Predictive factors for overall quality of life in patients with advanced cancer

Cramarossa, Gemma; Chow, Edward; Zhang, Liying; Bedard, Gillian; Zeng, Liang; Sahgal, Arjun; Vassiliou, Vassilios; Satoh, Takefumi; Arnalot, Palmira Foro; Buig-yue, Brigette; Chie, Wei‐Chu; Chen, Emily; Lam, Henry; Bottomley, Andrew

doi:10.1007/s00520-013-1717-7

Cited by 62 publications

(51 citation statements)

References 28 publications

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“…Multiple studies have found pain to be a determinant of quality of life in patients with cancer. 11,44,45,52,62 Furthermore, neuropathic pain has a greater effect on quality of life than nociceptive pain. 53 Identification of the type of pain experienced by chordoma patients will be important in achieving improvement in quality of life through pain control.…”

Section: Discussionmentioning

confidence: 99%

“…The GOSE classifies function into 1 of 8 categories with lower scores indicating a worse disability (1, To determine states of anxiety and depression, the Patient Health Questions-9 (PHQ-9) instrument was administered. 32 Based on participant responses to 9 questions, the severity of depression can be categorized into minimal (a score of 1-4), mild (a score of 5-9), moderate (a score of [10][11][12][13][14], moderately severe (a score of [15][16][17][18][19], and severe (a score of [20][21][22][23][24][25][26][27]. The 22-item Zarit Burden Interview (ZBI) was used to measure the level of subjective burden among caregivers.…”

Section: Instrumentsmentioning

confidence: 99%

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Determinants of quality of life in patients with skull base chordoma

Diaz

Maggacis

Zhang

et al. 2014

JNS

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Object Skull base chordomas can be managed by surgical intervention and adjuvant radiotherapy. As survival for this disease increases, identification of determinants of quality of life becomes an important focus for guiding comprehensive patient care. In this study the authors sought to measure functional outcome and quality of life in patients with skull base chordomas and to identify determinants of quality of life in these patients. Methods The authors carried out an internet-based cross-sectional survey, collecting detailed data for 83 individual patients. Demographic and clinical variables were evaluated. Functional outcomes were determined by Karnofsky Performance Scale (KPS) and Glasgow Outcome Scale Extended (GOSE), quality of life was measured using the 36-Item Short Form Health Survey (SF-36), and depression was assessed using Patient Health Questions–9 (PHQ-9) instrument. Caregiver burden was assessed using the Zarit Burden Interview (ZBI). Univariate and multivariate analysis was performed to identify determinants of the physical and mental components of the SF-36. Results Patients with skull base chordomas who have undergone surgery and/or radiation treatment had a median KPS score of 90 (range 10–100, IQR 10) and a median GOSE score of 8 (range 2–8, IQR 3). The mean SF-36 Physical Component Summary score (± SD) was 43.6 ± 11.8, the mean Mental Component Summary score was 44.2 ±12.6, and both were significantly lower than norms for the general US population (p < 0.001). The median PHQ-9 score was 5 (range 0–27, IQR 8). A PHQ-9 score of 10 or greater, indicating moderate to severe depression, was observed in 29% of patients. The median ZBI score was 12 (range 0–27, IQR 11), indicating a low burden. Neurological deficit, use of pain medication, and requirement for corticosteroids were found to be associated with worse SF-36 Physical Component Summary score, while higher levels of depression (higher PHQ-9 score) correlated with worse SF-36 Mental Component Summary score. Conclusions Patients with skull base chordomas have a lower quality of life than the general US population. The most significant determinants of quality of life in the posttreatment phase in this patient population were neurological deficits (sensory deficit and bowel/bladder dysfunction), pain medication use, corticosteroid use, and levels of depression as scored by PHQ-9.

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Section: Discussionmentioning

confidence: 99%

Section: Instrumentsmentioning

confidence: 99%

Determinants of quality of life in patients with skull base chordoma

Diaz

Maggacis

Zhang

et al. 2014

JNS

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“…(1-3) Since painful bone metastases have a major impact on quality of life (QoL) in patients with advanced cancer (4,5), reducing pain is likely to improve QoL. Although a few studies showed that radiotherapy for painful bone metastases contributes to improvement of QoL, no thorough studies have been published focusing on the course of QoL after radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life in Relation to Pain Response to Radiation Therapy for Painful Bone Metastases

Westhoff

Graeff

Monninkhof

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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“…Although reduction of pain is the main treatment goal, it is also important to focus on quality of life (QoL) [4]. Painful bone metastases have a negative impact on the QoL of patients [5,6]. Studies show that radiotherapy stabilizes or improves QoL [7][8][9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

et al. 2017

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Background: Psychological distress (PD) has a major impact on quality of life. We studied the incidence of PD before and after radiotherapy for painful bone metastases. Furthermore, we aimed to identify factors predictive for PD. Methods: Between 1996 and 1998, the Dutch Bone Metastasis Study included 1157 patients with painful bone metastases. Patients were randomized between two fractionation schedules. The study showed a pain response of 74% in both groups. Patients filled out weekly questionnaires for 13 weeks, then monthly for two years. The questionnaires included a subscale for PD on the Rotterdam Symptom Checklist. We used generalized estimating equations and multivariable logistic regression analyses. Results: At baseline, 290 patients (27%) had a high level of PD. For the entire group, the level of PD remained constant over time. The majority of patients with a low level of PD at baseline remained at a low level during follow-up. In patients with a high level of PD at baseline, the mean level of PD decreased after treatment and stabilized around the cutoff level. Female patients, higher age, worse performance, lower pain score and worse self-reported QoL were associated with an increased chance of PD, although the model showed moderate discriminative power. Conclusions: A substantial proportion of patients had a high level of PD before and after radiotherapy for painful bone metastases. Most patients who reported high levels of PD when referred for palliative radiotherapy remained at high levels thereafter. Therefore, screening of PD prior to treatment seems appropriate, in order to select patients requiring intervention.

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Predictive factors for overall quality of life in patients with advanced cancer

Abstract: 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.

Cited by 62 publications

References 28 publications

Determinants of quality of life in patients with skull base chordoma

Determinants of quality of life in patients with skull base chordoma

Quality of Life in Relation to Pain Response to Radiation Therapy for Painful Bone Metastases

Screening for psychological distress before radiotherapy for painful bone metastases may be useful to identify patients with high levels of distress

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