Publications (2)5 Total impact
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ABSTRACT: We prospectively evaluated the association of tumor response with change of quality of life (QOL) in patients with advanced gastrointestinal tumors receiving palliative chemotherapy. Out of 133 eligible patients, 90 (68%) completed the European Organization for Research and Treatment Quality of Life Questionnaire C-30 (EORTC QLQ C-30) at baseline and at regular intervals during palliative chemotherapy. Among the 90 available patients, 88 patients could be evaluated for response, and 32 (36%) responded. Taking into account 32 patients who had stable disease, 64 (73%) achieved a clinical benefit, defined as an objective response or stable disease. Improvement in the emotional functioning or global QOL was observed before the fourth cycle of chemotherapy in responders (P = 0.039) and patients with clinical benefit (P = 0.026). Grade 3 or 4 toxic effects occurred in 39% of patients; however, this did not adversely affect the global or other domains of QOL. Therefore, change of QOL during the chemotherapy was closely related with clinical outcomes. We should apply the QOL assessment to all patients who received palliative chemotherapy for their gastrointestinal tumors.
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ABSTRACT: We conducted this prospective study to assess the changes in quality of life (QOL), anxiety and depression in patients receiving palliative chemotherapy for solid cancers. Patients were eligible if they had histologically confirmed metastatic or recurrent cancer and a life expectancy of more than 6 months, and were able to complete the self-administered questionnaires. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) and Hospital Anxiety and Depression Scale (HADS) were used to measure the effects of chemotherapy on the patients' QOL, anxiety and depression at baseline and three times after every three cycles of chemotherapy. From July 2001 to October 2003, 146 patients were recruited, and of these 98 completed the questionnaires and 48 were withdrawn from the trial (27 lost to follow-up, 11 withdrew consent, 5 for toxicity, 5 for progression of the cancer). Their median age was 58 years (range 28-78 years) and the male to female ratio was 1.6. Of the 146 patients, 52 had gastric cancer, 39 non-small-cell cancer, 29 colorectal cancer, 11 breast cancer, and 15 had other cancers. Initial QOL scores were closely related to performance status. Compared with baseline, clinically meaningful relief (score decreased by more than 10) of symptoms such as pain and sleep disturbance was observed. There was significant improvement (score increased by more than 10) in the functional scales after the first cycle of chemotherapy, but these effects did not persist throughout the whole course of therapy. The incidences of probable anxiety and depression disorder before chemotherapy were 20% and 29%, respectively. The anxiety scores decreased throughout the period of intervention. Pretreatment anxiety and depression were negatively correlated with baseline QOL scores. Palliative chemotherapy treatment in patients with solid cancer improved cancer-related symptoms, lessened anxiety and did not disturb the QOL of cancer patients.
성남시, Gyeonggi-do, South Korea
- Department of Internal Medicine