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Alwhaibi A, Alenazi MA, Alnofaie SD, Aldekhail AM, Alanazi RJ, Alghadeer S, Alghamdi AA, Alanazi SA. Real-World Comparison of Health-Related Quality of Life Associated with Use of Immune-Checkpoint Inhibitors in Oncology Patients. J Clin Med 2024; 13:4918. [PMID: 39201062 PMCID: PMC11355607 DOI: 10.3390/jcm13164918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/14/2024] [Accepted: 08/16/2024] [Indexed: 09/02/2024] Open
Abstract
Background: Immune checkpoint inhibitors (ICIs) offer a new treatment approach for cancer, with an improvement in patient survival. However, it remains unclear whether their use impacts the quality of life of treated patients. This study aims to compare the health-related quality of life (HRQoL) of patients treated with different anti-PD-1 and anti-PD-L1 drugs, including several single or combination therapies. Methods: This is a prospective observational study conducted with adult cancer patients who received at least one dose of anti-PD-1 or anti-PD-L1. The HRQoL of all adult patients was assessed using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 module (QLQ-C30), version 3, Arabic version. Results: A total of 199 patients were found to be eligible for this study. Of these, 93 patients (82 on a single medication and 11 on multiple ICIs) completed the questionnaire, with a response rate of 46.7%. The majority of patients were treated with pembrolizumab (39.8%), followed by a smaller number treated with nivolumab (35.5%). Most of the patients were diagnosed with solid and advanced malignancies-88.2% (p = 0.023) and 87.1% (p = 0.021), respectively-with a significant difference between treatment groups. The median functioning score was 84.7%, with no significant difference between treatment groups (p = 0.752). Fatigue and pain were noted in >50% of patients, influencing the overall cohort's score related to these symptoms, with scores of 88.8% and 83.3%, respectively. Although a non-significant variation was found in the scores of all combined symptoms among all groups, ranging from 82.1% to 90.4% (p = 0.931), patients receiving anti-PD-1 + anti-PD-L1 tended to more frequently complain about fatigue, pain, dyspnea, and constipation and hence, exhibited the worst, yet non-significant, scores compared to those of the other groups, with p = 0.234, p = 0.79, p = 0.704, and p = 0.86, respectively. All combined groups scored 83.3% on the global health scale. Nevertheless, the nivolumab-treated patients scored 75%, which was the worst global health score compared with those of the other groups, but this score was not statistically significant (p = 0.809). Conclusions: Our findings revealed no significant difference in the impact of different ICIs on the HRQoL of cancer patients. However, a larger number of cases would be necessary to provide a robust analysis and to yield conclusive results.
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Affiliation(s)
- Abdulrahman Alwhaibi
- Department of Clinical Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (A.M.A.); (S.A.)
| | - Miteb A. Alenazi
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Saad D. Alnofaie
- Information Technology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh 11426, Saudi Arabia;
| | - Abdullah M. Aldekhail
- Department of Clinical Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (A.M.A.); (S.A.)
| | - Rakan J. Alanazi
- Pharmacy Practice Department, College of Pharmacy, Alfaisal University, Riyadh 11533, Saudi Arabia;
| | - Sultan Alghadeer
- Department of Clinical Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (A.M.A.); (S.A.)
| | - Abdulrhman A. Alghamdi
- Pharmaceutical Services Department, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia;
| | - Saleh A. Alanazi
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia;
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Johansen G, Lampic C, Flöter Rådestad A, Dahm-Kähler P, Rodriguez-Wallberg KA. Health-related quality of life, sexual function, psychological health, reproductive concerns and fertility outcome in young women treated with fertility-sparing surgery for ovarian tumors - A prospective longitudinal multicentre study. Gynecol Oncol 2024; 189:101-108. [PMID: 39084159 DOI: 10.1016/j.ygyno.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/14/2024] [Accepted: 07/07/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE This study aimed to investigate health-related quality of life (HRQoL), sexual function, psychological-health, reproductive concerns, and fertility outcomes of women of reproductive age undergoing Fertility-Sparing Surgery (FSS) for treatment of ovarian cancer (OC) or borderline ovarian tumor (BOT), over a 2-year period. METHODS Prospective longitudinal multicentre study including women 18-40 years undergoing FSS between 2016 and 2018 in Sweden. Clinical data at diagnosis, histopathological findings and 2-year follow-up regarding oncological and reproductive outcomes were collected. Participants completed the EORTC QLQ-C30 and OV-28, FSFI, HADS and study-specific items at time of diagnosis and at one- and two-years following FSS. Data were analysed using a model for repeated measures to investigate changes over time. RESULTS Of 68 eligible women, 49 were included following exclusions due to benign pathology or subsequent radical surgery. During a mean follow-up of 20.5 months, two women experienced a recurrence and 82% reported regular menstruations. The majority (94%) had a strong desire to become biological mothers, which remained or increased over time. The conception-rate was 76%. HRQoL, psychological-health and sexual function improved over time and the proportion of women with sexual dysfunction decreased. At one-year follow-up 50% of nulliparous women had scores indicating sexual dysfunction compared to 0% of the women who had given birth either before or after surgery (p = 0.008). CONCLUSION HRQoL, psychological-health and sexual function improved during two-year follow-up after FSS in young women presenting with OC or BOT. Women who had given birth prior to or after FSS reported improved sexual function compared to nulliparous women.
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Affiliation(s)
- Gry Johansen
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Gynecology, Division of Gynecology and Reproduction, Karolinska University Hospital, Stockholm, Sweden
| | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, Umeå University, Umeå, Sweden
| | - Angelique Flöter Rådestad
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Hereditary Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Pernilla Dahm-Kähler
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Kenny A Rodriguez-Wallberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, Stockholm, Sweden.
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Young T, Velikova G, Liegl G, Rose M, Nolte S. EORTC QLQ-C30 normative data for the United Kingdom: Results of a cross-sectional survey of the general population. Eur J Cancer 2024; 204:113927. [PMID: 38429166 DOI: 10.1016/j.ejca.2024.113927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE The cancer-specific health-related quality of life (HRQoL) questionnaire of the European Organisation for Research and Treatment of Cancer (EORTC), the EORTC QLQ-C30, is a frequently applied questionnaire to assess cancer patients' self-reported health used as part of research and clinical practice. Normative data obtained from the general population can facilitate the interpretation of these data. Despite its frequent application, no detailed EORTC QLQ-C30 normative data have yet been published for the United Kingdom (UK). This study presents detailed EORTC QLQ-C30 normative data for the United Kingdom overall and by sex and age. METHODS The data are drawn from a larger published, international, cross-sectional online survey. For the recruitment, the sample was stratified by sex (males, females) and age in five age groups with a sample size of n = 100 per subgroup. RESULTS A total of N = 1026 UK respondents completed the survey (n = 517 females, n = 509 males). There were no clear subgroup patterns by sex or age; however, older patients tended to show higher (i.e., better) scores in emotional and social functioning; they also reported some of the lowest (i.e., best) scores for symptoms, such as insomnia, appetite loss, diarrhoea, nausea/vomiting or financial difficulties. CONCLUSION This paper provides EORTC QLQ-C30 general population normative data for the UK, further stratified by sex and age. These data will greatly support the interpretation of EORTC QLQ-C30 scale scores obtained from UK cancer patients, and also enable comparison with other detailed national normative datasets collected in the same project, across several other European countries and the US.
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Affiliation(s)
- Teresa Young
- East & North Hertfordshire NHS Trust including Mount Vernon Cancer Centre, Northwood, Middlesex HA6 2RN, United Kingdom.
| | - Galina Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, United Kingdom
| | - Gregor Liegl
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Rose
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; German Centre for Mental Health (DZPG) - - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sandra Nolte
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Melbourne Health Economics, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia; School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
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Omar MT, Al-Malki MH, Bindawas SM, Alnahdi AH, Aljehan GH, M Al-Omari BN, Alhammad SA. Cross-cultural adaptation and validation of the Arabic version of McGill quality of life: revised questionnaire in the patients with cancer. Disabil Rehabil 2024; 46:1878-1887. [PMID: 37144328 DOI: 10.1080/09638288.2023.2207220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 04/23/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE The aims of this study were to translate and culturally adapt the McGill Quality of Life Questionnaire-revised (MQOL-R) to modern standard Arabic and to examine its reliability, construct, and discriminative validity in Arab patients with cancer. MATERIALS AND METHODS Translation and cultural adaptation of the English MQOL-R to modern standard Arabic were performed according to international guidelines. For psychometric evaluation, 125 participants with cancer were selected and completed the MQOL-R along with Global Health Status/QoL and functional subscales of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), and Eastern Cooperative Oncology Group performance status rating (ECOG-PS). The MQOL-R was tested for internal consistency, test-retest reliability, and construct validity. RESULTS The Arabic MQOL-R questionnaire had adequate internal consistency with Cronbach's alphas between 0.75 and 0.91. Test-retest reliability was very strong (ICC2.1 =0.91 to 0.96, p < 0.001). As hypothesized, the Arabic MQOL-R subscales demonstrated moderate to excellent correlation with functional subscales of EORTC QLQ-C30, and moderate to good correlation with Global health status/QoL. CONCLUSION The Arabic MQOL-R Questionnaire has adequate psychometric properties. Hence, it can be utilized in rehabilitation settings and research to measure health-related quality of life in the Arabic-speaking cancer population.
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Affiliation(s)
- Mohammed Ta Omar
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Majed Hassan Al-Malki
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
- Rehabilitation Department, Prince Mishari Bin Saoud Hospital, Kingdom of Saudi Arabia
| | - Saad M Bindawas
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
| | - Ali H Alnahdi
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
| | - Ghaidaa H Aljehan
- Rehabilitation Department, King Abdullah Medical City, Makkah, Kingdom of Saudi Arabia
| | - Badr Nasser M Al-Omari
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
- Rehabilitation Department, Prince Mishari Bin Saoud Hospital, Kingdom of Saudi Arabia
| | - Saad A Alhammad
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
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Musoro JZ, Coens C, Sprangers MAG, Brandberg Y, Groenvold M, Flechtner HH, Cocks K, Velikova G, Dirven L, Greimel E, Singer S, Pogoda K, Gamper EM, Sodergren SC, Eggermont A, Koller M, Reijneveld JC, Taphoorn MJB, King MT, Bottomley A. Minimally important differences for interpreting EORTC QLQ-C30 change scores over time: A synthesis across 21 clinical trials involving nine different cancer types. Eur J Cancer 2023; 188:171-182. [PMID: 37257278 DOI: 10.1016/j.ejca.2023.04.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Early guidelines for minimally important differences (MIDs) for the EORTC QLQ-C30 proposed ≥10 points change as clinically meaningful for all scales. Increasing evidence that MIDs can vary by scale, direction of change, cancer type and estimation method has raised doubt about a single global standard. This paper identifies MID patterns for interpreting group-level change in EORTC QLQ-C30 scores across nine cancer types. METHODS Data were obtained from 21 published EORTC Phase III trials that enroled 13,015 patients across nine cancer types (brain, colorectal, advanced breast, head/neck, lung, mesothelioma, melanoma, ovarian, and prostate). Anchor-based MIDs for within-group change and between-group differences in change over time were obtained via mean change method and linear regression, respectively. Separate MIDs were estimated for improvements and deteriorations. Distribution-based estimates were derived and compared with anchor-based MIDs. RESULTS Anchor-based MIDs mostly ranged from 5 to 10 points. Differences in MIDs for improvement vs deterioration, for both within-group and between-group, were mostly within a 2-points range. Larger differences between within-group and between-group MIDs were observed for several scales in ovarian, lung and head/neck cancer. Most anchor-based MIDs ranged between 0.3 SD and 0.5 SD distribution-based estimates. CONCLUSIONS Our results reinforce recent claims that no single MID can be applied to all EORTC QLQ-C30 scales and disease settings. MIDs varied by scale, improvement/deterioration, within/between comparisons and by cancer type. Researchers applying commonly used rules of thumb must be aware of the risk of dismissing changes that are clinically meaningful or underpowering analyses when smaller MIDs apply.
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Affiliation(s)
- Jammbe Z Musoro
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium.
| | - Corneel Coens
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Mirjam A G Sprangers
- Amsterdam UMC Location University of Amsterdam, Medical Psychology, Amsterdam, The Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
| | - Yvonne Brandberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Mogens Groenvold
- Department of Public Health, University of Copenhagen, and Bispebjerg Hospital, Copenhagen, Denmark
| | - Hans-Henning Flechtner
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
| | - Kim Cocks
- Adelphi Values, Bollington, Cheshire, UK
| | - Galina Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Leeds, UK; Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | | | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, Division of Epidemiology and Health Services Research, University Medical Centre Mainz, Germany; University Cancer Centre Mainz, Germany
| | - Katarzyna Pogoda
- Departmenf of Breast Cancer and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Eva M Gamper
- Innsbruck Institute of Patient-centered Outcome Research (IIPCOR), Innsbruck, Austria
| | | | - Alexander Eggermont
- Princess Máxima Center, Utrecht and University Medical Center Utrecht, The Netherlands; Comprehensive Cancer Center Munich, Technical University Munich & Ludwig Maximiliaan University, Munich, Germany
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Jaap C Reijneveld
- Amsterdam University Medical Centers, location VU University Medical Center, Department of Neurology Brain Tumor Center, Amsterdam, The Netherlands
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Madeleine T King
- University of Sydney, Faculty of Science, School of Psychology, Sydney, NSW, Australia
| | - Andrew Bottomley
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
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Okafor CN, Akosile CO, Nkechi CE, Okonkwo UP, Nwankwo CM, Okoronkwo IL, Okpala PU, Afonne AJ. Effect of educational intervention programme on the health-related quality of life (HRQOL) of individuals with type 2 diabetes mellitus in South-East, Nigeria. BMC Endocr Disord 2023; 23:75. [PMID: 37029340 PMCID: PMC10080927 DOI: 10.1186/s12902-023-01329-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/26/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Diabetes is one of the most important chronic diseases that have a great impact on health as people with diabetes are constantly being reminded of their disease daily; they have to eat carefully, exercise, and test their blood glucose. They often feel challenged by their disease because of its day-to-day management demands and these affect their quality of life. The study aimed at determining the effect of an educational intervention program on the quality of life of Individuals with type 2 Diabetes Mellitus in South East, Nigeria. METHODS A quasi-experimental controlled study involving three hundred and eighty-two (382) type 2 DM persons recruited from the tertiary health institutions in South East, Nigeria, and randomly assigned to intervention and control groups respectively. Data was collected from the diabetic clinics of the health institutions using the SF - 36 questionnaires. Pretest data collection was done, and thereafter, education on self-care was given to the intervention group. After a 6months follow-up, post-test data were collected from both groups. Analysis was done using an Independent t-test, Analysis of Covariance (ANCOVA), Paired Samples Test, and Spearman rank order correlation at 0.05 alpha level. RESULTS The control group indicated significantly higher mean HRQOL scores in most domains of the HRQOL before intervention (t = -1.927 to -6.072, p < 0.05). However, 6 months after the intervention, the mean HRQOL scores of the intervention group increased significantly in all the domains of HRQOL (p < 0.05) with an effect size of 0.14 (Eta squared). A comparison of the two groups shows a statistically significant difference (64.72 ± 10.96 vs. 58.85 ± 15.23; t = 4.349. p = 0.001) after the intervention. Age was inversely correlated with some domains of HRQOL; as age increases, HRQOL decreases in those domains. Gender had no significant influence on HRQOL. CONCLUSION Educational intervention was effective in improving HRQOL in individuals with type 2 DM. Hence, it is recommended for inclusion in all diabetes care plans.
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Affiliation(s)
- Christiana Nkiru Okafor
- Department of Nursing Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Christopher Olusanjo Akosile
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Nnewi, PMB 5001 Anambra State Nigeria
| | - Chiejina Edith Nkechi
- Department of Nursing Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Uchenna Prosper Okonkwo
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Nnewi, PMB 5001 Anambra State Nigeria
| | - Chinenye Mercy Nwankwo
- Department of Community Health, Kabela University School of Medicine, Kabale University, Kabale, Uganda
| | - Ijeoma Lewechi Okoronkwo
- Department of Nursing Sciences, Faculty of Health Sciences and Technology, University of Nigeria, Nsukka, Nigeria
| | - Pat Uzo Okpala
- Department of Nursing, College of Health Sciences, Evangel University, Akaeze, Ebonyi State Nigeria
| | - Anulika Johnson Afonne
- Department of Nursing Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Nigeria
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Pour-Rashidi A, Namvar M, Iranmehr A, Carpaneto A, Hanaei S, Rezaei N. Psychological and Psychiatric Aspects of Brain and Spinal Cord Tumors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1405:673-687. [PMID: 37452958 DOI: 10.1007/978-3-031-23705-8_26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Central nervous system (CNS) tumors are mainly diagnosed by physical symptoms such as paralysis, visual field defect, seizure, and loss of consciousness. The psychological and psychiatric background of CNS tumors, whether in preoperative or postoperative period, has long been a neglected topic; however, lately, many authors and researchers have paid more attention to these manifestations. Neurocognition is a subset of parameters, including attention, memory, mood, emotions, language production, personality, executive function, problem-solving, calculation, and spatial cognition, making up the patient's cognitive performance. Also, it is worthy to say that neurocognition is considered a parameter of quality of life (QoL). Currently, we know that neurocognitive disorders are a group of symptoms presenting by the patients. These symptoms may be the first picture of CNS lesions, which result in incorrect treatment, a higher financial burden on the patient and health system, and finally, poorer QoL and performance scale if they are not diagnosed early. Psychological and psychiatric problems such as depression, anxiety, and phobia following the CNS tumors have two aspects. These may present before any treatment resulting from the tumoral mass effect, peritumoral edema, or cerebral tissue disruption due to the space-occupying lesion. On the other hand, we can see these features after a kind of therapy such as surgery, medical therapy, or adjuvant therapy. Sometimes, the CNS tumors lead to psychosocial complications postoperatively. Indeed, considering tumor surgery complications, some patients may find various degrees of deficits that make the patient isolated either socially or professionally. Obviously, the improvement rate and outcome of this specific situation depend on the mechanism of occurrence and its causes. For instance, postoperative symptom relief would be expected when the symptoms are related to the tumoral mass effect. Getting familiar with this constellation of the symptoms, realizing them, and then localizing them to the correct area of the CNS are very crucial. Accordingly, because of their importance in QoL, their influence on patient's survival even more than the extent of resection of the tumor, and somehow their ignorance, we will discuss different neurocognitive manifestations related to CNS tumors in this chapter.
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Affiliation(s)
- Ahmad Pour-Rashidi
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Mohamad Namvar
- Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Arad Iranmehr
- Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Allegra Carpaneto
- Department of Neuro-Oncology, University and City of Health and Science Hospital, Via Cherasco 15, 10126, Turin, Italy
| | - Sara Hanaei
- Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Kumar V, Malhotra V, Sinha V. Evaluation of Individual Quality of Life (QOL) Among Patients with Tracheostomy Using WHO-QOL BREF Questionnaire. Indian J Otolaryngol Head Neck Surg 2022; 74:5207-5216. [PMID: 36742676 PMCID: PMC9895232 DOI: 10.1007/s12070-020-02052-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023] Open
Abstract
Tracheostomy is one of the most frequently performed surgical procedures worldwide. The placement of tracheostomy in a patient is associated with significant morbidities as apart from the physical impact of the procedure, a profound and persistent effect on psychosocial, financial, environmental and other aspects of global health of the patient becomes inevitable. However, there is a surprising paucity of literature assessing the Quality of Life (QOL) in patients with tracheostomy tube placement. This study was undertaken with the objective to assess the effect of tracheostomy on Quality of Life (QOL) of patients in an urban tertiary health care setup in India. Patients who underwent tracheostomy tube placement irrespective of the indication were included in the study and followed up for a period of up to 3 months to determine the effect of tracheostomy tube placement on the Quality of Life. A questionnaire based on World Health Organisation (WHO) QOL BREF scheme was utilized to evaluate QOL in the immediate post operative period and again appraised after a period of 3 months. The results were statistically analyzed, tabulated and compared using paired t test to evaluate the 'p' value in every domain i.e., physical, social, psychological and environmental, of the WHO QOL-BREF evaluation tool. 63 patients were enrolled in the study after excluding the patients not fulfilling the selection criteria. The majority of patients were male over the age of 50 years (mean age 57 years). There was a noteworthy depreciation in QOL score in patients as WHO-QOL-BREF scores in all the 4 domains were significantly lower after 3 months. The most affected were the Environmental domain (p value 5E-15) whereas the domain of Psychological showed least depreciation of mean QOL score (p value 7.7E-5). Insertion of a tracheostomy tube has a significant impact on the quality of life of the patient and the amount of burden increases with worsening quality of life. A holistic and scientific approach to assess and manage tracheostomy induced morbidity on the patient is necessary. The patients' views of the aspects of life should be used by health policy makers, clinicians, and caregivers as a reliable guide to the most important priorities for treatment and medical interventions. Large prospective multicenter studies may be undertaken for the developement of a standardized and internationally accepted tracheostomy specific quality of life evaluation tool.
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Affiliation(s)
- Vivek Kumar
- Department of ENT, PMCH, Ashok Rajpath, Patna, 800004 India
| | | | - Vineet Sinha
- Department of ENT, PMCH, Ashok Rajpath, Patna, 800004 India
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Tunthanathip T, Sae-heng S, Oearsakul T, Kaewborisutsakul A, Inkate S, Madteng S, Tanvejsilp P. Quality of life, out-of-pocket expenditures, and indirect costs among patients with the central nervous system tumors in Thailand. J Neurosci Rural Pract 2022; 13:740-749. [PMID: 36743773 PMCID: PMC9894017 DOI: 10.25259/jnrp-2022-3-45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/11/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives The aim of this study was to investigate out-of-pocket (OOP) expenditures, indirect costs, and health-related quality of life (HRQoL) associated with the central nervous system (CNS) tumors in Thailand. Materials and Methods A prospective study of CNS tumor patients who underwent first tumor resection at a tertiary care institution in Thailand was conducted. Patients were interviewed during hospitalization for undergoing first surgery. Within 6 months, they were interviewed once more if the disease continued to progress. Costs collected from a patient perspective and converted to 2019 US dollars. For dealing with these skewed data, a generalized linear model was used to investigate the effects of disease severity (malignancy, progressive disease, Karnofsky performance status score, and histology) and other factors on costs (OOP, informal care, productivity loss, and total costs). P < 0.05 was considered statistical significant for all analysis. Results Among a total of 123 intracranial CNS tumor patients, there were 83 and 40 patients classified into benign and malignant, respectively. In the first brain surgery, there was no statistical difference in HRQoL between patients with benign and malignant tumors (P = 0.072). However, patients with progressive disease had lower HRQoL mean scores at pre-operative and progressive disease periods were 0.711 (95% confidence interval [CI]: 0.662-0.760) and 0.261 (95% CI: 0.144-0.378), respectively. Indirect expenditures were the primary cost driver, accounting for 73.81% of annual total costs. The total annual costs accounted for 59.81% of the reported patient's income in malignant tumor patients. The progressive disease was the only factor that was significantly increases in all sorts of costs, including the OOP (P = 0.001), the indirect costs (P = 0.013), and the total annual costs (P = 0.001). Conclusion Although there was no statistical difference in HRQoL and costs between patients with benign and malignant tumor, the total costs accounted for more than half of the reported income in malignant tumor patients. The primary cause of significant increases in all costs categories was disease progression.
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Affiliation(s)
- Thara Tunthanathip
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Sakchai Sae-heng
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Thakul Oearsakul
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Anukoon Kaewborisutsakul
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Srirat Inkate
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Suphavadee Madteng
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Pimwara Tanvejsilp
- Department of Pharmacy Administration, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
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10
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Health-related quality of life in patients with advanced melanoma treated with ipilimumab: prognostic implications and changes during treatment. ESMO Open 2022; 7:100588. [PMID: 36116420 PMCID: PMC9588897 DOI: 10.1016/j.esmoop.2022.100588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 07/11/2022] [Accepted: 08/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background We have previously reported that the safety and efficacy of ipilimumab in real-world patients with metastatic melanoma were comparable to clinical trials. Few studies have explored health-related quality of life (HRQL) in real-world populations receiving checkpoint inhibitors. This study reports HRQL in real-world patients receiving ipilimumab and assesses the prognostic value of patient-reported outcome measures. Patients and methods Ipi4 (NCT02068196) was a prospective, multicentre, interventional phase IV trial. Real-world patients (N = 151) with metastatic melanoma were treated with ipilimumab 3 mg/kg intravenously as labelled. HRQL was assessed by the European Organisation of Research and Treatment of Cancer Quality of Life Questionnaire at baseline and after 10-12 weeks. Results The European Organisation of Research and Treatment of Cancer Quality of Life Questionnaire was completed by 93% (141/151 patients) at baseline, and by 82% at 10-12 weeks. Poor performance status and elevated C-reactive protein (CRP) were associated with worse baseline HRQL. Clinically relevant and statistically significant deteriorations in HRQL from baseline to weeks 10-12 were reported (P <0.05). Baseline physical functioning [hazard ratio (HR) 1.96, P = 0.016], role functioning (HR 2.15, P <0.001), fatigue (HR 1.60, P = 0.030), and appetite loss (HR 1.76, P = 0.012) were associated with poorer overall survival independent of performance status, lactate dehydrogenase (LDH), and CRP. We further developed a prognostic model, combining HRQL outcomes with performance status, LDH, and CRP. This model identified three groups with large and statistically significant differences in survival. Conclusions Systemic inflammation is associated with impaired HRQL. During treatment with ipilimumab, HRQL deteriorated significantly. Combining HRQL outcomes with objective risk factors provided additional prognostic information that may aid clinical decision making. HRQL was independently associated with survival in patients with metastatic melanoma receiving ipilimumab. Patients experienced clinically meaningful and statistically significant deteriorations in HRQL during therapy. A prognostic model combining HRQL and biological markers defined three groups with highly variable life expectancies. This prognostic model may be of use in clinical decision making.
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11
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Boeer B, Seller A, Schoenfisch B, Krainick-Strobel U, Dietrich A, Brucker SY, Wallwiener D, Niess A, Hahn M. The impact of rehabilitation sport on breast cancer-related lymphoedema and quality of life. Arch Gynecol Obstet 2022; 307:1529-1537. [PMID: 35879447 PMCID: PMC10110661 DOI: 10.1007/s00404-022-06609-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/01/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Surgery and radiotherapy as part of breast cancer treatment can lead to lymphoedema of the upper extremities (breast cancer-related lymphoedema = BCRL) and reduce the quality of life (health-related quality of life = HRQoL). The aim of the present study was to investigate the influence of paddling in a dragon boat (PP) on HRQoL and BCRL in breast cancer survivors (BCS). METHODS Between April and October 2017, a prospective case-control study evaluated the effects of PP compared to a control group. In the paddle group (n = 28), weekly arm circumference measurements were taken at four defined anatomic areas of the arm before and after training; in the control group (n = 70), the measurements were taken once a month. At the beginning and end of the study, questionnaires from both groups (SF 36, EORTC QLQ C30) were evaluated to understand the differences in HRQoL. RESULTS The paddle group started with a higher HRQoL compared to the control group. Most interesting, whether the affected or unaffected arm, whether before or after training-the arm circumference decreased over time in the paddling group. A pre-existing lymphoedema was not negatively influenced by paddling. In the paddle group, the physical health was constant over the season, while the physical health of the control group decreased significantly over time. CONCLUSION PP in a dragon boat does not lead to the development or worsening of pre-existing lymphoedema due to breast cancer therapy, and seems to have a positive effect on the quality of life.
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Affiliation(s)
- Bettina Boeer
- Department of Women's Health, University Hospital of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany.
| | - Anna Seller
- Department of Women's Health, University Hospital of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - Birgitt Schoenfisch
- Research Institute for Women's Health, University of Tuebingen, Tuebingen, Germany
| | | | - Andreas Dietrich
- Faculty of Economics and Social Sciences, Institute for Sports Science, University of Tuebingen, Tuebingen, Germany
| | - Sara Y Brucker
- Department of Women's Health, University Hospital of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - Diethelm Wallwiener
- Department of Women's Health, University Hospital of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
| | - Andreas Niess
- Department of Sports Medicine, University Hospital of Tuebingen, Tuebingen, Germany
| | - Markus Hahn
- Department of Women's Health, University Hospital of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany
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12
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Velikova G, Absolom K, Hewison J, Holch P, Warrington L, Avery K, Richards H, Blazeby J, Dawkins B, Hulme C, Carter R, Glidewell L, Henry A, Franks K, Hall G, Davidson S, Henry K, Morris C, Conner M, McParland L, Walker K, Hudson E, Brown J. Electronic self-reporting of adverse events for patients undergoing cancer treatment: the eRAPID research programme including two RCTs. PROGRAMME GRANTS FOR APPLIED RESEARCH 2022. [DOI: 10.3310/fdde8516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background
Cancer is treated using multiple modalities (e.g. surgery, radiotherapy and systemic therapies) and is frequently associated with adverse events that affect treatment delivery and quality of life. Regular adverse event reporting could improve care and safety through timely detection and management. Information technology provides a feasible monitoring model, but applied research is needed. This research programme developed and evaluated an electronic system, called eRAPID, for cancer patients to remotely self-report adverse events.
Objectives
The objectives were to address the following research questions: is it feasible to collect adverse event data from patients’ homes and in clinics during cancer treatment? Can eRAPID be implemented in different hospitals and treatment settings? Will oncology health-care professionals review eRAPID reports for decision-making? When added to usual care, will the eRAPID intervention (i.e. self-reporting with tailored advice) lead to clinical benefits (e.g. better adverse event control, improved patient safety and experiences)? Will eRAPID be cost-effective?
Design
Five mixed-methods work packages were conducted, incorporating co-design with patients and health-care professionals: work package 1 – development and implementation of the electronic platform across hospital centres; work package 2 – development of patient-reported adverse event items and advice (systematic and scoping reviews, patient interviews, Delphi exercise); work package 3 – mapping health-care professionals and care pathways; work package 4 – feasibility pilot studies to assess patient and clinician acceptability; and work package 5 – a single-centre randomised controlled trial of systemic treatment with a full health economic assessment.
Setting
The setting was three UK cancer centres (in Leeds, Manchester and Bristol).
Participants
The intervention was developed and evaluated with patients and clinicians. The systemic randomised controlled trial included 508 participants who were starting treatment for breast, colorectal or gynaecological cancer and 55 health-care professionals. The radiotherapy feasibility pilot recruited 167 patients undergoing treatment for pelvic cancers. The surgical feasibility pilot included 40 gastrointestinal cancer patients.
Intervention
eRAPID is an online system that allows patients to complete adverse event/symptom reports from home or hospital. The system provides immediate severity-graded advice based on clinical algorithms to guide self-management or hospital contact. Adverse event data are transferred to electronic patient records for review by clinical teams. Patients complete an online symptom report every week and whenever they experience symptoms.
Main outcome measures
In systemic treatment, the primary outcome was Functional Assessment of Cancer Therapy – General, Physical Well-Being score assessed at 6, 12 and 18 weeks (primary end point). Secondary outcomes included cost-effectiveness assessed through the comparison of health-care costs and quality-adjusted life-years. Patient self-efficacy was measured (using the Self-Efficacy for Managing Chronic Diseases 6-item Scale). The radiotherapy pilot studied feasibility (recruitment and attrition rates) and selection of outcome measures. The surgical pilot examined symptom report completeness, system actions, barriers to using eRAPID and technical performance.
Results
eRAPID was successfully developed and introduced across the treatments and centres. The systemic randomised controlled trial found no statistically significant effect of eRAPID on the primary end point at 18 weeks. There was a significant effect at 6 weeks (adjusted difference least square means 1.08, 95% confidence interval 0.12 to 2.05; p = 0.028) and 12 weeks (adjusted difference least square means 1.01, 95% confidence interval 0.05 to 1.98; p = 0.0395). No between-arm differences were found for admissions or calls/visits to acute oncology or chemotherapy delivery. Health economic analyses over 18 weeks indicated no statistically significant difference between the cost of the eRAPID information technology system and the cost of usual care (£12.28, 95% confidence interval –£1240.91 to £1167.69; p > 0.05). Mean differences were small, with eRAPID having a 55% probability of being cost-effective at the National Institute for Health and Care Excellence-recommended cost-effectiveness threshold of £20,000 per quality-adjusted life-year gained. Patient self-efficacy was greater in the intervention arm (0.48, 95% confidence interval 0.13 to 0.83; p = 0.0073). Qualitative interviews indicated that many participants found eRAPID useful for support and guidance. Patient adherence to adverse-event symptom reporting was good (median compliance 72.2%). In the radiotherapy pilot, high levels of consent (73.2%) and low attrition rates (10%) were observed. Patient quality-of-life outcomes indicated a potential intervention benefit in chemoradiotherapy arms. In the surgical pilot, 40 out of 91 approached patients (44%) consented. Symptom report completion rates were high. Across the studies, clinician intervention engagement was varied. Both patient and staff feedback on the value of eRAPID was positive.
Limitations
The randomised controlled trial methodology led to small numbers of patients simultaneously using the intervention, thus reducing overall clinician exposure to and engagement with eRAPID. Furthermore, staff saw patients across both arms, introducing a contamination bias and potentially reducing the intervention effect. The health economic results were limited by numbers of missing data (e.g. for use of resources and EuroQol-5 Dimensions).
Conclusions
This research provides evidence that online symptom monitoring with inbuilt patient advice is acceptable to patients and clinical teams. Evidence of patient benefit was found, particularly during the early phases of treatment and in relation to self-efficacy. The findings will help improve the intervention and guide future trial designs.
Future work
Definitive trials in radiotherapy and surgical settings are suggested. Future research during systemic treatments could study self-report online interventions to replace elements of traditional follow-up care in the curative setting. Further research during modern targeted treatments (e.g. immunotherapy and small-molecule oral therapy) and in metastatic disease is recommended.
Trial registration
The systemic randomised controlled trial is registered as ISRCTN88520246. The radiotherapy trial is registered as ClinicalTrials.gov NCT02747264.
Funding
This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 10, No. 1. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Galina Velikova
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Kate Absolom
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Jenny Hewison
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Patricia Holch
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
- Psychology Group, School of Social Sciences, Leeds Beckett University, Leeds, UK
| | - Lorraine Warrington
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
| | - Kerry Avery
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hollie Richards
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jane Blazeby
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Bryony Dawkins
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Claire Hulme
- Health Economics Group, Institute of Health Research, University of Exeter, Exeter, UK
| | - Robert Carter
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
| | - Liz Glidewell
- Department of Health Sciences, University of York, York, UK
| | - Ann Henry
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Kevin Franks
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Geoff Hall
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Karen Henry
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Mark Conner
- School of Psychology, University of Leeds, Leeds, UK
| | - Lucy McParland
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Katrina Walker
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Eleanor Hudson
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Julia Brown
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
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13
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Sommer M, Nielsen LK, Nielsen LB, Brøndum RF, Nielsen MM, Rytter AS, Vesteghem C, Severinsen MT, El-Galaly TC, Bøgsted M, Grønkjær M, Jørgensen L. Patient-reported outcomes in patients with hematological relapse or progressive disease: a longitudinal observational study. Health Qual Life Outcomes 2021; 19:251. [PMID: 34736479 PMCID: PMC8567661 DOI: 10.1186/s12955-021-01887-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022] Open
Abstract
Background Patients with hematological cancer who experience relapse or progressive disease often face yet another line of treatment and continued mortality risk that could increase their physical and emotional trauma and worsen their health-related quality of life. Healthcare professionals who use patient-reported outcomes to identify who will have specific sensitivities in particular health-related quality of life domains may be able to individualize and target treatment and supportive care, both features of precision medicine. Here, in a cohort of patients with relapsed or progressive hematological cancer, we sought to identify health-related quality of life domains in which they experienced deterioration after relapse treatment and to investigate health-related quality of life patterns.
Method Patients were recruited in connection with a precision medicine study at the Department of Hematology, Aalborg University Hospital. They completed the European Organization for Research and Treatment of Cancer questionnaire and the Hospital Anxiety and Depression Scale at baseline and at 3, 6, 9, and 12 months after the relapse diagnosis or progressive cancer. Modes of completion were electronically or on paper. Clinically relevant changes from baseline to 12 months were interpreted according to Cocks’ guidelines. We quantified the number of patients with moderate or severe symptoms and functional problems and the number who experienced improvements or deterioration from baseline to 12 months. Results A total of 104 patients were included, of whom 90 (87%) completed baseline questionnaires and 50 (56%) completed the 12-month assessments. The three symptoms that patients most often reported as deteriorating were fatigue (18%), insomnia (18%), and diarrhea (18%). The three functions that patients most often reported as deteriorating were role (16%) and emotional (16%) and cognitive (16%) functioning. Conclusion In this study, patient-reported outcome data were useful for identifying negatively affected health-related quality of life domains in patients with relapsed or progressive hematological cancer. We identified patients experiencing deterioration in health-related quality of life during treatment and characterized a potential role for patient-reported outcomes in precision medicine to target treatment and supportive care in this patient group. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01887-6.
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Affiliation(s)
- Mia Sommer
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark. .,Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark. .,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. .,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark. .,University College Northern Denmark, Aalborg, Denmark.
| | - Lene Kongsgaard Nielsen
- Quality of Life Research Centre, Department of Hematology, Odense University Hospital, Odense, Denmark.,Department of Internal Medicine and Cardiology, Regional Hospital Viborg, Viborg, Denmark
| | | | - Rasmus Froberg Brøndum
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | | | | | - Charles Vesteghem
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Marianne Tang Severinsen
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Tarec Christoffer El-Galaly
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Martin Bøgsted
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Grønkjær
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lone Jørgensen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinic for Surgery and Cancer Treatment, Aalborg University Hospital, Aalborg, Denmark
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14
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The effect of atopic dermatitis on quality of life of affected dogs and their owners in Romania. J Vet Behav 2021. [DOI: 10.1016/j.jveb.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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15
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Muthanna FMS, Karuppannan M, Hassan BAR, Mohammed AH. Impact of fatigue on quality of life among breast cancer patients receiving chemotherapy. Osong Public Health Res Perspect 2021; 12:115-125. [PMID: 33980002 PMCID: PMC8102880 DOI: 10.24171/j.phrp.2021.12.2.09] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/27/2021] [Indexed: 02/07/2023] Open
Abstract
Objectives Fatigue is the most frequently reported symptom experienced by cancer patients and has a profound effect on their quality of life (QOL). The study aimed to determine the impact of fatigue on QOL among breast cancer patients receiving chemotherapy and to identify the risk factors associated with severe fatigue incidence. Methods This was an observational prospective study carried out at multiple centers. In total, 172 breast cancer patients were included. The Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire was used to measure QOL, while the Brief Fatigue Inventory (BFI) was used to assess the severity of fatigue. Results The total average mean and standard deviation of QOL were 84.58±18.07 and 4.65±1.14 for BFI scores, respectively. A significant association between fatigue and QOL was found in linear and multiple regression analyses. The relationships between fatigue severity and cancer stage, chemotherapy dose delay, dose reduction, chemotherapy regimen, and ethnicity were determined using binary logistic regression analysis. Conclusion The findings of this study are believed to be useful for helping oncologists effectively evaluate, monitor, and treat fatigue related to QOL changes.
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Affiliation(s)
- Fares Mohammed Saeed Muthanna
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA, Cawangan Selangor, Kampus Puncak Alam, Selangor, Malaysia
| | - Mahmathi Karuppannan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA, Cawangan Selangor, Kampus Puncak Alam, Selangor, Malaysia
| | | | - Ali Haider Mohammed
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Selangor, Malaysia
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16
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Musoro JZ, Sodergren SC, Coens C, Pochesci A, Terada M, King MT, Sprangers MAG, Groenvold M, Cocks K, Velikova G, Flechtner HH, Bottomley A. Minimally important differences for interpreting the EORTC QLQ-C30 in patients with advanced colorectal cancer treated with chemotherapy. Colorectal Dis 2020; 22:2278-2287. [PMID: 32767619 DOI: 10.1111/codi.15295] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/28/2020] [Indexed: 12/13/2022]
Abstract
AIM The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) assesses the health-related quality of life of patients in cancer trials. There are currently no minimally important difference (MID) guidelines for the EORTC QLQ-C30 for colorectal cancer (CRC). This study aims to estimate MIDs for the EORTC QLQ-C30 scales in patients with advanced CRC treated with chemotherapy and enrolled in clinical trials. METHOD The data were obtained from three published EORTC trials that treated CRC patients using chemotherapy. Potential anchors were selected from clinical variables based on their correlation with EORTC QLQ-C30 scales. Anchor-based MIDs for within-group change and between-group change were estimated via the mean change method and linear regression, respectively, and summarized using weighted correlation. Distribution-based MIDs were also examined. RESULTS Anchor-based MIDs were determined for deterioration in 8 of the 14 EORTC QLQ-C30 scales and in 9 scales for improvement, and varied by scale, direction of change and anchor. MIDs for improvement (deterioration) ranged from 6 to 18 (-11 to -5) points for within-group change and 5 to 15 (-10 to -4) for between-group change. Summarized MIDs (in absolute values) per scale mostly ranged from 5 to 10 points. CONCLUSIONS These findings have clinical relevance for the interpretation of treatment efficacy and the design of clinical trials by informing sample size requirements.
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Affiliation(s)
- J Z Musoro
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - S C Sodergren
- School of Health Sciences, University of Southampton, Southampton, UK
| | - C Coens
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - A Pochesci
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - M Terada
- Japan Clinical Oncology Group, Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - M T King
- Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - M A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - M Groenvold
- Department of Public Health, University of Copenhagen and Bispebjerg Hospital, Copenhagen, Denmark
| | - K Cocks
- Adelphi Values, Bollington, Cheshire, UK
| | - G Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - H-H Flechtner
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
| | - A Bottomley
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
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Abstract
PURPOSE Cancer is of increasing prevalence in less-developed countries. However, research on the patients' quality of life (QoL) in these countries is very limited. The aim of this study was to examine QoL of cancer patients in Africa. METHOD A sample of 256 cancer patients treated in an Ethiopian hospital was examined with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire EORTC QLQ-C30, the Multidimensional Fatigue Inventory, and the Hospital Anxiety and Depression Scale. A group of 1664 German cancer patients served as a comparison group. RESULTS Most of the scales of the EORTC QLQ-C30 showed acceptable reliability in the Ethiopian sample. Compared with the German cancer patients, the Ethiopian patients showed lower QoL in most dimensions, especially in financial difficulties, physical functioning, pain, and appetite loss (effect sizes between 0.52 and 0.75). Illiteracy, tumor stage, and treatment (surgery and chemotherapy) were associated with QoL in the Ethiopian sample. QoL was strongly correlated with fatigue, anxiety, and depression. CONCLUSION The EORTC QLQ-C30 is a suitable instrument for measuring QoL in Ethiopia. The detriments in QoL in the Ethiopian patients indicate specific cancer care needs for the patients in a developing country.
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Affiliation(s)
- Yemataw Wondie
- Department of Psychology, University of Gondar, Gondar, Ethiopia
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany.
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18
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Liu S, Lin Z, Lin J, Chen H, Xie Q, Rao W, Chen Y, Yu K, Hu Z. Health-related quality of life and treatment modality among esophageal squamous cell carcinoma survivors: A prospective study using time to deterioration model analysis. J Surg Oncol 2020; 123:156-163. [PMID: 33126290 DOI: 10.1002/jso.26264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/09/2020] [Accepted: 10/05/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVES This study aimed to analyze the association between health-related quality of life and treatment modality among esophageal squamous cell carcinoma (ESCC) survivors. METHODS Patients completed the EORTC QLQ-C30 and EORTC QLQ-OES18 at baseline and follow-up. A time to deterioration model analysis was performed to compare longitudinal EORTC QLQ-C30/QLQ-OES18 data between surgery alone and surgery with adjuvant chemotherapy. RESULTS For EORTC QLQ-C30 scale, compared with surgery alone, significant delays in time to deterioration in role functioning (16.05 months vs. 15.00 months; p = .045), cognitive functioning (20.80 months vs. 16.26 months; p = .017), social functioning (19.09 months vs. 12.35 months; p = .001), and dyspnea (18.53 months vs. 14.62 months; p = .011) were observed for surgery with adjuvant chemotherapy. For QLQ-OES18 scale, compared with surgery alone, significant delays in time to deterioration in dysphagia (13.75 months vs. 8.16 months; p = .005), choking when swallowing (20.67 months vs. 15.08 months; p = .001), and dry mouth (21.78 months vs. 17.28 months; p = .039) were observed for surgery with adjuvant chemotherapy. CONCLUSIONS Patients who received postoperative chemotherapy had significant delay in time to deterioration in multiple ESCC-related symptoms, functions of EORTC QLQ-C30 and EORTC QLQ-OES18.
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Affiliation(s)
- Shuang Liu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Zheng Lin
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jianbo Lin
- Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Huilin Chen
- Department of Radiation Oncology, Anxi County Hospital, Quanzhou, China
| | - Qianwen Xie
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Wenqing Rao
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yuanmei Chen
- Department of Thoracic Surgery, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Kaili Yu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
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Musoro JZ, Coens C, Greimel E, King MT, Sprangers MAG, Nordin A, van Dorst EBL, Groenvold M, Cocks K, Velikova G, Flechtner HH, Bottomley A. Minimally important differences for interpreting European Organisation for Research and Treatment of Cancer (EORTC) Quality of life Questionnaire core 30 scores in patients with ovarian cancer. Gynecol Oncol 2020; 159:515-521. [PMID: 32972782 DOI: 10.1016/j.ygyno.2020.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/05/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Minimal important differences (MIDs) are useful for interpreting changes or differences in health-related quality of life scores in terms of clinical importance. There are currently no MID guidelines for the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire core 30 (EORTC QLQ-C30) specific to ovarian cancer. This study aims to estimate MIDs for interpreting group-level change of EORTC QLQ-C30 scores in ovarian cancer. METHODS Data were derived from four EORTC published trials. Clinical anchors for each EORTC QLQ-C30 scale were selected using correlation strength and clinical plausibility. MIDs for within-group change and between-group differences in change over time were estimated via mean change method and linear regression respectively. For each EORTC QLQ-C30 scale, MID estimates from multiple anchors were summarized via weighted-correlation. Distribution-based MIDs were also examined as supportive evidence. RESULTS Anchor-based MIDs were determined for deterioration in 7 of the 14 EORTC QLQ-C30 scales assessed, and in 11 scales for improvement. Anchor-based MIDs for within-group change ranged from 4 to 19 (improvement) and - 9 to -4 (deterioration). Between-group MIDs ranged from 3 to 13 (improvement) and - 11 to -4 (deterioration). Generally, absolute anchor-based MIDs for most scales ranged from 4 to 10 points. CONCLUSIONS Our findings will aid interpretation of EORTC QLQ-C30 scores in ovarian cancer and inform sample size calculations in future ovarian cancer trials with endpoints that are based on EORTC QLQ-C30 scales.
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Affiliation(s)
- Jammbe Z Musoro
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium.
| | - Corneel Coens
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | | | - Madeleine T King
- University of Sydney, Faculty of Science, School of Psychology, Sydney, NSW, Australia
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, location Academic Medical Center, University of Amsterdam, Cancer Center Amsterdam, the Netherlands
| | - Andy Nordin
- East Kent Gynaecological Oncology Centre, Queen Elizabeth the Queen Mother Hospital, UK
| | - Eleonora B L van Dorst
- Department of Obstetrics and Gynecology, Academic Hospital Utrecht, Utrecht, the Netherlands
| | - Mogens Groenvold
- Department of Public Health, University of Copenhagen, and Bispebjerg Hospital, Copenhagen, Denmark
| | - Kim Cocks
- Adelphi Values, Bollington, Cheshire, UK
| | - Galina Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Hans-Henning Flechtner
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
| | - Andrew Bottomley
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
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20
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Deschuymer S, Nevens D, Duprez F, Daisne JF, Voordeckers M, De Neve W, Nuyts S. Randomized Clinical Trial on Reduction of Radiotherapy Dose to the Elective Neck in Head and Neck Squamous Cell Carcinoma: Results on the Quality of Life. Qual Life Res 2020; 30:117-127. [PMID: 32920767 DOI: 10.1007/s11136-020-02628-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE A randomized trial was initiated to investigate whether a reduction of the dose to the elective nodal sites would result in less toxicity and improvement in Quality of Life (QoL) without compromising tumor control. This paper aimed to compare QoL in both treatment arms. METHODS Two-hundred head and neck cancer patients treated with radiotherapy (RT) or chemo-RT were randomized (all stages, mean age: 60 years, M/F: 82%/18%). The elective nodal volumes of patients randomized in the experimental arm were treated up to a 40 Gy equivalent dose. In the standard arm, the elective nodal volumes were treated up to a 50 Gy equivalent dose. The QoL data were collected using The European Organization for Research and Treatment of Cancer (EORTC) core questionnaire QLQ-C30 and the EORTC Head and Neck Cancer module (H&N35). RESULTS A trend toward less decline in QoL during treatment was observed in the 40 Gy arm compared to the 50 Gy arm. Statistically significant differences for global health status, physical functioning, emotional functioning, speech problems, and trouble with social eating in favor of the 40 Gy arm were observed. A clinically relevant better outcome in the 40 Gy arm was found for physical functioning at the end of therapy. CONCLUSION QoL during RT for head and neck cancer tends to be less impaired in the 40 Gy arm. However, reducing the dose only on the elective neck does not result in clinically relevant improvement of QoL. Therefore, additional treatment strategies must be examined to further improve the QoL of HNSCC patients.
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Affiliation(s)
- S Deschuymer
- Department of Radiation Oncology, KU Leuven - University of Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - D Nevens
- Department of Radiation Oncology, KU Leuven - University of Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Radiation Oncology, Iridium Kanker Netwerk, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - F Duprez
- Department of Radiotherapy-Oncology, Ghent University Hospital, Ghent, Belgium
| | - J F Daisne
- Department of Radiation Oncology, KU Leuven - University of Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Radiation Oncology, Université Catholique de Louvain, CHU-UCL-Namur, Site Ste-Elisabeth, Namur, Belgium
| | - M Voordeckers
- Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium
| | - W De Neve
- Department of Radiotherapy-Oncology, Ghent University Hospital, Ghent, Belgium
| | - S Nuyts
- Department of Radiation Oncology, KU Leuven - University of Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
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21
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Musoro JZ, Coens C, Singer S, Tribius S, Oosting SF, Groenvold M, Simon C, Machiels JP, Grégoire V, Velikova G, Cocks K, Sprangers MAG, King MT, Bottomley A. Minimally important differences for interpreting European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 scores in patients with head and neck cancer. Head Neck 2020; 42:3141-3152. [PMID: 32627261 DOI: 10.1002/hed.26363] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/08/2020] [Accepted: 06/16/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We aimed to estimate minimally important difference (MID) for interpreting group-level change over time for European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire core 30 (EORTC QLQ-C30) scores in head and neck cancer. METHODS Data were derived retrospectively from two published EORTC trials. Clinical anchors were selected using correlation strength and clinical plausibility of the given anchor/QLQ-C30 scale pair. MIDs for within-group and between-group change were estimated via the mean change method and linear regression, respectively. Distribution-based MIDs were also examined. MIDs for two of the scales, dyspnea and nausea/vomiting, are more uncertain considering their low correlations with the anchors. RESULTS Anchor-based MIDs could be determined for deterioration in 7 of the 14 QLQ-C30 scales assessed, and in 3 scales for improvement. MIDs varied by scale, direction of change, and anchor. Absolute MID values ranged from 5 to 15 points for within-group change and 4 to 12 for between-group change. Most MIDs were within 4 to 10 points. CONCLUSIONS Our findings, if confirmed, will aid interpreting changes in selected QLQ-C30 scale scores over time and inform sample size calculations in future clinical trials in head and neck cancer.
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Affiliation(s)
- Jammbe Z Musoro
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Corneel Coens
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Susanne Singer
- Division of Epidemiology and Health Services Research University Medical Centre, Institute of Medical Biostatistics, Epidemiology and Informatics, Mainz, Germany.,University Cancer Centre Mainz, Mainz, Germany
| | - Silke Tribius
- Department of Radiation Oncology, Asklepios Hospital St. Georg, Hamburg, Germany
| | - Sjoukje F Oosting
- University Medical Center Groningen, Department of Medical Oncology, University of Groningen, Groningen, The Netherlands
| | - Mogens Groenvold
- Department of Public Health, University of Copenhagen and Bispebjerg Hospital, Copenhagen, Denmark
| | - Christian Simon
- Department of Otolaryngology, Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Jean-Pascal Machiels
- Institut Roi Albert II, Service d'oncologie médicale, Cliniques universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale, U C Louvain, Brussels, Belgium
| | | | - Galina Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, St James's Hospital, Leeds, UK
| | - Kim Cocks
- Department of Health Sciences, University of York, York, UK.,Adelphi Values, Bollington, UK
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Cancer Center, Amsterdam, The Netherlands
| | - Madeleine T King
- Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew Bottomley
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
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22
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Exercise before, during, and after Hospitalization for Allogeneic Hematological Stem Cell Transplant: A Feasibility Randomized Controlled Trial. J Clin Med 2020; 9:jcm9061854. [PMID: 32545872 PMCID: PMC7355733 DOI: 10.3390/jcm9061854] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/26/2020] [Accepted: 06/10/2020] [Indexed: 01/14/2023] Open
Abstract
People with cancer who undergo allogeneic hematological stem cell transplant (allo-HSCT) experience significant deconditioning that can compromise quality of life. Exercise has shown to be beneficial before or after allo-HSCT; however, little is known about exercise therapy delivered across the continuum of care. We conducted a feasibility randomized controlled trial of exercise delivered prior to admission, during the inpatient stay, and after discharge versus control in people with planned allo-HSCT. Feasibility was assessed via recruitment and retention rates, the incidence of adverse events, and adherence to the exercise prescription. Estimates of efficacy were measured at baseline, one week prior to hospital admission, and 100 days and one year after transplant. The recruitment and retention rates were 20% and 33%, respectively. One serious adverse event occurred during the baseline six-minute walk test that precluded participation in the study and no adverse events were associated with the intervention. From baseline to pre-transplant, the intervention group improved six-minute walk test distances by 45 m (95% CI: −18.0 to 108.7)—a finding that warrants further investigation with an adequately powered trial. Our study contributes important feasibility considerations and pilot data for future exercise intervention research in allo-HSCT recipients.
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23
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De Bruycker A, Spiessens A, Dirix P, Koutsouvelis N, Semac I, Liefhooghe N, Gomez-Iturriaga A, Everaerts W, Otte F, Papachristofilou A, Scorsetti M, Shelan M, Siva S, Ameye F, Guckenberger M, Heikkilä R, Putora PM, Zapatero A, Conde-Moreno A, Couñago F, Vanhoutte F, Goetghebeur E, Reynders D, Zilli T, Ost P. PEACE V - Salvage Treatment of OligoRecurrent nodal prostate cancer Metastases (STORM): a study protocol for a randomized controlled phase II trial. BMC Cancer 2020; 20:406. [PMID: 32398040 PMCID: PMC7216526 DOI: 10.1186/s12885-020-06911-4] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/28/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Pelvic nodal recurrences are being increasingly diagnosed with the introduction of new molecular imaging techniques, like choline and PSMA PET-CT, in the restaging of recurrent prostate cancer (PCa). At this moment, there are no specific treatment recommendations for patients with limited nodal recurrences and different locoregional treatment approaches are currently being used, mostly by means of metastasis-directed therapies (MDT): salvage lymph node dissection (sLND) or stereotactic body radiotherapy (SBRT). Since the majority of patients treated with MDT relapse within 2 years in adjacent lymph node regions, with an estimated median time to progression of 12-18 months, combining MDT with whole pelvic radiotherapy (WPRT) may improve oncological outcomes in these patients. The aim of this prospective multicentre randomized controlled phase II trial is to assess the impact of the addition of WPRT to MDT and short-term androgen deprivation therapy (ADT) on metastasis-free survival (MFS) in the setting of oligorecurrent pelvic nodal recurrence. METHODS & DESIGN Patients diagnosed with PET-detected pelvic nodal oligorecurrence (≤5 nodes) following radical local treatment for PCa, will be randomized in a 1:1 ratio between arm A: MDT and 6 months of ADT, or arm B: WPRT added to MDT and 6 months of ADT. Patients will be stratified by type of PET-tracer (choline, FACBC or PSMA) and by type of MDT (sLND or SBRT). The primary endpoint is MFS and the secondary endpoints include clinical and biochemical progression-free survival (PFS), prostate cancer specific survival, quality of life (QoL), toxicity and time to castration-resistant prostate cancer (CRPC) and to palliative ADT. Estimated study completion: December 31, 2023. DISCUSSION This is the first prospective multicentre randomized phase II trial assessing the potential of combined WPRT and MDT as compared to MDT alone on MFS for patients with nodal oligorecurrent PCa. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03569241, registered June 14, 2018, ; Identifier on Swiss National Clinical Trials Portal (SNCTP): SNCTP000002947, registered June 14, 2018.
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Affiliation(s)
- A De Bruycker
- Department of Radiation oncology and experimental cancer research, Ghent University Hospital, Ghent, Belgium
| | - A Spiessens
- Department of Radiation oncology and experimental cancer research, Ghent University Hospital, Ghent, Belgium
| | - P Dirix
- Department of Radiation oncology, Iridium Cancer Network, GZ Antwerp, Antwerp, Belgium
| | - N Koutsouvelis
- Department of Radiation oncology, Geneva University Hospital, Geneva, Switzerland
| | - I Semac
- Department of Radiation oncology, Geneva University Hospital, Geneva, Switzerland
- Clinical Research Center, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland
| | - N Liefhooghe
- Department of Radiation oncology, AZ Groeninge, Kortrijk, Belgium
| | - A Gomez-Iturriaga
- Cruces University Hospital (Biocruces Health Research Institute), Barakaldo, Spain
| | - W Everaerts
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - F Otte
- Department of Radiation oncology, Jules Bordet Institute and Hôpital Erasme, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium
| | - A Papachristofilou
- Clinic of Radiotherapy & Radiation Oncology, University Hospital Basel, Basel, Switzerland
| | - M Scorsetti
- Humanitas Clinical and Research Hospital, IRCSS, Radiotherapy and Radiosurgery Department, Rozzano, Milan, Italy
| | - M Shelan
- Department of Radiation oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - S Siva
- Epworth Healthcare, University of Melbourne, Melbourne, Australia
| | - F Ameye
- Department of Urology, AZ Maria-Middelares Ghent, Ghent, Belgium
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zürich, University of Zurich, Zürich, Switzerland
| | - R Heikkilä
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - P M Putora
- Department of Radiation oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - A Zapatero
- University Hospital La Princesa, Madrid, Spain
| | - A Conde-Moreno
- Department of Radiation oncology, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - F Couñago
- Department of Radiation oncology, University Hospital of Quirón, Madrid, Spain
| | - F Vanhoutte
- Department of Radiation oncology and experimental cancer research, Ghent University Hospital, Ghent, Belgium
| | - E Goetghebeur
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium
| | - D Reynders
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium
| | - T Zilli
- Department of Radiation oncology, Geneva University Hospital, Geneva, Switzerland.
| | - P Ost
- Department of Radiation oncology and experimental cancer research, Ghent University Hospital, Ghent, Belgium.
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Faury S, Foucaud J. Health-related quality of life in cancer patients treated with immune checkpoint inhibitors: A systematic review on reporting of methods in randomized controlled trials. PLoS One 2020; 15:e0227344. [PMID: 31978145 PMCID: PMC6980610 DOI: 10.1371/journal.pone.0227344] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 12/15/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Immune checkpoint inhibitors (ICIs) have recently shown tremendous promise in the treatment of diverse cancers. The available data suggests that ICIs are well tolerated in terms of health-related quality of life (HRQOL) compared to other anticancer therapies. However, it appears that instruments currently used to evaluate HRQOL in this context may fail to capture important symptomatology unique to ICIs. This systematic review was designed to assess the adequacy of methods used to report HRQOL in cancer patients treated with ICIs and to identify the quality of life scales used. METHOD A systematic review was performed (systematic registration number: PROSPERO: CRD42019121427). A search of the PubMed, PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences collection, and SocINDEX databases was carried out for publications in English and in French. Relevant databases were searched from the earliest records through to March 2019. Publications were selected if they reported on HRQOL in patients with cancer treated by ICIs. Risk of bias was scored using the Cochrane Collaboration bias assessment tool. RESULTS Our search identified 144 publications between 2012 and 2019, of which 15 RCTs met the inclusion criteria. The results suggest that even though the overall reporting of HRQOL was deemed to be of good quality, the data available was marred by methodological aspects such as the lack of HRQOL research hypotheses and the lack of questionnaires validated for cancer patients treated with immunotherapy. CONCLUSION This study provides a comprehensive analysis of the current state of the art and identifies gaps in knowledge on HRQOL analysis with respect to ICIs. It also suggests avenues for further research.
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Affiliation(s)
- Stéphane Faury
- Laboratory Handicap, Activity, Cognition, Health, EA, University of Bordeaux, Bordeaux, France
| | - Jérôme Foucaud
- INCa, Institut National du Cancer, Boulogne Billancourt, France
- * E-mail:
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25
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Prognostic Value of Functional Assessment of Cancer Therapy-General (FACT-G) in Advanced Non-Small-Cell Lung Cancer Treated with Korean Medicine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2845401. [PMID: 32454853 PMCID: PMC7212313 DOI: 10.1155/2020/2845401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 01/02/2020] [Indexed: 12/24/2022]
Abstract
Objectives The impact of health-related quality of life (HRQoL) on survival has been investigated in patients with various cancers. Here, we evaluated the prognostic value of HRQoL using the Functional Assessment of Cancer Therapy-General (FACT-G) in advanced non-small-cell lung cancer (NSCLC) patients treated with Korean medicine. Methods A retrospective review of medical records and FACT-G scores of patients with advanced NSCLC who received treatment with Korean medicine was conducted. The reliability of the FACT-G was determined using Cronbach's alpha and calculating floor-and-ceiling effects. Correlations between FACT-G scores were estimated using Pearson's correlation analysis. Overall survival was calculated using the Kaplan-Meier method, and the prognostic impact of FACT-G scores and patients' characteristics was evaluated with Cox proportional hazards regression. Results Of the 165 enrolled patients, 115 (70%) had extrathoracic metastasis and 139 (84%) had undergone prior anticancer treatment. The median overall survival was 10.1 months. The mean FACT-G score was 65.0, and Cronbach's alpha for the FACT-G was 0.917. Age ≥65 years, male sex, smoking history, squamous-cell carcinoma, Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≥2, and presence of extrathoracic metastasis were associated with an increased risk of mortality. High FACT-G total scores, physical well-being (PWB), emotional well-being, and functional well-being were associated with prolonged survival. After adjusting for age, sex, smoking history, ECOG-PS, histological type, and presence of extrathoracic metastasis, a high FACT-G total score (hazard ratio (HR): 0.99, p=0.032) and high PWB score (HR: 0.94, p < 0.001) were associated with prolonged survival as independent prognostic factors in patients with advanced NSCLC. Conclusion The FACT-G total score and PWB score as HRQoL measurements were significant prognostic factors for survival in advanced NSCLC patients treated with Korean medicine. This finding implies that the FACT-G can be used in clinical practice as a predictor of survival in patients with advanced NSCLC.
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Milevoj N, Tozon N, Licen S, Lampreht Tratar U, Sersa G, Cemazar M. Health-related quality of life in dogs treated with electrochemotherapy and/or interleukin-12 gene electrotransfer. Vet Med Sci 2020; 6:290-298. [PMID: 31910331 PMCID: PMC7397887 DOI: 10.1002/vms3.232] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/28/2019] [Accepted: 12/08/2019] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to evaluate the owners' perception of health‐related quality of life (HRQoL) of dogs after treatment with electrochemotherapy (ECT) alone or combined with interleukin‐12 gene electrotransfer (IL‐12 GET) and/or surgery. The owners of 44 dogs with histologically different tumours were offered the »Cancer Treatment Form« at least one month after treatment. The owners assessed their dogs’ quality of life (QoL) after treatment as good (mean 7.4) (from 1–very poor to 10–excellent) and the general health compared with the initial diagnosis of cancer as improving (mean 3.9) (from 1–worse to 5–better). The assessment of the current QoL was better within the group of dogs treated with non‐invasive treatment (ECT and/or IL‐12 GET only), compared with those that received invasive treatment, where, in addition to ECT and/or IL‐12 GET, surgery was performed (p < .05). The owners of dogs that achieved an objective response (OR) to the treatment assessed the QoL as significantly better compared with those whose dogs did not respond to the treatment (p < .05). The majority of the owners (86.4%) would opt for the therapy again, regardless of the financial costs. In conclusion, the results of this study demonstrate that the majority of the owners of dogs assessed their dogs’ QoL as good and felt that it improved after the treatment, especially in dogs, treated with non‐invasive treatment and in those that responded to the treatment. This supports further use of ECT and IL‐12 GET as suitable methods for the treatment of selected tumours in veterinary medicine.
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Affiliation(s)
- Nina Milevoj
- Veterinary Faculty, Small Animal Clinic, University of Ljubljana, Ljubljana, Slovenia
| | - Natasa Tozon
- Veterinary Faculty, Small Animal Clinic, University of Ljubljana, Ljubljana, Slovenia
| | - Sabina Licen
- Faculty of Health Sciences, University of Primorska, Isola, Slovenia
| | | | - Gregor Sersa
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Maja Cemazar
- Faculty of Health Sciences, University of Primorska, Isola, Slovenia.,Institute of Oncology Ljubljana, Ljubljana, Slovenia
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Sheehan JP, Grills I, Chiang VL, Dong H, Berg A, Warnick RE, Kondziolka D, Kavanagh B. Quality of life outcomes for brain metastasis patients treated with stereotactic radiosurgery: pre-procedural predictive factors from a prospective national registry. J Neurosurg 2019; 131:1848-1854. [PMID: 30579284 DOI: 10.3171/2018.8.jns181599] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 08/03/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Stereotactic radiosurgery (SRS) is increasingly used for the treatment of brain metastasis. To date, most studies have focused on survival, radiological response, or surrogate quality endpoints such as Karnofsky Performance Scale status or neurocognitive indices. The current study prospectively evaluated pre-procedural factors impacting quality of life in brain metastasis patients undergoing SRS. METHODS Using a national, cloud-based platform, patients undergoing SRS for brain metastasis were accrued to the registry. Quality of life prior to SRS was assessed using the 5-level EQ-5D (EQ5D-L) validated tool; additionally, patient and treatment attributes were collected. Patient quality of life was assessed as part of routine follow-up after SRS. Factors predicting a difference in the aggregate EQ5D-L score or the subscores were evaluated. Pre-SRS covariates impacting changes in EQ5D-L were statistically evaluated. Statistical analyses were conducted using multivariate linear regression models. RESULTS EQ5D-L results were available for 116 patients. EQ5D-L improvement (average of 0.387) was noted in patients treated with earlier SRS (p = 0.000175). Worsening overall EQ5D-L (average of 0.052 per lesion) was associated with an increased number of brain metastases at the time of initial presentation (p = 0.0399). Male sex predicted a risk of worsening (average of 0.347) of the pain and discomfort subscore at last follow-up (p = 0.004205). Baseline subscores of pain/discomfort were not correlated with pain/discomfort subscores at follow-up (p = 0.604), whereas baseline subscores of anxiety/depression were strongly positively correlated with the anxiety/depression follow-up subscores (p = 0.0039). CONCLUSIONS After SRS, quality of life was likely to improve in patients treated early with SRS and worsen in those with a greater number of brain metastases. Sex differences appear to exist regarding pain and discomfort worsening after SRS. Those with high levels of anxiety and depression at SRS may benefit from medical treatment as this particular quality of life factor generally remains unchanged after SRS.
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Affiliation(s)
- Jason P Sheehan
- 1Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia
| | - Inga Grills
- 5Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan
| | - Veronica L Chiang
- 3Department of Neurological Surgery, Yale University, New Haven, Connecticut
| | - Huamei Dong
- 2Penn State Medical Center, Hershey, Pennsylvania
| | - Arthur Berg
- 2Penn State Medical Center, Hershey, Pennsylvania
| | | | - Douglas Kondziolka
- 4Department of Neurological Surgery, New York University, New York, New York
| | - Brian Kavanagh
- 6Department of Radiation Oncology, University of Colorado, Denver, Colorado; and
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Musoro JZ, Coens C, Fiteni F, Katarzyna P, Cardoso F, Russell NS, King MT, Cocks K, Sprangers MA, Groenvold M, Velikova G, Flechtner HH, Bottomley A. Minimally Important Differences for Interpreting EORTC QLQ-C30 Scores in Patients With Advanced Breast Cancer. JNCI Cancer Spectr 2019; 3:pkz037. [PMID: 32328553 PMCID: PMC7050000 DOI: 10.1093/jncics/pkz037] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/24/2019] [Accepted: 05/20/2019] [Indexed: 11/13/2022] Open
Abstract
Background We aimed to estimate the minimally important difference (MID) for interpreting group-level change over time, both within a group and between groups, for the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire core 30 (EORTC QLQ-C30) scores in patients with advanced breast cancer. Methods Data were derived from two published EORTC trials. Clinical anchors (eg, performance status [PS]) were selected using correlation strength and clinical plausibility of their association with a particular QLQ-C30 scale. Three change status groups were formed: deteriorated by one anchor category, improved by one anchor category, and no change. Patients with greater anchor changes were excluded. The mean change method was used to estimate MIDs for within-group change, and linear regression was used to estimate MIDs for between-group differences in change over time. For a given QLQ-C30 scale, MID estimates from multiple anchors were triangulated to a single value via a correlation-based weighted average. Results MIDs varied by QLQ-C30 scale, direction (improvement vs deterioration), and anchor. MIDs for within-group change ranged from 5 to 14 points (improvement) and −14 to −4 points (deterioration), and MIDs for between-group change over time ranged from 4 to 11 points and from −18 to −4 points. Correlation-weighted MIDs for most QLQ-C30 scales ranged from 4 to 10 points in absolute values. Conclusions Our findings aid interpretation of changes in EORTC QLQ-C30 scores over time, both within and between groups, and for performing more accurate sample size calculations for clinical trials in advanced breast cancer.
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Affiliation(s)
- Jammbe Z Musoro
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Corneel Coens
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Frederic Fiteni
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium.,Department of Medical Oncology, University Hospital of Nîmes, France.,Institut de Recherche en Cancérologie de Montpellier, France.,University of Montpellier, France
| | - Pogoda Katarzyna
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium.,Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland
| | - Fatima Cardoso
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium.,Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
| | - Nicola S Russell
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium.,Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Madeleine T King
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium.,University of Sydney, Faculty of Science, School of Psychology, Sydney, NSW, Australia
| | - Kim Cocks
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium.,Department of Health Sciences, University of York, York, UK.,Adelphi Values, Bollington, Cheshire, UK
| | - Mirjam Ag Sprangers
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium.,Department of Medical Psychology, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Cancer Center Amsterdam, The Netherlands
| | - Mogens Groenvold
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium.,Department of Public Health, University of Copenhagen, and Bispebjerg Hospital, Copenhagen, Denmark
| | - Galina Velikova
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium.,Leeds Institute of Cancer and Pathology, University of Leeds, St James's Hospital, Leeds, UK
| | - Hans-Henning Flechtner
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium.,Clinic for Child and Adolescent Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
| | - Andrew Bottomley
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
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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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30
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Draulans C, Joniau S, Fonteyne V, Delrue L, Decaestecker K, Everaerts W, Dirix P, Van den Bergh L, Crijns W, Vandendriessche H, Van Wynsberge L, Ost P, Lumen N, Buelens P, Haustermans K, Berghen C, De Meerleer G. Benefits of Elective Para-Aortic Radiotherapy for pN1 Prostate Cancer Using Arc Therapy (Intensity-Modulated or Volumetric Modulated Arc Therapy): Protocol for a Nonrandomized Phase II Trial. JMIR Res Protoc 2018; 7:e11256. [PMID: 30545809 PMCID: PMC6315267 DOI: 10.2196/11256] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/02/2018] [Accepted: 08/02/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In patients with prostate cancer (PCa) with histopathologically proven pelvic lymph node (LN) metastasis (pN1) after extended pelvic lymph node dissection (ePLND), multimodality treatment consisting of treatment of the primary tumor and whole pelvic radiotherapy (WPRT) combined with androgen deprivation therapy (ADT) offers promising results, leading to better cause-specific survival rates compared with ADT alone. However, in case more than one pelvic LN is invaded by the tumor, approximately 40% of the patients relapse biochemically and clinically. Clinical relapse is present in the para-aortic LNs (M1a disease) in up to 77% of the relapsing cases. OBJECTIVE We hypothesize that, based on the evidence that positive LNs represent the door to hematogenous dissemination, elective para-aortic irradiation will reduce the development of both retroperitoneal nodal (M1a) and distant metastasis (M1b or M1c disease), postpone the need for palliative ADT, and prolong the time to castration-refractory disease. METHODS To test this hypothesis, we will conduct a prospective, nonrandomized phase II trial to study the efficacy of additional elective para-aortic radiotherapy (PART) in pN1 patients compared with those who were historically treated with adjuvant WPRT alone. We aim to include 137 patients with PCa and presence of pN1 disease after ePLND. With this number of patients, an improvement of 15% in the 5-year clinical relapse-free survival can be detected with a power of 80%. RESULTS Recruitment of patients for this trial started in 2017 and will be completed approximately by March 2020. CONCLUSIONS This is the first phase II trial to investigate the benefits of an elective PART in patients with PCa. The results of this trial will potentially serve as a sound base for a later randomized phase III trial. All participants are given a PART information sheet and required to give written informed consent. Results are expected to be published in a peer-reviewed journal. TRIAL REGISTRATION ClinicalTrials.gov NCT03079323; https://clinicaltrials.gov/ct2/show/NCT03079323 (Archived by WebCite at http://www.webcitation.org/73ELimv1d). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/11256.
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Affiliation(s)
- Cédric Draulans
- Department of Radiation Oncology, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | - Valérie Fonteyne
- Department of Radiation Oncology, Ghent University Hospital, University of Ghent, Ghent, Belgium
| | - Louke Delrue
- Department of Radiology, Ghent University Hospital, University of Ghent, Ghent, Belgium
| | - Karel Decaestecker
- Department of Urology, Ghent University Hospital, University of Ghent, Ghent, Belgium
| | - Wouter Everaerts
- Department of Urology, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | - Piet Dirix
- Department of Radiation Oncology, Iridium Cancer Network, Wilrijk, Antwerp, Belgium
| | | | - Wouter Crijns
- Department of Radiation Oncology, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | | | | | - Piet Ost
- Department of Radiation Oncology, Ghent University Hospital, University of Ghent, Ghent, Belgium
| | - Nicolaas Lumen
- Department of Urology, Ghent University Hospital, University of Ghent, Ghent, Belgium
| | - Pieterjan Buelens
- Department of Radiation Oncology, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | - Karin Haustermans
- Department of Radiation Oncology, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | - Charlien Berghen
- Department of Radiation Oncology, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | - Gert De Meerleer
- Department of Radiation Oncology, University Hospitals Leuven, University of Leuven, Leuven, Belgium
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31
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Musoro JZ, Bottomley A, Coens C, Eggermont AMM, King MT, Cocks K, Sprangers MAG, Groenvold M, Velikova G, Flechtner HH, Brandberg Y. Interpreting European Organisation for Research and Treatment for Cancer Quality of life Questionnaire core 30 scores as minimally importantly different for patients with malignant melanoma. Eur J Cancer 2018; 104:169-181. [DOI: 10.1016/j.ejca.2018.09.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/14/2018] [Accepted: 09/10/2018] [Indexed: 12/18/2022]
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Hu X, Hay JW. First-line pembrolizumab in PD-L1 positive non-small-cell lung cancer: A cost-effectiveness analysis from the UK health care perspective. Lung Cancer 2018; 123:166-171. [PMID: 30089590 DOI: 10.1016/j.lungcan.2018.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/10/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Pembrolizumab has shown significant survival benefits in treating chemotherapy-naïve non-small-cell lung cancer patients (NSCLC) with increased level of PD-L1 expression. This analysis aimed to evaluate the cost-effectiveness of pembrolizumab as a first-line treatment for patients with PD-L1 positive NSCLC from the UK health care perspective. METHODS A Markov model with progression-free, progressive disease and death states was developed. Clinical parameters were informed by the KEYNOTE-024 trial. Utility values were sourced from published literature. Cost data including drug acquisition costs, disease management costs, and adverse event costs were derived from British National Formulary and published literature. The model was run until 99% patients died. Both health outcomes and costs were discounted at an annual rate of 3.5%. Deterministic and probabilistic sensitivity analyses were performed to address the uncertainties around model parameters. RESULTS In the base case, pembrolizumab is projected to increase patient's life expectancy by 1.32 life-years over chemotherapy (2.45 vs. 1.13) and 0.83 QALYs (1.55 vs. 0.71) at an additional cost of £72,465, yielding an incremental cost-effectiveness ratio of £86,913/QALY. When parameters were varied in the deterministic sensitivity analyses, results are most sensitive to duration of median overall survival in both groups. Probability sensitivity analyses showed that using a willingness-to-pay threshold of £50,000 per QALY, the probability of pembrolizumab being cost-effective is 29.4%. CONCLUSION Using a willingness-to-pay threshold of £50,000, pembrolizumab is not cost-effective at its current list price and a discount of 50% or more is required for it to be cost-effective comparing to commonly prescribed chemotherapy. Risk-sharing contracts may be helpful in resolving some of the underlying uncertainty associated with the long-term survival and varying extent of patient response.
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Affiliation(s)
- Xiaohan Hu
- USC Leonard D. Schaeffer Center for Health Policy and Economics, 635 Downey Way, Verna & Peter Dauterive Hall (VPD) Suite 210, Los Angeles, CA, 90089, United States.
| | - Joel W Hay
- USC Leonard D. Schaeffer Center for Health Policy and Economics, 635 Downey Way, Verna & Peter Dauterive Hall (VPD) Suite 210, Los Angeles, CA, 90089, United States.
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Bager L, Elsbernd A, Nissen A, Daugaard G, Pappot H. Danish translation and pilot testing of the European Organization for Research and Treatment of Cancer QLQ-TC 26 (EORTC QLQ-TC26) questionnaire to assess health-related quality of life in patients with testicular cancer. Health Qual Life Outcomes 2018; 16:128. [PMID: 29914500 PMCID: PMC6006858 DOI: 10.1186/s12955-018-0954-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/05/2018] [Indexed: 11/18/2022] Open
Abstract
Background The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 is a core questionnaire designed to evaluate health-related quality of life (HRQoL) of cancer patients participating in international clinical trials. It is available in several languages including Danish. The EORTC QLQ-TC26 is a supplemental module developed for patients with testicular cancer, which can be useful in clinical trials. Despite Denmark holding a high prevalence and incidence of testicular cancer, no Danish translation was previously available. This paper describes the translation process and pilot testing of the Danish translation of QLQ-TC26. Methods The English language EORTC QLQ-TC26 was translated into Danish using forward and backward procedures with reconciliation. The translated instrument was assessed in semi structured cognitive interviews in a sample of 10 patients ages 20–56 receiving treatment for testicular cancer. Results In one round of pilot testing, no changes were required for the Danish translation based upon patient comments. The Danish translation was agreed by participants to be both culturally acceptable and semantically comprehensible. Conclusions The pilot testing of the Danish translation of the EORTC QLQ-TC26 was performed in one round of patient interviews; these results support the Danish translation as a comparable instrument to the English language version. However, further validation is required to ensure complete equivalency. These results support the use of the EORTC QLQ-TC26 in future clinical trials conducted with Danish-speaking patients.
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Affiliation(s)
- Louise Bager
- Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Abbey Elsbernd
- University of Kansas School of Medicine, Kansas City, USA
| | - Aase Nissen
- Documentation and Quality, Danish Cancer Society, Copenhagen, Denmark
| | - Gedske Daugaard
- Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
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Health-related quality of life in adults with relapsed/refractory acute lymphoblastic leukemia treated with blinatumomab. Blood 2018; 131:2906-2914. [PMID: 29739753 DOI: 10.1182/blood-2017-09-804658] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 04/26/2018] [Indexed: 12/16/2022] Open
Abstract
In the phase 3 TOWER study, blinatumomab significantly improved overall survival in adults with relapsed or refractory (R/R) Philadelphia chromosome-negative (Ph-) B-cell precursor acute lymphoblastic leukemia (BCP-ALL) relative to standard-of-care chemotherapy. A secondary objective of this study was to assess the impact of blinatumomab on health-related quality of life (HRQL) as measured by the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). This analysis included the 342 of 405 randomized patients for whom baseline and ≥1 postbaseline result were available in any EORTC multi-item scale or single-item measure. In general, patients receiving blinatumomab (n = 247) reported better posttreatment HRQL across all QLQ-C30 subscales, based on descriptive mean change from baseline, than did those receiving chemotherapy (n = 95). The hazard ratios for time to deterioration (TTD) of ≥10 points from baseline in HRQL or death ranged from 0.42 to 0.81 in favor of blinatumomab, with the upper bounds of the 95% confidence interval <1.0 across all measures, except insomnia, social functioning, and financial difficulties; sensitivity analysis of TTD in HRQL without the event of death were consistent with these findings. When treatment effect over time was tested using a restricted maximum likelihood-based mixed model for repeated measures analysis, P < .05 was reached for blinatumomab vs chemotherapy for all subscale measures except financial difficulties. The clinically meaningful benefits in overall survival and HRQL support the clinical value of blinatumomab in patients with R/R Ph- BCP-ALL when compared with chemotherapy. This trial was registered at www.clinicaltrials.gov as #NCT02013167.
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Lee CK, Novello S, Rydén A, Mann H, Mok T. Patient-Reported Symptoms and Impact of Treatment With Osimertinib Versus Chemotherapy in Advanced Non-Small-Cell Lung Cancer: The AURA3 Trial. J Clin Oncol 2018; 36:1853-1860. [PMID: 29733770 DOI: 10.1200/jco.2017.77.2293] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Capturing patient-reported outcome data is important for evaluating the overall clinical benefits of new cancer therapeutics. We assessed self-reported symptoms of advanced non-small-cell lung cancer in patients treated with osimertinib or chemotherapy in the AURA3 phase III trial. Patients and Methods Patients completed the European Organisation for Research and Treatment of Cancer 13-item Quality of Life Questionnaire-Lung Cancer Module (EORTC QLQ-LC13) questionnaire on disease-specific symptoms and the EORTC 30-item Core Quality of Life Questionnaire (EORTC QLC-C30) on general cancer symptoms, functioning, global health status/quality of life. We assessed differences between treatments in time to deterioration of individual symptoms and odds of improvement (a deterioration or improvement was defined as a change in score from baseline of ≥ 10). Hazard ratios (HRs) were calculated using a log-rank test stratified by ethnicity; odds ratios (ORs) were assessed using logistic regression adjusted for ethnicity. Results At baseline, the questionnaires were completed by 82% to 88% of patients, and 30% to 70% had individual key symptoms. Time to deterioration was longer with osimertinib than with chemotherapy for cough (HR, 0.74; 95% CI, 0.53 to 1.05), chest pain (HR, 0.52; 95% CI, 0.37 to 0.73), and dyspnea (HR, 0.42; 95% CI, 0.31 to 0.58). The proportion of symptomatic patients with improvement in global health status/quality of life was higher with osimertinib (80 [37%] of 215) than with chemotherapy (23 [22%] of 105; OR, 2.11; 95% CI, 1.24 to 3.67; P = .007). Proportions were also higher for appetite loss (OR, 2.50; 95% CI, 1.31 to 4.84) and fatigue (OR, 1.96; 95% CI, 1.20 to 3.22). Conclusion Time to deterioration of key symptoms was longer with osimertinib than with chemotherapy, and a higher proportion of patients had improvement in global health status/quality of life, demonstrating improved patient outcomes with osimertinib.
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Affiliation(s)
- Chee Khoon Lee
- Chee Khoon Lee, St George Hospital, Kogarah, New South Wales, Australia; Silvia Novello, University of Turin, Turin, Italy; Anna Rydén, AstraZeneca Gothenburg, Mölndal, Sweden; Helen Mann, AstraZeneca R&D, Cambridge, United Kingdom; and Tony Mok, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Special Administrative Region, People's Republic of China
| | - Silvia Novello
- Chee Khoon Lee, St George Hospital, Kogarah, New South Wales, Australia; Silvia Novello, University of Turin, Turin, Italy; Anna Rydén, AstraZeneca Gothenburg, Mölndal, Sweden; Helen Mann, AstraZeneca R&D, Cambridge, United Kingdom; and Tony Mok, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Special Administrative Region, People's Republic of China
| | - Anna Rydén
- Chee Khoon Lee, St George Hospital, Kogarah, New South Wales, Australia; Silvia Novello, University of Turin, Turin, Italy; Anna Rydén, AstraZeneca Gothenburg, Mölndal, Sweden; Helen Mann, AstraZeneca R&D, Cambridge, United Kingdom; and Tony Mok, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Special Administrative Region, People's Republic of China
| | - Helen Mann
- Chee Khoon Lee, St George Hospital, Kogarah, New South Wales, Australia; Silvia Novello, University of Turin, Turin, Italy; Anna Rydén, AstraZeneca Gothenburg, Mölndal, Sweden; Helen Mann, AstraZeneca R&D, Cambridge, United Kingdom; and Tony Mok, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Special Administrative Region, People's Republic of China
| | - Tony Mok
- Chee Khoon Lee, St George Hospital, Kogarah, New South Wales, Australia; Silvia Novello, University of Turin, Turin, Italy; Anna Rydén, AstraZeneca Gothenburg, Mölndal, Sweden; Helen Mann, AstraZeneca R&D, Cambridge, United Kingdom; and Tony Mok, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Special Administrative Region, People's Republic of China
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36
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Quality of life in cancer patients-a comparison of inpatient, outpatient, and rehabilitation settings. Support Care Cancer 2018; 26:3533-3541. [PMID: 29700655 DOI: 10.1007/s00520-018-4211-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 04/13/2018] [Indexed: 11/12/2022]
Abstract
PURPOSE The aim of this study was to compare quality of life (QoL) data from cancer patients in different clinical settings with data from the general population. METHODS A sample of 4020 German cancer patients (1735 inpatients, 1324 outpatients, 961 participants in rehabilitation treatment) was tested with the EORTC QLQ-C30. RESULTS Compared with the general population, cancer patients reported markedly worse QoL. There were clinically significant differences on all 15 scales of the EORTC QLQ-C30 (except one). For the sum score, averaging across 13 scales, the effect size of the difference between cancer patients and the general population was d = 1.16. Inpatients reported the greatest detriments to QoL, followed by the rehabilitation patients and the outpatients (mean sum scores 68.6, 71.0, and 72.3, respectively, compared with 89.2 in the general population). Mean scores for different groups of cancer sites are given separately for the three settings. CONCLUSION The detriments to QoL were stronger than in comparable studies conducted on data from clinical trials. Since these detriments were found in all three settings to a similar degree, health care providers should offer their services not only to inpatients but to outpatients and patients treated in rehabilitation clinics as well. The data can be used for QoL comparisons of assessments from different settings.
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Assessment of content validity for patient-reported outcome measures used in patients with non-muscle invasive bladder cancer: a systematic review. Support Care Cancer 2018; 26:1061-1076. [PMID: 29392479 DOI: 10.1007/s00520-018-4058-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 01/15/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Non-muscle invasive bladder cancer (NMIBC) is a chronic condition requiring ongoing treatment and endoscopic examinations that are frequent and can be life-long. To ensure the comprehensive assessment of the benefits and harms of treatments for NMIBC, the impact on important and relevant patient-reported outcomes (PROs) should be determined. We systematically reviewed the NMIBC PRO literature to determine the suitability of available PRO measures (PROMs) for use in evaluating patient outcomes in NMIBC research. METHODS We searched six electronic databases, reference lists, and key authors. Two reviewers independently applied inclusion and quality criteria and extracted findings. PROM domains, item content, and content coverage and relevance were determined for identified PROMs. Content validity was assessed against an empirically derived NMIBC-specific conceptual framework that includes 11 PRO domains and 19 sub-domains. RESULTS Seventeen studies assessed PROs related to NMIBC and treatment impact. From these studies, 11 PROMs were identified, including three generic, three cancer-specific, and five symptom-specific. None of the PROMs cover all PRO domains important in NMIBC as assessed against our conceptual framework. The EORTC QLQ-C30 plus the NMIBC24 module was best aligned to the conceptual model, but failed to represent six outcomes important to NMIBC patients. CONCLUSIONS Currently, some outcomes important in NMIBC are inadequately covered by generic and cancer-specific measures despite similar conceptual models. This review identified gaps in the literature regarding assessment of symptoms and other PROs considered important by NMIBC patients. Careful consideration of PROM item content is required when selecting outcome measures for use in future NMIBC clinical trials to ensure that appropriate measures are used to assess outcomes that matter to patients.
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Musoro ZJ, Hamel JF, Ediebah DE, Cocks K, King MT, Groenvold M, Sprangers MAG, Brandberg Y, Velikova G, Maringwa J, Flechtner HH, Bottomley A, Coens C. Establishing anchor-based minimally important differences (MID) with the EORTC quality-of-life measures: a meta-analysis protocol. BMJ Open 2018; 8:e019117. [PMID: 29326191 PMCID: PMC5781104 DOI: 10.1136/bmjopen-2017-019117] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/15/2017] [Accepted: 11/16/2017] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION As patient assessment of health-related quality of life (HRQOL) in cancer clinical trials has increased over the years, so has the need to attach meaningful interpretations to differences in HRQOL scores between groups and changes within groups. Determining what represents a minimally important difference (MID) in HRQOL scores is useful to clinicians, patients and researchers, and can be used as a benchmark for assessing the success of a healthcare intervention. Our objective is to provide an evidence-based protocol to determine MIDs for the European Organisation for Research and Treatment for Cancer Quality of life Questionnaire core 30 (EORTC QLQ-C30). We will mainly focus on MID estimation for group-level comparisons. Responder thresholds for individual-level change will also be estimated. METHODS AND ANALYSIS Data will be derived from published phase II and III EORTC trials that used the QLQ-C30 instrument, covering several cancer sites. We will use individual patient data to estimate MIDs for different cancer sites separately. Focus is on anchor-based methods. Anchors will be selected per disease site from available data. A disease-oriented and methodological panel will provide independent guidance on anchor selection. We aim to construct multiple clinical anchors per QLQ-C30 scale and also to compare with several anchor-based methods. The effects of covariates, for example, gender, age, disease stage and so on, will also be investigated. We will examine how our estimated MIDs compare with previously published guidelines, hence further contributing to robust MID guidelines for the EORTC QLQ-C30. ETHICS AND DISSEMINATION All patient data originate from completed clinical trials with mandatory written informed consent, approved by local ethical committees. Our findings will be presented at scientific conferences, disseminated via peer-reviewed publications and also compiled in a MID 'blue book' which will be made available online on the EORTC Quality of Life Group website as a free guideline document.
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Affiliation(s)
- Zebedee Jammbe Musoro
- Quality of life department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Jean-Francois Hamel
- Department of Methodology and Biostatistics, University Hospital of Angers UNAM, Angers, France
| | - Divine Ewane Ediebah
- Brain Tumour Center Amsterdam of the VU University Medical Center, Amsterdam, The Netherlands
| | - Kim Cocks
- Adelphi Values, Bollington, UK
- Department of Health Sciences, University of York, York, UK
| | - Madeleine T King
- School of Psychology, University of Sydney, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Mogens Groenvold
- Department of Public Health and Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Yvonne Brandberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Galina Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, St James's Hospital, Leeds, UK
| | | | - Hans-Henning Flechtner
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
| | - Andrew Bottomley
- Quality of life department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Corneel Coens
- Quality of life department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
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Rutherford C, King MT, Smith DP, Costa DS, Tait MA, Patel MI. Psychometric Evaluation of a Patient-Reported Symptom Index for Nonmuscle Invasive Bladder Cancer: Field Testing Protocol. JMIR Res Protoc 2017; 6:e216. [PMID: 29117930 PMCID: PMC5700405 DOI: 10.2196/resprot.8761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 11/23/2022] Open
Abstract
Background Nonmuscle invasive bladder cancer (NMIBC) is a chronic condition requiring intensive follow-up, repeated endoscopic examinations, tumor resections, and intravesical treatments that can occur every 3 months for life. In this clinical context, patient-reported outcomes (PROs) are a critical concern for patients and their managing clinicians. PROs have enormous potential to be integral to treatment assessment and recommendations for NMIBC; however, current PRO measures are inadequate for NMIBC because they lack key NMIBC-specific symptoms and side effects associated with contemporary treatments. Objective The overarching aim of this study was to develop and evaluate a patient-reported symptom index (SI) for individuals with NMIBC (the NMIBC-SI) that is acceptable to patients; reliable, valid, and responsive to differences between contemporary treatments for NMIBC; and fit for purpose as an endpoint in clinical trials. Methods The NMIBC-SI will be evaluated in 2 field tests across a total of 3 years. Field test 1 is a cross-sectional study design involving 225 adult NMIBC patients recruited while undergoing active treatment or those who completed final treatment within the past week. Data collected include patient demographics, clinical features of the tumor, risk category, treatment type, comorbidity, and PROs. Field test 2 is a prospective longitudinal study involving 225 newly diagnosed NMIBC-SI patients. Clinical data and patient-completed questionnaires will be collected at 4 time points during treatment: before tumor resection, 1 week after resection, end-of-induction intravesical therapy, and 1-year follow-up. Standard psychometric tests will be performed to assess the reliability, validity, responsiveness, and clinical utility of the NMIBC-SI. Results Participant recruitment to field test 1 commenced in February 2017. Recruitment for field test 2 is planned to commence in January 2018. Final results are expected to be published in 2019. The NMIBC-SI will be freely available for use via registration. Conclusions This study protocol contains detailed methods that will be used across multiple international sites. Phase 2 in the development of the NMIBC-SI will enable a comprehensive evaluation of its reliability, validity, and responsiveness to ensure that the NMIBC-SI is fit for purpose in clinical research and provides an evidence base for the ongoing improvement of future therapies for NMIBC. Trial Registration ClinicalTrials.gov NCT03091764; http://clinicaltrials.gov/ct2/showNCT03091764 (Archived by WebCite at http://www.webcitation.org/6umBhQeNX)
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Affiliation(s)
| | - Madeleine T King
- School of Psychology, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - David P Smith
- Sydney Medical School, The University of Sydney, Sydney, Australia.,Cancer Research Division, Cancer Council NSW, Kings Cross, Australia
| | - Daniel Sj Costa
- Sydney Medical School, The University of Sydney, Sydney, Australia.,Pain Management Research Institute, Royal North Shore Hospital, St Leonards, Australia
| | | | - Manish I Patel
- Sydney Medical School, The University of Sydney, Sydney, Australia
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- Nonmuscle Invasive Bladder Cancer Symptom Index Working Group, Sydney, Australia
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Gender and age make no difference in the re-irradiation of painful bone metastases: A secondary analysis of the NCIC CTG SC.20 randomized trial. Radiother Oncol 2017; 126:541-546. [PMID: 29102263 DOI: 10.1016/j.radonc.2017.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/26/2017] [Accepted: 10/03/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND PURPOSE Patient's gender and age may influence physicians in prescribing palliative radiotherapy. The purpose of this secondary analysis of the National Cancer Institute of Canada Clinical Trials Group Symptom Control Trial SC.20 was to explore the gender and age differences in pain and patient reported outcomes in cancer patients with bone metastases undergoing re-irradiation. MATERIALS AND METHODS Response to radiation was evaluated using the International Bone Metastases Consensus Endpoint Definitions. Patients completed the Brief Pain Inventory (BPI) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (C30) before and 2 months after re-irradiation. RESULTS A total of 847 patients were analyzed. At baseline, men had more dyspnea, and mild pain. Older patients consumed less analgesic. More women reported clinically significant improvement in mood and enjoyment of life in the BPI after radiation. Similarly, younger patients reported better improvement in enjoyment of life. There were no significant gender or age differences in overall survival, response to radiation, or in C30 scores at 2 months. CONCLUSION Similar benefit in terms of pain relief was observed across all patient groups. Cancer patients with bone metastases should be offered palliative re-irradiation irrespective of gender or age. TRIAL REGISTRATION NCT00080912; https://clinicaltrials.gov/ct2/show/NCT00080912.
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Barajas Galindo DE, Vidal-Casariego A, Calleja-Fernández A, Hernández-Moreno A, Pintor de la Maza B, Pedraza-Lorenzo M, Rodríguez-García MA, Ávila-Turcios DM, Alejo-Ramos M, Villar-Taibo R, Urioste-Fondo A, Cano-Rodríguez I, Ballesteros-Pomar MD. Appetite disorders in cancer patients: Impact on nutritional status and quality of life. Appetite 2017; 114:23-27. [DOI: 10.1016/j.appet.2017.03.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 03/13/2017] [Accepted: 03/14/2017] [Indexed: 01/08/2023]
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Rutherford C, Costa DSJ, King MT, Smith DP, Patel MI. A conceptual framework for patient-reported outcomes in non-muscle invasive bladder cancer. Support Care Cancer 2017; 25:3095-3102. [DOI: 10.1007/s00520-017-3717-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 04/17/2017] [Indexed: 10/19/2022]
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Miller JA, Kotecha R, Barnett GH, Suh JH, Angelov L, Murphy ES, Vogelbaum MA, Mohammadi A, Chao ST. Quality of Life following Stereotactic Radiosurgery for Single and Multiple Brain Metastases. Neurosurgery 2017; 81:147-155. [DOI: 10.1093/neuros/nyw166] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 12/25/2016] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND: Given the neurological morbidity and poor prognosis associated with brain metastases, it is critical to deliver appropriate therapy while remaining mindful of patient quality of life (QOL). For many patients, stereotactic radiosurgery (SRS) effectively controls intracranial disease, but QOL outcomes have not been characterized.
OBJECTIVE: To determine the effect of number of brain metastases upon QOL preservation following SRS.
METHODS: The EuroQol 5 Dimensions questionnaire (EQ-5D) and Patient Health Questionnaire 9 instruments were prospectively collected from a cohort of patients undergoing SRS for brain metastasis between 2008 and 2015. These instruments served as measures of overall QOL and depression. QOL deterioration exceeding the minimum clinically important difference was considered failure. Freedom from 12-month EQ-5D index failure was the primary outcome.
RESULTS: One hundred and twenty-two SRS treatments (67 patients, 421 lesions) were eligible for inclusion. Intracranial failure (local or distant) occurred following 61% of treatments. Among 421 lesions, 8% progressed locally. Median follow-up was 12 months.
All subscores of the EQ-5D instrument expectantly worsened at last follow-up; however, the magnitude of this difference (0.079) did not exceed the EQ-5D index minimum clinically important difference (mean 0.752 vs 0.673, P < .01). Twelve-month EQ-5D index QOL preservation was 79%. Patients with more than 3 brain metastases had a greater rate of EQ-5D index deterioration (hazard ratio 4.14, P < .01) than those with a single metastasis.
CONCLUSIONS: Among patients with brain metastasis, QOL preservation must remain paramount as multimodality therapy continues to improve. In the present investigation, 12-month QOL preservation was 79%. However, patients with more than 3 brain metastases were at significantly greater risk for QOL decline.
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Affiliation(s)
- Jacob A. Miller
- Cleveland Clinic Lerner College of Medi-cine, Cleveland Clinic, Cleveland, Ohio
| | - Rupesh Kotecha
- Department of Radiation Oncology, Tau-ssig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
| | - Gene H. Barnett
- Department of Neu-rosurgery, Cleveland Clinic, Cleveland, Ohio
- Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio
| | - John H. Suh
- Department of Radiation Oncology, Tau-ssig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
- Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio
| | - Lilyana Angelov
- Department of Neu-rosurgery, Cleveland Clinic, Cleveland, Ohio
- Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio
| | - Erin S. Murphy
- Department of Radiation Oncology, Tau-ssig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
- Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio
| | - Michael A. Vogelbaum
- Department of Neu-rosurgery, Cleveland Clinic, Cleveland, Ohio
- Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio
| | - Alireza Mohammadi
- Department of Neu-rosurgery, Cleveland Clinic, Cleveland, Ohio
- Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio
| | - Samuel T. Chao
- Department of Radiation Oncology, Tau-ssig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
- Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio
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Association of thyroid hormone concentrations with quality of life of primary brain tumor patients: a pilot study. J Neurooncol 2016; 131:385-391. [DOI: 10.1007/s11060-016-2311-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 11/06/2016] [Indexed: 01/22/2023]
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Mol L, Ottevanger PB, Koopman M, Punt CJA. The prognostic value of WHO performance status in relation to quality of life in advanced colorectal cancer patients. Eur J Cancer 2016; 66:138-43. [PMID: 27573427 DOI: 10.1016/j.ejca.2016.07.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 07/05/2016] [Accepted: 07/07/2016] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Performance status (PS) is an established prognostic factor in patients with advanced cancer and is usually scored by the treating physician. The EORTC QLQ-C30 questionnaire as reported by cancer patients is a validated tool to assess quality of life (QoL). Subjectivity plays a role in both assessments, and data on a direct comparison are scarce. METHODS We compared the prognostic value for overall survival (OS) of the WHO PS to the baseline physical function scale of the EORTC QLQ-C30 (QLQ-C30 PF) in a prospective randomised phase 3 trial in advanced colorectal cancer (ACC), the CAIRO study. Patients were divided into two groups based on the baseline QLQ-C30 PF. QLQ-C30 PF was considered 'good' if the score was more than 66.7% and 'poor' if 66.7% or less. Results were validated in a subsequent phase 3 study in ACC, the CAIRO2 study. RESULTS The median OS for patients with a 'good' QLQ-C30 PF and a 'poor' PF in patients with WHO PS 0 was 20.3 months (n = 300) and 10.4 months (n = 44), in patients with WHO PS 1 16.8 months (n = 125) and 10.1 months (n = 63), and in patients with WHO PS 2 16.2 months (n = 11) and 9.9 months (n = 12), respectively. In a Cox regression model which included other prognostic factors, 'good' versus 'poor' QLQ-C30 PF was significantly prognostic for OS (0.57 95% confidence interval: 0.46-0.72), but not WHO PS. These results were confirmed in the CAIRO2 study. CONCLUSIONS We demonstrate in ACC patients that PF, as assessed by patients using the EORTC QLQ-C30, is superior in terms of prognostic value to WHO PS as scored by physicians. Our data support to include the results of baseline EORTC QLQ-C30 PF instead of WHO PS as a stratification parameter in oncology trials.
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Affiliation(s)
- L Mol
- Clinical Trial Department, Netherlands Comprehensive Cancer Organisation (IKNL), The Netherlands
| | - P B Ottevanger
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M Koopman
- Department of Medical Oncology, University Medical Centre, Utrecht, The Netherlands
| | - C J A Punt
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, The Netherlands.
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Health-related quality of life in locally advanced and metastatic breast cancer: methodological and clinical issues in randomised controlled trials. Lancet Oncol 2016; 17:e294-e304. [PMID: 27396647 DOI: 10.1016/s1470-2045(16)30099-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/13/2016] [Accepted: 04/18/2016] [Indexed: 12/21/2022]
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Jeppesen MM, Mogensen O, Dehn P, Jensen PT. Needs and priorities of women with endometrial and cervical cancer. J Psychosom Obstet Gynaecol 2016; 36:122-32. [PMID: 26123123 DOI: 10.3109/0167482x.2015.1059417] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Rehabilitation after cancer is important, and efficient rehabilitation requires knowledge of patient's needs. This study aimed to identify short-term rehabilitation needs of women with endometrial and cervical cancer. METHODS Ninety-six women (82.6%) were included in an exploratory questionnaire study from Odense University Hospital from September 2011 to March 2012. Needs were assessed pre-treatment and 3 months later using the three-levels-of-needs questionnaire. Furthermore, 16 women participated in focus group interviews following the treatment. The interviews were audio-recorded, transcribed verbatim and analyzed thematically. RESULTS Forty-four of the included women were diagnosed with cervical cancer (median age 45 years). Of these, 22 had FIGO-stage 1 disease (50%) and 23 received radiation therapy (52.3%). The remaining 52 women (median age 66.5 years) were diagnosed with endometrial cancer. Of these, 38 had FIGO-stage 1 disease (73.1%) and 25 were treated with laparoscopic surgery (48.1%). Emotional functioning was significantly worse prior to treatment in both the cancers (p < 0.001 cervical and p = 0.002 endometrial) and worry constituted an unmet need in 70.7% of cervical and 34.7% of endometrial cancer patients. Both the patient groups experienced significant lymphedema post-treatment [endometrial cancer (p = 0.006) and cervical cancer (p = 0.002)]. Further, urological problems were more prevalent post-treatment in endometrial cancer patients (p = 0.018), while sexual problems were of specific concern for cervical cancer patients (p = 0.029). However, in both cancer groups, the mean problem intensity scores were comparable to normative data, suggesting that the majority of patients will not require extensive rehabilitation. Qualitative analysis indicated that treatment modality and marital status severely impacted on coping, suggesting that irradiated and single women are at higher risk of developing rehabilitation needs. Additionally, women younger than 55 years more often requested help dealing with sexual and psychological complications. DISCUSSION Women with endometrial and cervical cancer experience emotional problems prior to therapy and lymphedema, and urological and sexual problems following treatment. An awareness of these problems may facilitate early identification of women with unmet needs and enable individualized follow-up adjusted for such patient's needs. Interventions aimed at improving sexual and psychological functioning should be available.
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Affiliation(s)
- Mette Moustgaard Jeppesen
- a Department of Gynecology and Obstetrics, Faculty of Health Sciences , Odense University Hospital, Clinical Institute, University of Southern Denmark , Odense , Denmark
| | - Ole Mogensen
- a Department of Gynecology and Obstetrics, Faculty of Health Sciences , Odense University Hospital, Clinical Institute, University of Southern Denmark , Odense , Denmark
| | - Pernille Dehn
- a Department of Gynecology and Obstetrics, Faculty of Health Sciences , Odense University Hospital, Clinical Institute, University of Southern Denmark , Odense , Denmark
| | - Pernille Tine Jensen
- a Department of Gynecology and Obstetrics, Faculty of Health Sciences , Odense University Hospital, Clinical Institute, University of Southern Denmark , Odense , Denmark
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Janssens GO, Langendijk JA, Terhaard CH, Doornaert PA, van den Ende P, de Jong MA, Takes RP, Span PN, Kaanders JH. Quality-of-life after radiotherapy for advanced laryngeal cancer: Results of a phase III trial of the Dutch Head and Neck Society. Radiother Oncol 2016; 119:213-20. [PMID: 27165613 DOI: 10.1016/j.radonc.2016.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 02/23/2016] [Accepted: 02/26/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND/PURPOSE To report on health-related quality-of-life (HRQoL) of patients with laryngeal cancer, treated in a randomized trial comparing accelerated radiotherapy with carbogen and nicotinamide (ARCON) against accelerated radiotherapy alone (AR). MATERIAL/METHODS HRQoL was assessed using the HRQoL Questionnaire-C30 (QLQ-C30) and the Head & Neck cancer module (QLQ-H&N35) at baseline, at completion of radiotherapy and at 6, 12, and 24months post-baseline. RESULTS From 269/345 patients (AR: 136/174; ARCON: 133/171) data on HRQoL were available for analysis. Moderate to severe clinical impact of the treatment was observed for nearly all items of the QLQ-C30 and QLQ-H&N35 between baseline and end-of-treatment. At 6months, scores returned to baseline level with exception of dry mouth, sticky saliva, and taste/smell. No difference between AR and ARCON was observed. At 2years from baseline, the percentage of patients reporting moderate to severe complaints of dry mouth, sticky saliva, or changes in taste/smell was 30%, 22% and 18%, respectively, while the majority of patients had no or few complaints of swallowing (79%) or speech (64%). CONCLUSIONS With accelerated radiotherapy, high local tumor control was obtained while maintaining good speech and swallowing function. Long-term dry mouth, sticky saliva and changes in taste/smell are limited to one quarter of patients. (ClinicalTrials.gov number, NCT00147732).
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Affiliation(s)
- Geert O Janssens
- Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Radiation Oncology, University Medical Center Utrecht, The Netherlands.
| | - Johannes A Langendijk
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Chris H Terhaard
- Department of Radiation Oncology, University Medical Center Utrecht, The Netherlands
| | - Patricia A Doornaert
- Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands
| | - Piet van den Ende
- Department of Radiation Oncology (MAASTRO), Maastricht University Medical Centre, The Netherlands
| | - Martin A de Jong
- Department of Clinical Oncology, Leiden University Medical Centre, The Netherlands
| | - Robert P Takes
- Department of Oto-Rhino-Laryngology and Head & Neck Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Paul N Span
- Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Johannes H Kaanders
- Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
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Akshulakov S, Aldiyarova N, Ryskeldiyev N, Akhmetzhanova Z, Gaitova K, Auezova R, Doskaliyev A, Kerimbayev T. Introduction of Questionnaires for Quality of Life of Patients with Malignant Tumors of the Central Nervous System into Neurosurgical Practice in the Republic of Kazakhstan. Asian Pac J Cancer Prev 2016; 17:873-6. [PMID: 26925695 DOI: 10.7314/apjcp.2016.17.2.873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Studies of quality of life (QoL) of oncological patients is carried out using questionnaires approved in many international clinical studies. The European Organization for Research and Treatment of Cancer EORTC QLQ-C30 (Quality of Life Questionnary-Core 30) and its special brain cancer module EORTC QLQ-BN20 are widely used in the world neurooncologic practice. They are available in more than 80 official versions of 30 languages of the world. Previously we used the official versions in Russian, which often causes difficulty in understanding for native Kazakh language speakers, who comprise more than 60% of our respondents. This was the reason for creating a version of Kazakh language. Therefore, in 2014 for the first time the process of adaptation of questionnaires to the Kazakh language was initiated. MATERIALS AND METHODS The translation process of questionnaires to Kazakh language was held in accordance with the requirements of the European Organization for Research and Treatment of Cancer EORTC on QoL and consisted of the following stages: preparation - translation - pilot testing - approval. The official permission of authors and "Guideline on translation" was obtained which was developed by the working group of the EORTC on QoL. The pilot testing of EORTC QLQ-C30 and QLQ-BN20 questionnaires was conducted on the basis of the Department of Central Nervous System Pathology of the "National Centre for Neurosurgery" in patients with malignant tumors of the central nervous system. RESULTS The official versions of the EORTC QLQ-C30 and QLQ-BN20 questionnaires in Kazakh language were introduced and adapted in practical neurosurgical operations in Kazakhstan. CONCLUSIONS The approved versions of the questionnaires in Kazakh language are now available for mainstream use on the official website EORTC.com. The versions of these questionnaires can be used in domestic cohort studies and clinical practice in the Republic of Kazakhstan. The use of these tools for assessing QoL will help professionals in the planning of individual treatment strategies and selection of the necessary therapy.
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Affiliation(s)
- Serik Akshulakov
- JSC, National Centre for Neurosurgery, Astana, Kazakhstan E-mail :
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Rajendran V, Jeevanantham D. Assessment of physical function in geriatric oncology based on International Classification of Functioning, Disability and Health (ICF) framework. CURRENT GERIATRICS REPORTS 2016. [DOI: 10.1007/s13670-016-0162-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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