levels of fatigue. Reducing fatigue levels by treatment of depression and anxiety should be further explored.
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Affiliation(s)
- L A Daniëls
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - S Oerlemans
- 1] Comprehensive Cancer Centre South, Eindhoven, The Netherlands [2] Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - A D G Krol
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - C L Creutzberg
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - L V van de Poll-Franse
- 1] Comprehensive Cancer Centre South, Eindhoven, The Netherlands [2] Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
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439
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Kripp M, Al-Batran SE, Rosowski J, Pauligk C, Homann N, Hartmann JT, Moehler M, Hofheinz RD. Quality of life of older adult patients receiving docetaxel-based chemotherapy triplets for esophagogastric adenocarcinoma: a randomized study of the Arbeitsgemeinschaft Internistische Onkologie (AIO). Gastric Cancer 2014; 17:181-7. [PMID: 23455717 DOI: 10.1007/s10120-013-0242-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 02/03/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Treatment of patients with advanced or metastatic esophagogastric adenocarcinoma should not only prolong life but also provide relief of symptoms and improve quality of life (QOL). Esophagogastric adenocarcinoma mainly occurs in elderly patients, but they are underrepresented in most clinical trials and often do not receive effective combination chemotherapy, most probably for fear of intolerance. Using validated instruments, we prospectively assessed QOL within the randomized FLOT65+ phase II trial. METHODS Within the FLOT65+ trial, a total of 143 patients aged ≥65 years were randomly allocated to receive biweekly oxaliplatin plus 5-fluorouracil (5-FU) continuous infusion and folinic acid (FLO) or the same regimen in combination with docetaxel 50 mg/m(2) (FLOT). The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and the gastric module STO22 were administered every 8 weeks until progression. Time to definitive deterioration of QOL parameters was analyzed and compared within the treatment arms. RESULTS The median age of patients was 70 years. Patients receiving FLOT exhibited higher response rates and had improved disease-free and progression-free survival (PFS). The proportions of patients with evaluable baseline EORTC QLQ-C30 and STO22 questionnaires were balanced (83 % in FLOT and 89 % in FLO). Considering evaluable patients with assessable questionnaires (n = 123), neither functioning nor symptom parameters differed significantly in favor of one of the two treatment groups. Particularly, there was no significant difference regarding time to definitive deterioration of global health status/quality of life from baseline (primary endpoint). Notably, patients receiving FLO or FLOT as palliative treatment (n = 98) achieved comparable QOL results. CONCLUSIONS Although toxicity was higher in patients receiving FLOT, no negative impact of the addition of docetaxel on QOL parameters could be demonstrated. Thus, elderly patients in need of intensified chemotherapy may receive FLOT without compromising patient-reported outcome parameters.
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Affiliation(s)
- Melanie Kripp
- III. Medizinische Klinik, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany,
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440
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Abstract
Continuous improvements in the diagnosis and treatment of cancer lead to improved cure rates and longer survival. However, in many patients, the disease becomes chronic. In this context, the patients' quality of life (QOL) becomes a crucial issue. After an introduction about QOL, results from different areas of cancer treatment are presented considering their impact on QOL. Finally, implications are discussed for researchers, clinicians, and patients.
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Affiliation(s)
- Ute Goerling
- Department of Psychooncology, Charité Comprehensive Cancer Center, Berlin, Germany,
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441
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Quality of life more impaired in younger than in older diffuse large B cell lymphoma survivors compared to a normative population: a study from the population-based PROFILES registry. Ann Hematol 2013; 93:811-9. [DOI: 10.1007/s00277-013-1980-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/27/2013] [Indexed: 01/04/2023]
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442
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Gender-specific quality of life after cancer in young adulthood: a comparison with the general population. Qual Life Res 2013; 23:1377-86. [PMID: 24197479 DOI: 10.1007/s11136-013-0559-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2013] [Indexed: 11/12/2022]
Abstract
PURPOSE Over the last years, adolescents and young adults with cancer (AYA) have moved strongly into scientific focus. However, there have only been a few studies about the quality of life of the AYA group, and gender differences have very rarely been examined. METHODS A cross-sectional study was conducted with young adult cancer patients who were aged 18-39 years at the time of survey and had completed their acute treatment. We used the quality of life questionnaire European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). The EORTC QLQ-C30 contains five function scales (physical, role, emotional, cognitive and social), nine symptom scales and a global quality of life scale. The patient sample was compared to a gender- and age-matched representative sample (REP). RESULTS Compared to the general population (N = 585), significantly poorer quality of life (p = .001) was observed for the 117 young cancer patients (40 male, 77 female) on all scales and items of the EORTC QLQ-C30. Analyses of variance with the factors group (AYA vs. REP) and gender showed interaction effects for the physical (p < .012), emotional (p < .029) and cognitive function scales (p < .008) and fatigue (p < .026) as well as for the items insomnia (p < .011), constipation (p < .037) and financial difficulties (p < .026). The pattern of the interaction was that female cancer patients reported the lowest quality of life outcomes. The same effects were found for the three calculated sum scales function, symptom and total. CONCLUSIONS Results clearly indicate that young adult cancer patients have a reduced quality of life in comparison with the general population even long after the treatment of their disease is complete. Women had a lower quality of life than men. Age-specific interventions should be offered that lead to improvements in quality of life for this age group. And future studies should clarify what factors lead to women's quality of life being worse than men's.
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443
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Cocks K, Velikova G, King M, Fayers P, Brown J. Can individual patients assess differences in quality of life between groups of patients? Eur J Cancer Care (Engl) 2013; 23:228-38. [DOI: 10.1111/ecc.12113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2013] [Indexed: 11/28/2022]
Affiliation(s)
- K. Cocks
- Clinical Trials Research Unit; University of Leeds; Leeds UK
- York Trials Unit; University of York; York UK
| | - G. Velikova
- St James's Institute of Oncology; Leeds Institute for Molecular Medicine; University of Leeds; Leeds UK
| | - M.T. King
- Quality of Life Office; Psycho-Oncology Cooperative Research Group; University of Sydney; Sydney NSW Australia
| | - P.M. Fayers
- Institute of Applied Health Sciences; School of Medicine and Dentistry; University of Aberdeen; Aberdeen UK
- Department of Cancer Research and Molecular Medicine; Faculty of Medicine; NTNU; Trondheim Norway
| | - J.M. Brown
- Clinical Trials Research Unit; University of Leeds; Leeds UK
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444
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Schaake W, de Groot M, Krijnen WP, Langendijk JA, van den Bergh ACM. Quality of life among prostate cancer patients: a prospective longitudinal population-based study. Radiother Oncol 2013; 108:299-305. [PMID: 23932157 DOI: 10.1016/j.radonc.2013.06.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/18/2013] [Accepted: 06/19/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the course of quality of life (QoL) among prostate cancer patients treated with external beam radiotherapy and to compare the results with QoL of a normal age-matched reference population. PATIENTS AND METHODS The study population was composed of 227 prostate cancer patients, treated with radiotherapy. The EORTC QLQ-C30 was used to assess QoL before radiotherapy and six months, one year, two years and three years after completion of radiotherapy. Mixed model analyses were used to investigate longitudinal changes in QoL. QoL of prostate cancer patients was compared to that of a normative cohort using a multivariate analysis of covariance. RESULTS A significant decline in QoL was observed after radiotherapy (p<0.001). The addition of hormonal therapy to radiotherapy was associated with a lower level of role functioning. Patients with coronary heart disease and or chronic obstructive pulmonary disease or asthma had a significantly worse course in QoL. Although statistically significant, all differences were classified as small or trivial. CONCLUSION Prostate cancer patients experience a small worsening of QoL as compared with baseline and as compared with a normal reference population. As co-morbidity modulates patients' post-treatment QoL, a proper assessment of co-morbidity should be included in future longitudinal analyses on QoL.
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Affiliation(s)
- Wouter Schaake
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, The Netherlands; Hanze University of Applied Sciences, Professorship in Health Care and Nursing, Groningen, The Netherlands.
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445
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Mandelblatt JS, Makgoeng SB, Luta G, Hurria A, Kimmick G, Isaacs C, Tallarico M, Barry WT, Pitcher B, Winer EP, Hudis C, Cohen HJ, Muss HB. A planned, prospective comparison of short-term quality of life outcomes among older patients with breast cancer treated with standard chemotherapy in a randomized clinical trial vs. an observational study: CALGB #49907 and #369901. J Geriatr Oncol 2013; 4:353-61. [PMID: 24472479 DOI: 10.1016/j.jgo.2013.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Revised: 04/29/2013] [Accepted: 05/04/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Patients ≥ 65 years old ("older") are often not included in randomized clinical trials (RCT), but when they are, care in an RCT might improve quality of life (QoL). We conducted a prospective comparison of QoL among older women receiving standard chemotherapy from the same cooperative group physicians in an RCT vs. an observational study ("off-trial"). METHODS Older women with invasive, non-metastatic breast cancer (n=150 RCT; 530 off-trial) were included. Linear mixed-effects models tested associations between chemotherapy on- vs. off-trial and changes in EORTC (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire) QoL scores over 24 months, controlling for pre-treatment QoL, age, education, tumor factors, comorbidity, and other covariates. RESULTS Anthracycline regimens were used by 58% of women treated on-trial vs. 54% of those treated off-trial. Women in the RCT reported an adjusted mean increase of 13.7 points (95% CI 10.2, 17.1) in global QoL at 24 months (vs. mid-treatment), while women treated off-trial had only an adjusted improvement of 7.0 points (95% CI 3.5, 10.4; p=.007 for difference in mean changes). Women in the RCT had significantly greater improvement in emotional function than those treated off-trial, controlling for baseline; they also had greater reductions in therapy side effects and fatigue at 24 months than women off-trial, controlling for covariates. CONCLUSION There may be different QoL trajectories for older women undergoing breast cancer chemotherapy on- vs. off-trial. If confirmed, the results suggest that the extra monitoring and communication within an RCT could provide the infrastructure for interventions to address symptoms and improve QoL for the growing older cancer population.
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Affiliation(s)
- Jeanne S Mandelblatt
- Department of Oncology, Georgetown University Medical Center and Lombardi Cancer Center, Cancer Prevention and Control Program, Washington, DC, USA.
| | - Solomon B Makgoeng
- Department of Oncology, Georgetown University Medical Center and Lombardi Cancer Center, Cancer Prevention and Control Program, Washington, DC, USA
| | - Gheorghe Luta
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University Medical Center and Lombardi Cancer Center, Washington, DC, USA
| | - Arti Hurria
- Department of Medical Oncology & Therapeutics Research, City of Hope, LA, CA, USA
| | - Gretchen Kimmick
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, NC, USA
| | - Claudine Isaacs
- Department of Medicine, Georgetown University School of Medicine and Lombardi Cancer Center, Breast Cancer Program, Washington, DC, USA
| | - Michelle Tallarico
- Department of Oncology, Georgetown University Medical Center and Lombardi Cancer Center, Cancer Prevention and Control Program, Washington, DC, USA
| | - William T Barry
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, and Cancer and Leukemia Group B Statistical Center, Durham, NC, USA
| | - Brandy Pitcher
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, and Cancer and Leukemia Group B Statistical Center, Durham, NC, USA
| | - Eric P Winer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Clifford Hudis
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Harvey J Cohen
- Department of Medicine and Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
| | - Hyman B Muss
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
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446
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Mols F, Beijers T, Lemmens V, van den Hurk CJ, Vreugdenhil G, van de Poll-Franse LV. Chemotherapy-induced neuropathy and its association with quality of life among 2- to 11-year colorectal cancer survivors: results from the population-based PROFILES registry. J Clin Oncol 2013; 31:2699-707. [PMID: 23775951 DOI: 10.1200/jco.2013.49.1514] [Citation(s) in RCA: 261] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To gain insight into the prevalence and severity of chemotherapy-induced neuropathy and its influence on health-related quality of life (HRQOL) in a population-based sample of colorectal cancer (CRC) survivors 2 to 11 years after diagnosis. METHODS All alive individuals diagnosed with CRC between 2000 and 2009 as registered by the Dutch population-based Eindhoven Cancer Registry were eligible for participation. Eighty-three percent (n = 1,643) of patients filled out the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) C30 and the EORTC QLQ Chemotherapy-Induced Peripheral Neuropathy 20. RESULTS The five neuropathy subscale-related symptoms that bothered patients with CRC the most during the past week were erectile problems (42% of men), trouble hearing (11%), trouble opening jars or bottles (11%), tingling toes/feet (10%), and trouble walking stairs or standing up (9%). Additionally, patients who received oxaliplatin more often reported tingling (29% v 8%; P = .001), numbness (17% v 5%; P = .005), and aching or burning pain (13% v 6%; P = .03) in toes/feet compared with those not treated with chemotherapy. They also more often reported tingling toes/feet (29% v 14%; P = .0127) compared with those treated with chemotherapy without oxaliplatin. Those with many neuropathy symptoms (eg, upper 10%) reported statistically significant and clinically relevant worse HRQOL scores on all EORTC QLQ-C30 subscales (all P < .01). CONCLUSION Two to 11 years after diagnosis of CRC, neuropathy-related symptoms are still reported, especially sensory symptoms in the lower extremities among those treated with oxaliplatin. Because neuropathy symptoms have a negative influence on HRQOL, these should be screened for and alleviated. Future studies should focus on prevention and relief of chemotherapy-induced neuropathy.
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Affiliation(s)
- Floortje Mols
- Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE Tilburg, the Netherlands.
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447
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Søreide K, Søreide AH. Using patient-reported outcome measures for improved decision-making in patients with gastrointestinal cancer - the last clinical frontier in surgical oncology? Front Oncol 2013; 3:157. [PMID: 23785670 PMCID: PMC3682158 DOI: 10.3389/fonc.2013.00157] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 06/03/2013] [Indexed: 11/18/2022] Open
Abstract
The genomic era has introduced concepts of “personalized medicine” and “targeted therapy” in the field of oncology. Medicine has become increasingly complex with a plethora of potential dilemmas in diagnosis, treatment, and management. The focus on classical outcomes for clinical decision-making is now increasingly being replaced by patient-reported outcome measures (PROMs). PROMs should increasingly now be in the center of patient-centered decision-making, based on valid, reliable, and clinically useful measures delivered directly by the patient to the caregiver. Surgeons’ ability to interpret and apply PROMs and quality of life results must improve by education and further research, and has an unreleased potential to contribute to a better understanding of the patients’ well-being. A number of caveats must be addressed before this can be brought to fruition; standardization for valid items; appropriate use of instruments; correct timing of the application; missing data handling, compliance, and respondent drop-outs are but a few issues to be addressed. Based on the apparent lack of use in both research and clinical work, it should call for an educational effort to address this among surgeons caring for patients with cancer.
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Affiliation(s)
- Kjetil Søreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital , Stavanger , Norway ; Department of Clinical Medicine, University of Bergen , Bergen , Norway
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448
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Daniëls LA, Oerlemans S, Krol ADG, van de Poll-Franse LV, Creutzberg CL. Persisting fatigue in Hodgkin lymphoma survivors: a systematic review. Ann Hematol 2013; 92:1023-32. [PMID: 23728609 DOI: 10.1007/s00277-013-1793-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 05/13/2013] [Indexed: 12/24/2022]
Abstract
Hodgkin Lymphoma (HL) survivors are at risk for adverse psychosocial events as a result from cancer diagnosis and treatment. Fatigue is one of the most frequently reported long-term symptoms and is often reported to interfere with daily life. We conducted a systematic review to determine prevalence, severity and predisposing factors of fatigue in HL survivors. A literature search was conducted up to August 2012. Twenty-two articles comparing HL survivors with norm population data met all predefined selection criteria. Prevalence rates, levels of fatigue and clinical relevance of the results were determined. Prevalence of fatigue ranged from 11-76 % in HL survivors compared to 10 % in the general population. Mean fatigue scores were 5-13 % higher compared to the normative population; these findings were clinically relevant in 7 out of 11 studies. Increasing age was associated with higher levels of fatigue in HL survivors. Treatment modality and stage of initial disease were not associated with higher fatigue levels, while comorbidities or other treatment sequelae seemed to impact on the levels of fatigue. HL survivors are at serious risk for developing clinically relevant, long-term fatigue. The impact of patient and treatment characteristics on risk of fatigue is limited. Focus for future research should shift to the role of late-treatment sequelae and psychological distress symptoms.
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Affiliation(s)
- Laurien A Daniëls
- Departments of Clinical Oncology, K1-P, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.
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449
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Tian Y, Schofield PE, Gough K, Mann GB. Profile and predictors of long-term morbidity in breast cancer survivors. Ann Surg Oncol 2013; 20:3453-60. [PMID: 23702642 DOI: 10.1245/s10434-013-3004-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Indexed: 12/26/2022]
Abstract
BACKGROUND A sound understanding of the benefits of different treatment options and their health-related quality of life (HRQoL) impacts is required for optimal breast cancer care. METHODS A cross-sectional cohort study was conducted to determine the prevalence and severity of persistent functional decrements and symptoms and identify demographic, clinical and treatment variables associated with poorer outcomes. Four hundred English-speaking women treated for ductal carcinoma-in-situ or stage I to III breast cancer between 1999 and 2009, at least 12 months after surgery and currently disease free, were randomly selected and invited to complete (1) the Breast Cancer Treatment Outcome Scale and (2) the EORTC core Quality of Life Questionnaire, version 3. RESULTS The response rate was 85.60 %. Many participants reported moderate to severe decrements in a number of HRQoL domains, including functional well-being (15 %), cosmetic status (32 %) and overall quality of life (21 %). There were significant associations (p < .05) between younger age and poorer HRQoL but none between time since surgery and morbidity (p > .05). Different treatments were associated with different HRQoL impacts. Poorer functional status was predicted by axillary dissection (p = .011), and adjuvant radiotherapy was a significant predictor of breast-specific pain (p < .05). CONCLUSIONS Many breast cancer survivors report long-term morbidity that is unaffected by time since surgery. The significant associations between the extent of locoregional therapies and poorer HRQoL outcomes emphasize the importance of the safe tailoring of these treatments.
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Affiliation(s)
- Yuan Tian
- Department of Surgery, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia
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450
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Dimopoulos MA, Delforge M, Hájek R, Kropff M, Petrucci MT, Lewis P, Nixon A, Zhang J, Mei J, Palumbo A. Lenalidomide, melphalan, and prednisone, followed by lenalidomide maintenance, improves health-related quality of life in newly diagnosed multiple myeloma patients aged 65 years or older: results of a randomized phase III trial. Haematologica 2013; 98:784-8. [PMID: 23242595 PMCID: PMC3640125 DOI: 10.3324/haematol.2012.074534] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 11/22/2012] [Indexed: 12/23/2022] Open
Abstract
The MM-015 trial assessed the effect of lenalidomide-based therapy on health-related quality of life. Patients (n=459) with newly diagnosed multiple myeloma aged 65 years or over were randomized 1:1:1 to nine 4-week cycles of lenalidomide, melphalan, and prednisone, followed by lenalidomide maintenance; or lenalidomide, melphalan, and prednisone, or melphalan and prednisone, with no maintenance therapy. Patients completed health-related quality of life questionnaires at baseline, after every third treatment cycle, and at treatment end. Health-related quality of life improved in all treatment groups during induction therapy. Patients receiving lenalidomide maintenance had the most pronounced improvements, Global Health Status/Quality of Life (P<0.05), Physical Functioning (P<0.01), and Side Effects of Treatment (P<0.05) out of 6 pre-selected health-related quality of life domains. More patients receiving lenalidomide maintenance achieved minimal important differences (P<0.05 for Physical Functioning). Therefore, lenalidomide, melphalan, and prednisone, followed by lenalidomide maintenance, improves health-related quality of life in patients with newly diagnosed multiple myeloma. (Clinicaltrials.gov identifier NCT00405756).
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