Vassilios Vassiliou

Bank of Cyprus Oncology Center, Lefkoşa, Lefkosia, Cyprus

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Publications (65)143.12 Total impact

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    ABSTRACT: Colorectal cancer remains a major cause of cancer mortality in the Western world both in men and women. In this manuscript a concise overview and recommendations on adjuvant chemotherapy in colon cancer are presented. An executive team from the Hellenic Society of Medical Oncology was assigned to develop a consensus statement and guidelines on the adjuvant treatment of colon cancer. Fourteen statements on adjuvant treatment were subjected to the Delphi methodology. Voting experts were 68. All statements achieved a rate of consensus above than 80% (>87%) and none revised and entered to a second round of voting. Three and 8 of them achieved a 100 and an over than 90% consensus, respectively. These statements describe evaluations of therapies in clinical practice. They could be considered as general guidelines based on best available evidence for assistance in treatment decision-making. Furthermore, they serve to identify questions and targets for further research and the settings in which investigational therapy could be considered.
    No preview · Article · Jan 2016 · Annals of Gastroenterology
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    ABSTRACT: Despite considerable improvement in the management of colon cancer, there is a great deal of variation in the outcomes among European countries, and in particular among different hospital centers in Greece and Cyprus. Discrepancy in the approach strategies and lack of adherence to guidelines for the management of colon cancer may explain the situation. The aim was to elaborate a consensus on the multidisciplinary management of colon cancer, based on European guidelines (ESMO and EURECCA), and also taking into account local special characteristics of our healthcare system. Following discussion and online communication among members of an executive team, a consensus was developed. Statements entered the Delphi voting system on two rounds to achieve consensus by multidisciplinary international experts. Statements with an agreement rate of ≥80% achieved a large consensus, while those with an agreement rate of 60-80% a moderate consensus. Statements achieving an agreement of <60% after both rounds were rejected and not presented. Sixty statements on the management of colon cancer were subjected to the Delphi methodology. Voting experts were 109. The median rate of abstain per statement was 10% (range: 0-41%). In the end of the voting process, all statements achieved a consensus by more than 80% of the experts. A consensus on the management of colon cancer was developed by applying the Delphi methodology. Guidelines are proposed along with algorithms of diagnosis and treatment. The importance of centralization, care by a multidisciplinary team, and adherence to guidelines is emphasized.
    No preview · Article · Jan 2016 · Annals of Gastroenterology
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    ABSTRACT: Radiochemotherapy is the standard of care for the treatment of anal carcinoma achieving good loco-regional control and sphincter preservation. This approach is however associated with acute and late toxicities including haematological, skin, bowel function and genito-urinary complications. This paper systematically reviews studies addressing the quality of life (QoL) implications of anal cancer and radiochemotherapy. The paper also evaluates how QoL is assessed in anal cancer. Medline, EMBASE, CINAHL, PsycInfo, Web of Science and the Cochrane Library were searched for publications (1996-2014) reporting the effects on patients of anal cancer and radiochemotherapy. Of the 152 papers reporting treatment-related effects on patients, only 11 provided a formal assessment of QoL. In the absence of an anal cancer-specific measure, QoL was assessed using generic cancer instruments such as the core EORTC quality of life questionnaire (EORTC QLQ-C30) or colorectal cancer tools such as the EORTC QLQ-CR29. Bowel function, particularly diarrhoea, and sexual problems were the most commonly reported QoL concerns. The review of QoL issues of anal cancer patients treated with radiochemotherapy is limited by the QoL assessment measures used. It is argued that certain treatment-related toxicities, for example skin-induced radiation problems, are overlooked or inadequately represented in existing measures. This review emphasises the need to develop an anal cancer-specific QoL measure and to incorporate QoL as an outcome of future trials in anal cancer. The results of this review are informative to clinicians and patients in terms of treatment decision-making.
    No preview · Article · Aug 2015 · Supportive Care in Cancer
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    ABSTRACT: Gastric cancer remains one of the most common malignancies worldwide. Despite the significant advances in surgical treatment and multimodality strategies, prognosis has modestly improved over the last two decades. Locoregional relapse remains one of the main issues and the combined chemoradiation treatment seems to be one of the preferred approaches. However, more than ten years after the hallmark INT-0116 trial, minimal progress has been made both in terms of effectiveness and toxicity. Moreover, new regimens added to combined therapy failed to prove favourable results. Herein, we attempt a thorough literature review comparing pros and cons of all relative studies and potential bias, targeting well-designed future approaches.
    Full-text · Article · Jun 2015 · Gastroenterology Research and Practice
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    Full-text · Article · Sep 2014 · Hematology/ Oncology and Stem Cell Therapy
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    ABSTRACT: Lynch syndrome is the most common form of hereditary colorectal cancer and is caused by germline mutations in the mismatch repair (MMR) genes MLH1, MSH2, MSH6 and PMS2. Mutation carriers have an increased lifetime risk of developing colorectal cancer as well as other extracolonic tumours. The aim of the current study was to evaluate the frequency and distribution of mutations in the MLH1, MSH2 and MSH6 genes within a cohort of Cypriot families that fulfilled the revised Bethesda guidelines. The study cohort included 77 patients who fulfilled at least one of the revised Bethesda guidelines. Mutational analysis revealed the presence of 4 pathogenic mutations, 3 in the MLH1 gene and 1 in the MSH2 gene, in 5 unrelated individuals. It is noted that out of the 4 pathogenic mutations detected, one is novel (c.1610delG in exon 14 of the MLH1) and has been detected for the first time in the Cypriot population. Overall, the pathogenic mutation detection rate in our patient cohort was 7%. This percentage is relatively low but could be explained by the fact that the sole criterion for genetic screening was compliance to the revised Bethesda guidelines. Larger numbers of Lynch syndrome families and screening of the two additional predisposition genes, PMS2 and EPCAM, are needed in order to decipher the full spectrum of mutations associated with Lynch syndrome predisposition in Cyprus.
    Full-text · Article · Aug 2014 · PLoS ONE
  • Vassilios Vassiliou · Edward Chow · Dimitrios Kardamakis
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    ABSTRACT: The survival and prognosis of patients with metastatic bone disease varies widely and depends on many factors including the histologic type and grade of the primary tumor, performance status and age of patients, presence of extraosseus metastases, level of tumor markers and extend of skeletal disease. Bone metastases are inevitably associated with considerable morbidity and suffering, and severe complications such as pain, pathological fractures, spinal cord or nerve root compression, impaired mobility, bone marrow infiltration and hypercalcemia of malignancy. All aforementioned complications are thoroughly discussed, giving emphasis to associated symptomatology, clinical features and patient evaluation. The last part of the chapter deals with symptom clusters that occur in patients with bone metastases before and after treatment. Such symptoms are pain, depression, fatigue, drowsiness, anxiety, shortness of breath, nausea, poor sense of well being and poor appetite.
    No preview · Article · Jan 2014 · Cancer Metastasis - Biology and Treatment
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    ABSTRACT: In the last decades life expectancy of western populations has increased considerably, resulting in a steep rise in the number of elderly patients diagnosed with cancer. Metastatic bone disease (MBD) is a major concern in such patients since it may be associated with the development of skeletal related events (SREs) including fractures and cord compression. These complications may deteriorate the quality of life (Qol) of affected patients and also reduce expected survival. Due to the fact that in elderly patients there is an increased risk for the development of SREs, maintaining bone health and using effective therapies for MBD is of vital importance. Through numerous clinical trials Bisphosphonates (Bps) have proved to be effective in reducing the risk for SREs significantly in patients with MBD. Moreover, they have shown to decrease pain and improve Qol of treated patients. In elderly patients Bps should be used with caution since their use may cause serious complications such as renal function deterioration. Denosumab is a monoclonal antibody that targets and inhibits RANKL and has shown superiority over zoledronic acid in decreasing the risk of SREs. The elimination of denosumab is done through the immunoglobulin clearance pathway through the reticuloendothelial system and does not to affect renal function. It can therefore be safely used in the elderly. Osteonecrosis of the jaws (ONJ) is a serious complication that may develop after treatment with either denosumab or zoledronic acid. The incidence rates between the two were reported to be comparable. In order to decrease the risk of renal function deterioration or ONJ all preventive measures and treatment guidelines should be followed with caution. In this review article we comment on the effectiveness and safety of Bps and denosumab in elderly patients and discuss all indicated measures that should be implemented for minimizing the risk of potential complications. Several studies have investigated the cost effectiveness of denosumab versus zoledronic acid in terms of SRE prevention. These studies reported contradictory results mainly due to the application of different analytical perspectives and model parameters.
    No preview · Article · Jan 2014 · Cancer Metastasis - Biology and Treatment
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    ABSTRACT: Radiological and nuclear medicine imaging modalities that are used for evaluating the therapeutic response of metastatic bone disease include plain or digitalized radiography (XR), skeletal scintigraphy (SS), dual energy X-ray absorptiometry (DEXA), computed tomography (CT), magnetic resonance imaging (MRI), [18F] fluorodeoxyglucose positron emission tomography (FDG PET) and PET/CT. In this chapter we comment on the advantages and disadvantages of the aforementioned assessment modalities as seen through different clinical studies. Moreover, we present the well known response criteria described by the International Union Against Cancer (UICC) and World Health Organization (WHO) and the newer MDA (MD Anderson) criteria. In spite of the fact that serial XR and SS have been used for evaluating the treatment response for decades, changes are evident several months post therapy. Earlier response to treatment can be evaluated by using newer techniques such as the MRI or PET. Additionally therapeutic response may be quantified by monitoring changes in signal intensity (SI) and standard uptake value (SUV) respectively. PET/CT may be applied to follow both morphologic and metabolic changes in areas on skeletal metastases yielding interesting and promising results that reveal a new insight into the natural history of bone metastases. Due to the fact that only a few studies have investigated the use of these newer imaging modalities, further clinical trials are required to corroborate their promising results and establish the most appropriate imaging parameters and assessment time points. Finally, there is an absolute need to establish and adopt uniform response criteria for skeletal metastases through an international consensus in order to better evaluate therapeutic response in terms of accuracy and objectivity.
    No preview · Chapter · Jan 2014
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    ABSTRACT: The role of imaging is crucial in detecting and differentiating bone lesions and has a vital role in monitoring response to treatment and providing guidance for interventional procedures. Bone scintigraphy is a very sensitive method and remains the basic screening examination. Plain radiography is a supplementary method for assessing symptomatic sites and confirming suspicious findings revealed in scintigraphy. The role of conventional radiography (CR) is still important in multiple myeloma evaluation and is the best method for delineating the nature of a bone lesion. Computed tomography (CT), due to its high temporal and spatial resolution, is more sensitive than CR in detecting bone metastases. Because of its wide use and availability for staging and follow up of oncologic patients this method is of particular importance for the evaluation of skeletal disease. MR imaging is considered as the most sensitive and effective imaging modality in detecting and characterising bone metastases but the cost and the low availability are major drawbacks.
    No preview · Article · Jan 2014 · Cancer Metastasis - Biology and Treatment
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    ABSTRACT: Objective: To identify which domains/symptoms from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were predictive of overall quality of life (QoL) in advanced cancer patients. Methods: Four hundred and forty seven patients with brain metastases or bone metastases from seven countries were enrolled with regression analysis to determine the predictive value of the QLQ-C30 functional/symptom scores for patient reported overall QoL (question 30), overall health (question 29) and the global health status domain (questions 29 and 30). Results: Worse role functioning, social functioning, fatigue and financial problems were the most significant predictive factors for worse QoL. In the bone metastases subgroup (n = 400), role functioning, fatigue and financial problems were the most significant predictors. In patients with brain metastases (n = 47), none of the EORTC domains significantly predicted worse QOL. Conclusion: Deterioration of certain QLQ-C30 functional/symptom scores significantly contributes to worse QoL, overall health and global health status.
    No preview · Article · Dec 2013 · Expert Review of Pharmacoeconomics & Outcomes Research
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    ABSTRACT: Background: Older people represent the majority of cancer patients but their specific needs are often ignored in the development of health-related quality of life (HRQOL) instruments. The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-ELD15 was developed to supplement the EORTC's core questionnaire, the QLQ-C30, for measuring HRQOL in patients aged >70 years in oncology studies. Methods: Patients (n=518) from 10 countries completed the QLQ-C30, QLQ-ELD15 and a debriefing interview. Eighty two clinically stable patients repeated the questionnaires 1 week later (test-retest analysis) and 107 others, with an expected change in clinical status, repeated the questionnaires 3 months later (response to change analysis, RCA). Results: Information from the debriefing interview, factor analysis and item response theory analysis resulted in the removal of one item (QLQ-ELD15QLQ-ELD14) and revision of the proposed scale structure to five scales (mobility, worries about others, future worries, maintaining purpose and illness burden) and two single items (joint stiffness and family support). Convergent validity was good. In known-group comparisons, the QLQ-ELD14 differentiated between patients with different disease stage, treatment intention, number of comorbidities, performance status and geriatric screening scores. Test-retest and RCA analyses were equivocal. Conclusion: The QLQ-ELD14 is a validated HRQOL questionnaire for cancer patients aged 70 years. Changes in elderly patients' self-reported HRQOL may be related to both cancer evolution and non-clinical events.
    Full-text · Article · Jul 2013 · British Journal of Cancer
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    ABSTRACT: Objective: Health related quality of life (HRQOL) is a multidimensional concept that is especially important for cancer patients with bone metastases, as maintaining and improving HRQOL is often the main focus of treatment. This study aims to determine factors that may influence HRQOL, which may in turn influence treatment and care of patients. Methods: Patients (n=396) completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) Bone Metastases module (BM22) at baseline. The EORTC QLQ-BM22 consists of four scales: painful site (PS), pain characteristics (PC), functional interference (FI), and psychosocial aspect (PA) scales. EORTC QLQ-BM22 data, together with sociodemographic and medical factors were analyzed by univariate analysis of variance (ANOVA). Items of significance were determined through backward selection, which were then put through multivariate analysis to determine further significance. Results: Through ANOVA analysis, KPS>80 and breast primary histology were predictive of better HRQOL in the PS scale, while KPS>80, female gender, and breast primary histology were predictive of better HRQOL in the PC and FI scales. KPS>80 and prostate primary histology were predictive of better HRQOL in the PA scale. KPS>80 and primary cancer site were confirmed as significant predictive factors in multivariate analysis. Recommendations: This study identified baseline factors of gender, performance status, and primary histology as determinants of HRQOL in patients with bone metastases. Further study focusing on current treatment (chemotherapy, bisphosphonates, and radiotherapy) and spiritual well-being may identify additional factors affecting HRQOL. Understanding the influence of these factors will allow health care professionals to provide more effective palliative care.
    Full-text · Article · Jul 2013 · Journal of palliative medicine
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    ABSTRACT: Adenocarcinoma of the pancreas carries a uniformly poor prognosis with high rates of loco-regional as well as systemic recurrence. Outcomes remain poor, even for early stage and resectable disease. It is perceived as inherently resistant to most of the currently available treatment options. Evidence supports the need for adjuvant chemotherapy but controversy remains in relation to the use of combined therapy, novel agents and the most appropriate timing of therapy. Despite no clear consensus, mainstay of treatment following resection is based primarily on single agent gemcitabine. Promising new agents and molecules of prognostic as well as predictive value under evaluation offer intriguing data, despite issues surrounding adjuvant therapy strategies. In this article, we sought to review the different therapeutic adjuvant modalities and future directions.
    Full-text · Article · Jun 2013 · Cancer Treatment Reviews
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    ABSTRACT: Purpose: Assessment of health-related quality of life (HRQOL) is critical to effective delivery of palliative care in patients with advanced cancer. The current study analyzes relationships between baseline social determinants of health and medical factors, and self-reported HRQOL in patients with bone metastases receiving palliative radiotherapy. Methods and materials: Advanced cancer patients referred for radiotherapy treatment of bone metastases completed the EORTC QLQ-C30 questionnaire in multiple outpatient clinics internationally. Demographics and social determinants were collected as baseline information. Univariate and Bonferroni-adjusted multivariate linear regression analyses were used to detect significant correlations between baseline determinants and different HRQOL domains. Results: Karnofsky Performance Status (KPS) was correlated with better physical (p = 0.0002), role (p < 0.0001), emotional (p < 0.0001), and social (p < 0.0001) functioning, and global health scores (p = 0.0015) and predicted lower symptom scores for fatigue (p < 0.0001), pain (p < 0.0001), appetite loss (p < 0.0001), and constipation (p < 0.0001). Increased age was predictive of better social functioning (p < 0.0001) and less insomnia (p = 0.0036), higher education correlated with better global health status (p = 0.0043), and patients who were employed or retired had improved physical functioning (p = 0.0004 and p = 0.0030, respectively) and less financial challenges compared to patients who were unemployed (p = 0.0005). Conclusions: Baseline KPS had the greatest influence on EORTC QLQ-C30 domain scores. Age, education level, and employment status had significant impacts, although on fewer domains. Further studies that investigate baseline determinants are worthwhile to clarify relationships in order to care for patients more effectively at the end of life.
    Full-text · Article · Jun 2013 · Supportive Care in Cancer
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    ABSTRACT: Objective: The European Organization of Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 15 Palliative (EORTC QLQ-C15-PAL) was developed to assess quality of life (QOL) for the palliative cancer population to decrease patient burden. The purpose of this study was to compare predictive factors for well-being in the QLQ-C15-PAL extracted from the EORTC Quality of Life Questionnaire - Core 30 (QLQ-C30) with the QLQ-C30 itself. Methods and materials: Patients with advanced cancer referred for treatment of bone metastases completed the QLQ-C30. Fifteen items from the QLQ-C15-PAL were extracted from the QLQ-C30. Univariate and multivariate analyses were used to determine predictive factors of the global QOL/health score in both tools. In the multivariate analyses, a p value of <0.003 indicated statistical significance. Results: Overall, predictive factors were similar when analyzing data from both tools. Predictive factors for the QLQ-C30 were role functioning (p<0.0001), fatigue (p<0.0001), nausea/vomiting (p<0.0001), and financial problems (p<0.0001) and factors for the extracted QLQ-C15-PAL were physical functioning (p<0.0001) and fatigue (p<0.0001). Conclusions: Extraction of the QLQ-C15-PAL items from the QLQ-C30 resulted in similar predictive QOL domains for all patient subgroups analyzed individually. The QLQ-C15-PAL is reflective of the QLQ-C30 domains and is recommended for future studies involving patients in a palliative setting, as this shorter questionnaire reduces patient burden and may increase accrual and compliance, while maintaining a similar breadth of coverage and achieving the same predictive ability.
    No preview · Article · Mar 2013 · Journal of palliative medicine
  • Vassilios Vassiliou
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    ABSTRACT: The life expectancy of Western populations has risen in the last few decades, resulting in a steep increase in the number of elderly cancer patients. Metastatic bone disease (MBD) is an important problem in such patients as it is associated with the development of skeletal-related events (SREs), such as fractures and spinal cord compression. These complications do not only deteriorate the quality of life of affected patients, but can also reduce expected survival. Due to the fact that elderly patients have an increased risk of SREs, maintaining bone health and implementing effective treatments for managing MBD is of vital importance. Bisphosphonates have been shown to be effective in reducing the risk of SREs considerably in patients with MBD. Moreover, they have been shown to reduce pain and improve the quality of life of affected patients. Bisphosphonates should be used with caution in elderly patients due to the fact that their use can bring about renal function deterioration. Several preventive measures need to be followed in order to minimise the risk of this complication. Denosumab is a monoclonal antibody inhibiting receptor activator of NF-kB ligand and has shown superiority over zoledronic acid in reducing the risk of SREs. In the three comparative trials between denosumab and zoledronic acid, survival and disease progression were similar between the two groups. Denosumab has been shown not to affect renal function and can therefore be safely used in the elderly. Osteonecrosis of the jaws is a devastating complication that may occur after treatment with either denosumab or zoledronic acid. The incidence rates between the two are comparable and percentage differences not statistically significant. In the three randomised trials, hypocalcaemia occurred more frequently in denosumab-treated patients than in those managed with zoledronic acid, with the corresponding percentages being 5.5-13% versus 3.4-6%. In order to minimise the risk of osteonecrosis of the jaws and hypocalcaemia, all precautionary measures and treatment guidelines should be followed closely. Several studies have investigated the cost-effectiveness of denosumab versus zoledronic acid when used for SRE prevention. These studies reported contradictory results due to the application of different analytical perspectives and model parameters.
    No preview · Article · Mar 2013 · Clinical Oncology
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    ABSTRACT: Purpose: This study explored international radiation oncology trainee decision making in the management of radiotherapy-induced nausea and vomiting (RINV). Methods: Radiation oncology trainees who were members of the national radiation oncology associations of the USA, Canada, Netherlands, Australia, New Zealand, France, Spain and Singapore completed a Web-based survey. Respondents estimated the risks of nausea and vomiting associated with six standardised radiotherapy-only clinical case vignettes modelled after international anti-emetic guidelines and then committed to prophylactic, rescue or no therapy as an initial management approach for each case. Results: One hundred and seventy-six trainees from 11 countries responded. Only 28 % were aware of any anti-emetic guideline. In general, risk estimates and management approaches for the high-risk and minimal risk cases varied less and were more in line with guideline standards than were estimates and approaches for the moderate- and low-risk cases. Prophylactic therapy was the most common approach for the high-risk and a moderate-risk case (83 and 71 % of respondents respectively), while rescue therapy was the most common approach for a second moderate-risk case (69 %), two low-risk cases (69 and 76 %) and a minimal risk case (68 %). A serotonin receptor antagonist was the most commonly recommended prophylactic agent. On multivariate analysis, a higher estimated risk of nausea predicted for recommending prophylactic therapy, and a lower estimated risk of nausea predicted for recommending rescue therapy. Conclusions: Radiation oncology trainee risk estimates and recommended management approaches for RINV clinical case vignettes varied and matched guideline standards more often for high-risk and minimal risk cases than for moderate- and low-risk cases. Risk estimates of nausea specifically were strong predictors of management decisions.
    No preview · Article · Feb 2013 · Supportive Care in Cancer
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    ABSTRACT: Objective: This study examined which domains/symptoms from the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 15 Palliative (QLQ-C15-PAL), an abbreviated version of the health-related EORTC QLQ-C30 questionnaire designed for palliative cancer patients, were predictive of overall quality of life (QOL) in advanced cancer patients. Methods: Patients with advanced cancer from six countries completed the QLQ-C15-PAL at consultation and at one follow-up point. Univariate and multivariate regression analyses were conducted to determine the predictive value of the EORTC QLQ-C15-PAL functional/symptom scores for global QOL (question 15). Results: Three hundred forty-nine patients completed the EORTC QLQ-C15-PAL at baseline. In the total patient sample, worse emotional functioning, pain, and appetite loss were the most significant predictive factors for worse QOL. In the subgroup of patients with bone metastases (n = 240), the domains mentioned above were also the most significant predictors, whereas in patients with brain metastases (n = 109), worse physical and emotional functioning most significantly predicted worse QOL. One-month follow-up in 267 patients revealed that the significant predictors changed somewhat over time. For example, in the total patient sample, physical functioning, fatigue, and appetite loss were significant predictors at the follow-up point. A sub-analysis of predictive factors affecting QOL by primary cancer (lung, breast, and prostate) was also conducted for the total patient sample. Conclusion: Deterioration of certain EORTC QLQ-C15-PAL functional/symptom scores significantly contributes to worse overall QOL. Special attention should be directed to managing factors most influential on overall QOL to ensure optimal management of advanced cancer patients.
    Full-text · Article · Jan 2013 · Supportive Care in Cancer
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    ABSTRACT: In advanced cancer patients, quality of life (QOL) is often a more meaningful clinical endpoint as patients often have shorter life expectancies and treatment intent is palliative in nature. Since 1993, the European Organization for Research and Treatment of Cancer Core 30 Questionnaire (EORTC QLQ-C30) has been widely used to study cancer-specific health-related quality of life. This study seeks to compare EORTC QLQ-C30 scores in patients with bone and brain metastases. Methods: The EORTC QLQ-C30 was used to assess QOL internationally in patients with bone metastases. A univariate linear regression model (GLM) was applied to detect significant differences between both groups on each QLQ-C30 scale at baseline. To normalize the distribution, natural log-transformations were applied for each C30 summary scale. Results: KPS, gender, marital status, and primary cancer site were found to be significantly different between the two groups (p < 0.005). After accounting for these confounding factors, three EORTC-C30 scales found to be significantly different between patients with bone and brain metastases: physical functioning (p < 0.0001), role functioning (p < 0.0004), and pain scale (p < 0.0001). Bone metastases patients reported worse pain and physical functioning, while brain metastases exhibited greater role functioning deficits. Conclusion: Patients with bone metastases have more pain and reduced physical functioning. However, patients with brain metastases have more severe role functioning deficits. The use of disease-specific assessment modules such as the QLQ-BM22 and QLQ-BN20 will enhance the capture of relevant QOL in these populations.
    No preview · Article · Jan 2013

Publication Stats

363 Citations
143.12 Total Impact Points

Institutions

  • 2009-2016
    • Bank of Cyprus Oncology Center
      Lefkoşa, Lefkosia, Cyprus
  • 2006-2010
    • University of Patras
      • Department of Radiology
      Rhion, West Greece, Greece
  • 2008
    • Πανεπιστημιακό Γενικό Νοσοκομείο Πατρών
      Pátra, West Greece, Greece