Quality of life one year after chemoradiotherapy for localized primary gastric diffuse large B-cell lymphoma

Health-related quality of life in Korean lymphoma survivors compared with the general population

The objective of this study was to evaluate the health-related quality of life (HRQOL) of lymphoma survivors, to compare it with that of the general population, and to identify its predictors in lymphoma survivors. We enrolled 837 participants (mean age, 54.6 years; mean time since diagnosis, 6.3 years) with a history of Hodgkin's lymphoma (HL) (n = 58) or non-Hodgkin's lymphoma (NHL) (n = 779) who had been treated at any of three Korean hospitals from 1989 through 2010. For controls, we selected 1,000 subjects randomly from a representative Korean population. We administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the Hospital Anxiety and Depression Scale. Overall, the HRQOL in both groups of survivors and the general population were comparable, but we observed clinically meaningful worse social functioning in NHL survivors (p < 0.001) and more severe fatigue in HL survivors (p < 0.001) than in the general population. Analysis of covariance revealed no clinically meaningful difference in HRQOL associated with age or sex. Survivors who received peripheral blood stem cell transplants showed clinically meaningful worse role (p = 0.001) and social (p < 0.001) functioning than those who were treated with first-line chemotherapy alone. In multivariate analyses, fatigue, depression, and financial difficulties emerged as the strongest predictors for almost all subscales of functioning and global quality of life. Interventions for alleviating fatigue, depression, and financial difficulties are needed to enhance the HRQOL of Korean lymphoma survivors.

Efficient palliative involved-field radiotherapy on highly progressive diffuse large B-cell primary gastric lymphoma with liver cirrhosis

We report the case of a 73-year-old woman having diffuse large B-cell primary gastric lymphoma with a cirrhotic liver caused by hepatitis C virus infection. She visited our hospital with symptoms of nausea and vomiting, which appeared to be caused by stenosis due to the tumor. Metastatic tumors were seen in the gastric and jugular lymph nodes. The clinical stage was IVB with a high risk of poor prognosis according to the international index. Because of poor hepatic reserve function, standard chemotherapy could not be administered. To maintain her quality of life, palliative involved-field radiotherapy was performed. The symptoms and tumor markers significantly improved, and computed tomography and endoscopy indicated the disappearance of the primary gastric tumor. Two months after radiotherapy and her return home, she died of pneumonia. Autopsy showed neither lymphoma cells nor stenosis of gastric lesion. The significant anti-tumor effect on primary tumor in our case suggests that the involved-field radiotherapy, although palliative, can be a therapeutic option for primary gastric lymphoma patients with various complications.

Quality of life in patients with gastric cancer: translation and psychometric evaluation of the Iranian version of EORTC QLQ-STO22

Background

Disease and treatment related events, can adversely affect the quality of life of patients with cancer. The purpose of this study was to translate and validate a gastric cancer specific health related quality of life questionnaire (EORTC QLQ-STO22) for Iranian patients suffering from gastric cancer.

Methods

Forward-backward procedure was applied to translate the English language version of the EORTC QLQ-STO22 into Persian (Iranian language). Then, the questionnaire and the EORTC core quality of life instrument (QLQ-C30) were administered to a sample of patients with confirmed diagnosis of gastric cancer. All patients filled in questionnaires before and after one month of treatment. Patients were divided into two groups based on intension of treatment (curative vs. palliative). Reliability and validity of the module was tested by internal consistency and known group comparisons, respectively.

Results

In all, 105 patients were entered into the study. Cronbach's alpha for multi-item scales (to test reliability) ranged from 0.54 to 0.87. The questionnaire discriminated well between clinically distinct subgroups of patients both before and after treatment lending support to its convergent and clinical validity.

Conclusion

Overall, the Iranian version of the EORTC QLQ-STO22 demonstrated a good reliability and clinical validity to support its use in combination with core questionnaire in outcome studies of gastric cancer in Iran. However, using the QLQ-STO22 in a wide range of Iranian patients with gastric cancer should allow further confirmation for its psychometric properties.