Evaluation of quality of life in patients with advanced-stage cancer undergoing palliative chemotherapy
Keywords:advanced-stage cancer, quality of life, chemotherapy
Quality of life (QoL) was a significant medical outcome measure and was an important goal for the planning of treatment among cancer patients. In order to evaluate changes in QoL during palliative chemotherapy among Thai patients with an advanced-stage cancer. A single-center prospective study was conducted with advanced-stage cancer patients enrolled in the study who were undergoing palliative chemotherapy in a single university hospital. The data were collected using self-administered questionnaires. The baseline characteristics, performance status, and quality of life using the European Organization for Research and Treatment of Cancer (EORTC QLQ C30) were measured at 3 and 6 months after chemotherapy treatment. The QoL scores were compared across the three-time points using repeated-measures analysis of variance. The QoL scores were reported in terms of mean and standard deviation and a p-value less than 5% was statistically significant. A total of 70 patients were enrolled in this study, with a mean age of 55.07 (SD 14.88) years, with 44 males and 26 females. Solid cancers and hematologic malignancies were found in 49 and 21 patients, respectively. After 6 months of follow-up, 27 participants were evaluated completely. The functioning scales such as emotional, cognitive, and social functions had higher scores after three months of therapy and marked minor further improvements over 6 months. The symptoms of fatigue and financial difficulties also significantly improved after 3 to 6 months of chemotherapy treatment. The overall QoL showed worsening after 3 months of treatment and a slight improvement after 6 months. While the functioning scales of fatigue and financial conditions of the patients improved after chemotherapy, but the overall quality of life worsened after 3 months of treatment.
2. Donovan K, Sanson-Fisher RW, Redman S. Measuring quality of life in cancer patients. J Clin Oncol 1989;7:959-68.
3. Nayak MG, George A, Vidyasagar MS, et al. Quality of life among cancer patients. Indian J Palliat Care 2017;23:445-50.
4. Drake K. Quality of life for cancer patients: From diagnosis to treatment and beyond. [published online ahead of print, 2012 Jan 10]. Nurs Manage. 2012; doi:10.1097/
5. Hwang SS, Chang VT, Fairclough DL, et al. Longitudinal quality of life in advanced cancer patients: pilot study results from a VA medical cancer center. J Pain Symptom Manage 2003;25:225-35.
6. Yang SC, Lai WW, Hsiue TR, et al. Health-related quality of life after first-line anti-cancer treatments for advanced non-small cell lung cancer in clinical practice. Qual Life Res 2016;25:1441-9.
7. Charalambous A, Kouta C. Cancer related fatigue and quality of life in patients with advanced prostate Cancer Undergoing Chemotherapy. Biomed Res Int 2016;2016:
8. Zimmermann C, Burman D, Swami N, et al. Determinants of quality of life in patients with advanced cancer. Support Care Cancer 2011;19:621-9.
9. Kypriotakis G, Vidrine DJ, Francis LE, et al. The longitudinal relationship between quality of life and survival in advanced stage cancer. Psychooncology 2016;25:
10. Enien M, Ibrahim N, Makar W, et al. Healthrelated quality of life: Impact of surgery and treatment modality in breast cancer. J Cancer Res Ther 2018;14:957-63.
11. Akça M, Ata A, Nayır E, et al. Impact of Surgery Type on Quality of Life in Breast Cancer Patients. J Breast Health 2014;10: 222-8.
12. Yucel B, Akkaş EA, Okur Y, et al. The impact of radiotherapy on quality of life for cancer patients: a longitudinal study. Support Care Cancer 2014;22:2479-87.
13. Xiao C, Miller AH, Felger J, et al. A prospective study of quality of life in breast cancer patients undergoing radiation therapy. Adv Radiat Oncol
14. Lee SH, Lee T-G, Baek MJ, et al. Quality of life changes during adjuvant chemotherapy in patients with colon cancer. Korean J Clin Oncol 2016;12:60-6.
15. Akhtari-Zavare M, Mohd-Sidik S, Periasamy U, et al. Determinants of quality of life among Malaysian cancer patients: a crosssectional study. Health Qual Life Outcomes
16. Wintner LM, Giesinger JM, Zabernigg A, et al. Quality of life during chemotherapy in lung cancer patients: results across different treatment lines. Br J Cancer 2013;109:2301-8.
17. Yan B, Yang L-M, Hao L-P, et al. Determinants of quality of life for breast cancer patients in Shanghai, China. PLoS One 2016;11: e0153714-e.
18. Hassen AM, Taye G, Gizaw M, et al. Quality of life and associated factors among patients with breast cancer under chemotherapy at Tikur Anbessa specialized
hospital, Addis Ababa, Ethiopia. PLoS One 2019;14:e0222629.
19. Rosati G, Pinto C, Di Fabio F, et al. Quality of life, compliance, safety and effectiveness in fit older metastatic colorectal patients with cancer treated in first-line with
chemotherapy plus cetuximab: A restrospective analysis from the ObservEr study. J Geriatr Oncol 2018;9:243-8.
20. Maneechawakajorn J, Hathaisanguan S. Quality of life achieved by carboplatin plus etoposide as third-line chemotherapy compared with best supportive care in non-small cell lung cancer stage IIIB/IV. J Med Assoc Thai 2016;99(Suppl 2):S175-81.
21. Maneechawakajorn J, Suksuperm J. Quality of life in advanced non-small cell lung cancer receiving chemotherapy of platinum combination in old versus new
standard chemotherapy regimen. J Med Assoc Thai 2014;97(Suppl 11):S69-75.
22. Singh H, Kaur K, Banipal RPS, et al. Quality of life in cancer patients undergoing chemotherapy in a tertiary care center in malwa region of punjab. Indian J Palliat Care 2014;20:116-22.
23. Niwas R, Suri JC, Chakrabarti S, et al. Quality of life assessment in advanced stage of lung cancer patients before and after chemotherapy. Eur Respir J 2019;54(suppl 63):PA4650.
24. Mannion E, Gilmartin JJ, Donnellan P, et al. Effect of chemotherapy on quality of life in patients with non-small cell lung cancer. Support Care Cancer 2014;22:
25. Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993;85:365-76.
26. Sirisinha T, Ratanatharathorn V, Jirajarus M, et al. The European Organization for Research and Treatment of Cancer quality of life questionnaire: Translation and reliability study of the Thai version. J Med Assoc Thai 2002;85:1210-9.
27. Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982;5:649-55.
28. Anderson F, Downing GM, Hill J, et al. Palliative performance scale (PPS): a new tool. J palliat Care 1996;12:5-11.
29. Domati F, Luppi G, Reggiani-Bonetti L, et al. The perception of health-related quality of life in colon cancer patients during chemotherapy: differences between men and women. Intern Emerg Med 2015;10:423-9.
30. Üstündağ S, Zencirci AD. Factors affecting the quality of life of cancer patients undergoing chemotherapy: A questionnaire study. Asia Pac J Oncol Nurs 2015;2:17-25.
31. Can G, Erol O, Aydiner A, et al. Quality of life and complementary and alternative medicine use among cancer patients in Turkey. Eur J Oncol Nurs 2009;13:287-94.
32. Pud D. Gender differences in predicting quality of life in cancer patients with pain. Eur J Oncol Nurs 2011;15:486-91.
33. Cheng KK, Lee DT. Effects of pain, fatigue, insomnia, and mood disturbance on functional status and quality of life of elderly patients with cancer. Crit Rev Oncol Hematol 2011;78:127-37.
34. Inglis JE, Janelsins MC, Culakova E, et al. Longitudinal assessment of the impact of higher body mass index on cancer-related fatigue in patients with breast cancer
receiving chemotherapy. Support Care Center 2020;28:1411-8.
35. Ul-Haq Z, Mackay DF, Fenwick E, et al. Meta-analysis of the association between body mass index and health-related quality of life among adults, assessed by the SF-36. Obesity (Siver Spring) 2013;21: E322-E7.
36. Ravindran OS, Shankar A, Murthy T. A comparative study on perceived stress, coping, quality of life, and hopelessness between cancer patients and survivors. Indian J Palliat Care 2019;25:414-20.