scholarly journals Anorectal function and quality of life after chemoradiotherapy in patients with anal canal carcinoma

2017 ◽  
Vol 5 (2) ◽  
pp. 33-38
Author(s):  
Francesca De Felice ◽  
Daniela Musio ◽  
Gloria Bernardi ◽  
Lavinia Grapulin ◽  
Alessio Impagnatiello ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fecal Incontinence ◽  
Anal Canal ◽  
Anorectal Manometry ◽  
Anorectal Function ◽  
Anal Canal Cancer ◽  
European Organization ◽  
Patient Reported ◽  
Sphincter Complex

Background: A retrospective study was conducted to evaluate sphincter function and quality of life (QoL) in patients treated with radiotherapy and concurrent chemotherapy (CRT) for anal canal cancer. Materials and Methods: From 1998 to 2010, patients with anal canal cancer treated with CRT were eligible. Radiation dose was 59.4 Gy (1.8 Gy/ fraction) and the chemotherapy regimen was 5-fluorouracil and mitomycin C. Anorectal function was investigated by anorectal manometry and transrectal ultrasound. QoL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C29 questionnaire. Correlations between diagnostic parameters and patient-reported outcomes were evaluated. Results: Eighteen patients were enrolled. Overall, 4 patients had stage I disease, 8 stage II and 6 stage III. Anorectal manometry parameters were significantly lower compared to healthy scores. Patients-reported continence was significantly higher than fecal incontinence manometry scores. Ultrasound sphincter complex defects were recorded in 17 patients. Globally, a positive correlation was described between resting pressure of manometric exam and sexual functioning items and sphincter complex and patient-reported flatulence, respectively. Conclusions: Definitive CRT represents the standard of care for anal canal cancer. Patients experienced low rates of fecal incontinence compared with results of diagnostic exams. Further studies are needed to better define toxicity and QoL after definitive CRT in anal canal cancer.

scholarly journals Determinants of Cancer-specific Quality of Life in Veteran Lung Cancer Survivors Eligible for Long-Term Cure

2019 ◽  
Author(s):  
Duc Ha ◽  
Andrew L. Ries ◽  
Jeffrey J. Swigris
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Cancer Survivors ◽  
Summary Score ◽  
European Organization ◽  
Specific Patient ◽  
Patient Reported ◽  
Sleep Difficulties

AbstractRationale/ObjectiveQuality of life (QoL) is an important issue in lung cancer survivors. We aimed to identify determinants of QoL in lung cancer survivors eligible for long-term cure.MethodsWe performed an exploratory analysis of a cross-sectional study of consecutive lung cancer survivors who completed curative-intent treatment ≥1 month previously. Variables tested included demographic, clinical, physiologic, and symptom-specific patient-reported outcome measures. We defined the primary outcome as a previously-validated cancer-specific QoL measure – the European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 (C30) summary score. We also verified our findings with the C30 global health status/QoL subscale and a summated score of lung cancer-specific QoL from the EORTC-Lung Cancer Module 13.ResultsIn 75 enrolled participants, measures of fatigue, depression, sleep difficulties, and dyspnea were statistically significant determinants of the C30 summary score in multivariable linear regression analyses. Together, these four symptoms accounted for approximately 85% of the variance in cancer-specific QoL (p<0.001). When we verified our findings with global QoL and lung cancer-specific QoL, fatigue and dyspnea were consistent determinants of QoL.ConclusionsWe found four symptoms – dyspnea, fatigue, depression, and sleep difficulties – that are important determinants of and together accounted for almost all of the variance in cancer-specific QoL in lung cancer survivors eligible for long-term cure. These findings have implications to reduce symptom burden and improve function and QoL in these patients.

scholarly journals Quality of life trajectories during the first three years after diagnosis of breast cancer: the NEON-BC study

2019 ◽  
Author(s):  
Luisa Lopes-Conceição ◽  
Mariana Brandão ◽  
Natália Araújo ◽  
Milton Severo ◽  
Teresa Dias ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Sleep Quality ◽  
Patient Reported Outcomes ◽  
Life Questionnaire ◽  
European Organization ◽  
Life Trajectories ◽  
Patient Reported ◽  
Anxiety Depression

Abstract Background We aimed to identify and characterize quality of life trajectories up to 3 years after breast cancer diagnosis. Methods A total of 460 patients were evaluated at baseline (before treatments), and after 1- and 3-years. Patient-reported outcomes, including quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, QLQ-C30), anxiety, depression and sleep quality, were assessed in all evaluations. Model-based clustering was used to identify quality of life trajectories. Results We identified four trajectories without intersection during 3 years. The two trajectories characterized by better quality of life depicted relatively stable scores; in the other trajectories, quality of life worsened until 1 year, though in one of them the score at 3 years improved. Sociodemographic and clinical characteristics at baseline did not differ between trajectories, except for mastectomy, which was higher in the worst trajectory. Anxiety, depression and poor sleep quality increased from the best to the worst trajectory. Conclusions The type of surgery and the variation of other patient-reported outcomes were associated with the course of quality of life over 3 years. More research to understand the heterogeneity of individual trajectories within these major patterns of variation is needed.

Self-reported financial stress among patients evaluated at a community cancer program.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6553-6553
Author(s):  
Christopher S. Lathan ◽  
Ruth N. Akindele ◽  
Ludmila Svoboda ◽  
Daniel A. Gundersen
Keyword(s):  
Quality Of Life ◽  
Underserved Populations ◽  
Financial Burden ◽  
Financial Stress ◽  
Stress Index ◽  
Life Questionnaire ◽  
European Organization ◽  
Cancer Program ◽  
Patient Reported

6553 Background: Cancer related financial stress has been linked to a multitude of factors including socio-economic status, but its impact on the quality of life (QOL) for underserved populations is less well characterized. We evaluated patient reported financial stress, QOL, and quality of health (QOH) at an outreach cancer program located in a federally qualified health center. Methods: Study participants were interviewed at initial clinic visit for financial stress, QOH and QOL between January 2012 and December 2016. Demographic information, insurance coverage, clinical parameters, and comorbidities were abstracted from participants’ medical records. Responses to the financial stress index question “how difficult is it for you or your family to meet monthly payment of your/your family bills?” and overall QOL and QOH of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 were analyzed. Proportional odds logistic regression models were constructed for 5-point quality of life measures and three levels of financial toxicity. Results: Of the 288 participants analyzed, 52% and 12% reported somewhat and extreme financial stress. In an adjusted analysis, patients who reported financial stress were more likely to be younger in age (OR = 4.03, p < 0.001) unemployed (OR = 3.24, p = 0.002), have less than bachelor’s degree (OR = 0.035, p = 0.018), insured by Medicaid (OR = 3.22, p < 0.011), and were more likely to rate their QOL (OR = 3.76, p = 0.031) as poor, compared to those without financial stress. Race, gender, presence of cancer diagnosis and comorbidities were not associated with financial distress. Independent predictors of poor QOL were disability (OR = 3.12, p = 0.005), depression (OR = 2.12, p = 0.007) and extreme financial difficulty (OR = 2.57, p = 0.011). There was a nearly perfect positive correlation between overall QOL and QOH (r = 0.984, p < 0.001). Conclusions: There is a high prevalence of financial burden among underserved minority patients seeking cancer related care, and this is closely associated with poor quality of life. Interventions targeting cancer disparities need to assess financial stress in order to address this issue.

The Prognostic Significance of Patient-Reported Outcomes in Cancer Clinical Trials

2008 ◽  
Vol 26 (8) ◽  
pp. 1355-1363 ◽  
Author(s):  
Carolyn C. Gotay ◽  
Crissy T. Kawamoto ◽  
Andrew Bottomley ◽  
Fabio Efficace
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Patient Reported Outcomes ◽  
Prognostic Significance ◽  
Cancer Clinical Trials ◽  
Life Questionnaire ◽  
European Organization ◽  
Patient Reported ◽  
The Impact

Purpose Patient-reported outcomes (PROs), routinely collected as a part of cancer clinical trials, have been linked with survival in numerous clinical studies, but a comprehensive critical review has not been reported. This study systematically assessed the impact of PROs on patient survival after a cancer diagnosis within the context of clinical trials. Design Cancer clinical trials that assessed baseline PROs and mortality were identified through MEDLINE (through December 2006) supplemented by the Cochrane database, American Society of Clinical Oncology/European Society for Medical Oncology abstracts and hand searches. Inclusion criteria were publication in English language and use of multivariate analyses of PROs that controlled for one or more clinical factors. Two raters reviewed each study, abstracted data, and assessed study quality; two additional raters verified abstractions. Results In 36 of 39 studies (N = 13,874), at least one PRO was significantly associated with survival (P < .05) in multivariate analysis, with varying effect sizes. Studies of lung (n = 12) and breast cancer (n = 8) were most prevalent. The most commonly assessed PRO was quality of life, measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 in 56% of studies. Clinical variables adjusted for included performance status (PS), treatment arm, stage, weight loss, and serum markers. Results indicated that PROs provide distinct prognostic information beyond standard clinical measures in cancer clinical trials. Conclusion PROs might be considered for stratification purposes in future trials, as they were often better predictors of survival than PS. Studies are needed to determine whether interventions that improve PROs also increase survival and to identify explanatory mechanisms through which PROs relate to survival.

How Accurate Is Clinician Reporting of Chemotherapy Adverse Effects? A Comparison With Patient-Reported Symptoms From the Quality-of-Life Questionnaire C30

2004 ◽  
Vol 22 (17) ◽  
pp. 3485-3490 ◽  
Author(s):  
Erik K. Fromme ◽  
Kristine M. Eilers ◽  
Motomi Mori ◽  
Yi-Ching Hsieh ◽  
Tomasz M. Beer
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Adverse Event ◽  
Adverse Effects ◽  
Adverse Events ◽  
Life Questionnaire ◽  
European Organization ◽  
Quality Of Life Questionnaire ◽  
Patient Reported

Purpose Adverse events in chemotherapy clinical trials are assessed and reported by clinicians, yet clinician accuracy in assessing symptoms has been questioned. We compared patient reporting of eight symptoms using a validated instrument, the European Organization for the Research and Treatment of Cancer Quality-of-Life Questionnaire C30 (QLQ-C30 or QLQ) with physicians' reporting of the same symptoms in the study's adverse events log. Patients and Methods Thirty-seven men with metastatic, androgen-independent prostate cancer enrolled onto a phase II trial of weekly calcitriol and docetaxel completed the QLQ every 4 weeks for up to 28 weeks. A patient-reported symptom was defined as an increase in a QLQ symptom score by at least 10 points (0 to 100 scale), sustained for at least 4 weeks. A physician-reported symptom was considered present if it was ever documented in the adverse event log. Results Forty-nine (new or worsened) symptoms were detected by both physician and QLQ, 48 symptoms were detected by the physician alone, and 55 symptoms were detected by the QLQ alone. They agreed on the absence of a symptom in 102 instances of 254 possible opportunities. Their uncorrected agreement was 59.4%, but Cohen's κ, a coefficient of agreement that corrects for chance, was 0.15, indicating only slight agreement. Using the QLQ as the standard, overall physician sensitivity and specificity was 47% and 68%, respectively, although it varied considerably among symptoms. Conclusion Even in a tightly controlled clinical trial, physician reporting was neither sensitive nor specific in detecting common chemotherapy adverse effects. Tools for collecting patient-reported adverse event data in chemotherapy clinical trials should be developed.

scholarly journals Importance of personality and coping expectancy on patient-reported hearing disability, quality of life and distress level: a study of patients referred to an audiology service

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Øyvind Nordvik ◽  
Peder O. Laugen Heggdal ◽  
K. Jonas Brännström ◽  
Anne Kari Aarstad ◽  
Hans Jørgen Aarstad
Keyword(s):  
Quality Of Life ◽  
Hearing Aids ◽  
Adult Population ◽  
General Health Questionnaire ◽  
World Health ◽  
European Organization ◽  
Hearing Disability ◽  
Patient Reported ◽  
And Coping

Abstract Purpose According to the World Health Organization (WHO), hearing loss (HL) affects up to 15% of the world’s adult population. Coping and personality are hypothesized to underlie quality of life (QoL) and distress scores. We aimed to study the importance of personality and coping in persons with HL for self-reported hearing disability, QoL, and distress. Methods A cross-sectional survey was carried out, including one hundred and fifty-eight adults seeking hearing aids. Pure-tone average hearing thresholds (PTA) were determined for each ear. A revised version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) served as a measure of self-reported hearing disability. Further, the generic part of the European Organization for Research and Treatment (EORTC) QoL questionnaire and the General Health Questionnaire (GHQ) (distress measure) were answered. Levels of neuroticism and the Theoretically Originated Measure of the Cognitive Activation Theory of Stress (TOMCATS) coping expectancy were determined. Results Hearing disability was determined by PTA (better ear) and level of neuroticism. Distress and QoL were determined by neuroticism and coping. Conclusion More neuroticism was associated with worse outcome for the variables hearing disability, distress, and QoL. Helplessness and hopelessness were associated with worse hearing disability, increased distress, and lowered QoL. Patient reported hearing disability was also associated with PTA (better ear). There is a need to investigate further the associations between hearing disability and QoL to psychosocial parameters.

scholarly journals Neurocognitive, Symptom, and Health- Related Quality of Life Outcomes of a Randomized Trial of Bevacizumab for Newly Diagnosed Glioblastoma (NRG/RTOG 0825)

2021 ◽  
Author(s):  
Jeffrey S Wefel ◽  
Terri S Armstrong ◽  
Stephanie L Pugh ◽  
Mark R Gilbert ◽  
Merideth M Wendland ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Function ◽  
Phase Iii ◽  
Life Questionnaire ◽  
Patient Centered ◽  
European Organization ◽  
Patient Reported ◽  
Survival Endpoints ◽  
Over Time

Abstract Background Results of NRG Oncology RTOG 0825 reported adding bevacizumab to standard chemoradiation did not significantly improve survival endpoints and resulted in greater decline in neurocognitive function (NCF) and patient reported outcomes (PRO) over time in bevacizumab treated patients. The present report provides additional results of patient centered outcomes over time and their prognostic association with survival endpoints. Methods NCF tests, MD Anderson Symptom Inventory brain tumor module (MDASI-BT), and European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire with brain-cancer module (QLQ-C30/BN20) were completed in a subset of progression-free patients at baseline and longitudinally. The prognostic value of baseline and early changes in NCF and PROs and differences between treatments from baseline to follow-up assessments was evaluated. Results 508 randomized patients participated. Baseline/early changes in NCF and PROs were prognostic for OS and PFS. No between arm differences in time to deterioration was found. At week 6, patients treated with bevacizumab evidenced greater improvement on NCF tests of executive function and the MDASI-BT Cognitive Function scale, but simultaneously reported greater decline on the EORTC Cognitive Function Scale. At later time points (week 22, 34, and 46), patients treated with bevacizumab had greater worsening on NCF tests as well as PRO measures of cognitive, communication, social function, motor symptoms, general symptoms and interference. Conclusion The collection of patient centered clinical outcome assessments in this phase III trial revealed greater deterioration in NCF, symptoms and QOL in patients treated with bevacizumab. Baseline and early change in NCF and PROs were prognostic for survival endpoints.

scholarly journals Incorporating Quality of Life Metrics in Interventional Oncology Practice

2017 ◽  
Vol 34 (04) ◽  
pp. 313-321 ◽  
Author(s):  
David Li ◽  
David Madoff
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Brief Pain Inventory ◽  
Patient Reported Outcome ◽  
Life Questionnaire ◽  
European Organization ◽  
Patient Reported

AbstractInterventional radiologists care for a large number of cancer patients with the breadth of palliative intent minimally invasive procedures that we provide. Understanding our meaningful impact on patients' quality of life is essential toward validating our role in the palliation of cancer patients. As such, it is critically important for interventional radiologists to understand common instruments used for the reporting of patient's quality of life measures. Common instruments used to measure pain and quality of life for cancer patients include the numerical rating scale, visual analog scale, brief pain inventory, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and the Functional Assessment of Cancer Therapy. An ideal quality of life instrument should be a patient reported outcome measure across multiple domains (e.g., physical health, psychological, social), and be both validated and reliable.

scholarly journals The burden of illness in patients with paroxysmal nocturnal hemoglobinuria receiving treatment with the C5-inhibitors eculizumab or ravulizumab: results from a US patient survey

2022 ◽  
Author(s):  
David Dingli ◽  
Joana E. Matos ◽  
Kerri Lehrhaupt ◽  
Sangeeta Krishnan ◽  
Michael Yeh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Burden Of Illness ◽  
Patient Survey ◽  
Life Questionnaire ◽  
Complement Protein ◽  
Cross Sectional ◽  
European Organization ◽  
Patient Reported

Abstract Paroxysmal nocturnal hemoglobinuria (PNH) is a rare and life-threatening disease with symptoms of hemolysis and thrombosis. Current therapies for this complement-mediated disease rely predominantly on inhibition of the C5 complement protein. However, data on treatment responses and quality of life in C5-inhibitor (C5i)-treated PNH patients are scarce. The objective of this study was to determine C5i treatment effects on clinical parameters, PNH symptoms, quality of life, and resource use for PNH patients. This cross-sectional study surveyed 122 individuals in the USA receiving treatment for PNH with C5-targeted monoclonal antibodies, eculizumab (ECU) or ravulizumab (RAV). Despite most patients receiving C5i therapy for ≥ 3 months (ECU 100%, n = 35; RAV 95.4%, n = 83), many patients remained anemic with hemoglobin levels ≤ 12 g/dL in 87.5% (n = 28/32) and 82.9% (n = 68/82) of ECU and RAV recipients, respectively. A majority of patients on ECU (88.6%; n = 31/35) and RAV (74.7%; n = 65/87) reported fatigue symptoms. Among PNH patients receiving C5i therapy for ≥ 12 months, some still reported thrombotic events (ECU, 10.0%, n = 1/10; RAV, 23.5%, n = 4/17) and required transfusions within the past year (ECU, 52.2%, n = 12/23; RAV, 22.6%, n = 7/31). Other patient-reported PNH symptoms included breakthrough hemolysis, shortness of breath, and headaches. Patients reported scores below the average population norms on the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scales. Overall, this study found that PNH patients receiving ECU or RAV therapy demonstrated a significant burden of illness, highlighting the need for improved PNH therapies.

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