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Inoue J, Morishita S, Okayama T, Suzuki K, Tanaka T, Nakano J, Fukushima T. Impact of quality of life on mortality risk in patients with esophageal cancer: a systematic review and meta-analysis. Esophagus 2024:10.1007/s10388-024-01064-w. [PMID: 38772959 DOI: 10.1007/s10388-024-01064-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/14/2024] [Indexed: 05/23/2024]
Abstract
This systematic review and meta-analysis investigated the impact of quality of life (QoL) on mortality risk in patients with esophageal cancer. A literature search was conducted using the CINAHL, PubMed/MEDLINE, and Scopus databases for articles published from inception to December 2022. Observational studies that examined the association between QoL and mortality risk in patients with esophageal cancer were included. Subgroup analyses were performed for time points of QoL assessment and for types of treatment. Seven studies were included in the final analysis. Overall, global QoL was significantly associated with mortality risk (hazard ratio 1.02, 95% confidence interval 1.01-1.04; p < 0.00004). Among the QoL subscales of QoL, physical, emotional, role, cognitive, and social QoL were significantly associated with mortality risk. A subgroup analysis by timepoints of QoL assessment demonstrated that pre- and posttreatment global and physical, pretreatment role, and posttreatment cognitive QoL were significantly associated with mortality risk. Moreover, another subgroup analysis by types of treatment demonstrated that the role QoL in patients with surgery, and the global, physical, role, and social QoL in those with other treatments were significantly associated with mortality risk. These findings indicate that the assessment of QoL in patients with esophageal cancer before and after treatment not only provides information on patients' condition at the time of treatment but may also serve as an outcome for predicting life expectancy. Therefore, it is important to conduct regular QoL assessments and take a proactive approach to improve QoL based on the results of these assessments.
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Affiliation(s)
- Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center, 1-5-1 Minatojimaminamimachi, Chuo-ku, Kobe, 650-0047, Japan.
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Okayama T, Suzuki K, Morishita S, Inoue J, Tanaka T, Nakano J, Fukushima T. Pretreatment quality of life and survival in patients with lung cancer: a systematic review and meta-analysis. BMC Cancer 2024; 24:495. [PMID: 38637726 PMCID: PMC11027547 DOI: 10.1186/s12885-024-12267-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 04/16/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Although many studies have explored the correlation between quality of life and survival, none have reported this relationship for specific cancers assessed at distinct time points. This meta-analysis aimed to investigate the impact of pretreatment Global Quality of Life (QOL) and functioning QOL, including physical, social, role, emotional, and cognitive QOLs, on mortality risk in patients with lung cancer. METHODS A literature search was conducted across the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and PubMed databases for articles published between their inception and December 2022. Subsequently, 11 studies were selected based on predefined eligibility criteria to investigate the relationship between pretreatment QOLs and mortality risk in patients with lung cancer. RESULTS Pretreatment global, physical, social, role, and emotional QOLs were significantly associated with mortality risk as follows: Global QOL (hazard ratio [HR] = 1.08 95% confidence interval [CI] = 1.03-1.13); Physical QOL (HR = 1.04 95% CI = 1.02-1.05); Social QOL (HR = 1.02 95% CI = 1.01-1.03; Role QOL (HR = 1.01 95% CI = 1.01-1.02); Emotional QOL (HR = 1.01 95% CI = 1.00-1.03). CONCLUSIONS These findings underscore the importance of early QOL assessment after diagnosis as well as early provision of physical, social, and psychological support accommodating each patient's demands. TRIAL REGISTRATION The International Prospective Register of Systematic Reviews registration number CRD42023398206, Registered on February 20, 2023.
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Affiliation(s)
- Taro Okayama
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Katsuyoshi Suzuki
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Science, Fukushima Medical University, Fukushima, Japan
| | - Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center, Kobe, Japan
| | - Takashi Tanaka
- Department of Rehabilitation, Hyogo Medical University Hospital, Nishinomiya, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Takuya Fukushima
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.
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Zub V, Manzhalii E. ASSESSMENT OF QUALITY OF LIFE IN PATIENTS WITH GASTRIC CANCER IN UKRAINE. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:956-963. [PMID: 37326076 DOI: 10.36740/wlek202305111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The aim: To identify the main problems in the quality of life of patients with gastric cancer to optimize health care for them. PATIENTS AND METHODS Materials and methods: The sociological study was performed by surveying 404 patients with gastric cancer usage questionnaires EORTC QLQ-C30 and QLQ-STO22. Calculations were performed according to the EORTC QLQ-C30 Scoring Manual and QLQ-STO22. The analysis of three main indicators was performed: functional scale, symptom scale and quality of life scale. RESULTS Results: The quality of life of gastric cancer patients amounted to 51.80±11.35 on a 100-point scale. According to the QLQ-C30 functional scale, the psy¬cho-emotional sphere (59.62±12.91), social functioning (66.42±13.48) are the most impressive in patients. According to the results obtained in the QLQ-C30 symptoms scale, gastric cancer patients were most concerned about financial difficulties (57.18±12.45) and fatigue with a score of 50.12±10.86 on a 100-point scale. According to the QLQ-STO22 symptom scale in the study of patients, anxiety (59.07±12.46) and hair loss (56.97±11.78) amounted to the highest scores. CONCLUSION Conclusions: Given the low quality of life of gastric cancer patients, they need psychological support, which is aimed at adapting to the manifestations of the disease and should be a mandatory component in the development of models or strategies for providing medical care to cancer patients. Standardized psychological care should be organized at all stages of diagnosis, treatment and rehabilitation in all institutions that provide treatment to gastric cancer pa¬tients. It is also important to develop and implement a comprehensive program to support gastric cancer patients in interaction with society, family and work.
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Affiliation(s)
- Valeriy Zub
- SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE
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Armbrust R, Richter R, Woopen H, Hilpert F, Harter P, Sehouli J. Impact of health-related quality of life (HRQoL) on short-term mortality in patients with recurrent ovarian, fallopian or peritoneal carcinoma (the NOGGO-AGO QoL Prognosis-Score-Study): results of a meta-analysis in 2209 patients. ESMO Open 2021; 6:100081. [PMID: 33743329 PMCID: PMC8010392 DOI: 10.1016/j.esmoop.2021.100081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/11/2021] [Accepted: 01/30/2021] [Indexed: 11/18/2022] Open
Abstract
Objective Recurrent ovarian cancer is an incurable disease with variable but poor prognosis. Health-related quality of life (HRQoL) is a patient-reported outcome measure generally applied to measure effects of therapies. Our aim was the development and validation of a risk score for the prediction of short-term mortality using the combination of sociodemographic and clinical factors and HRQoL. Methods For exploratory and validation analysis, the North-Eastern German Society of Gynecological Oncology (NOGGO) and Working Group Gynecological Oncology (AGO) study databases were screened for trials. Only trials which obtained defined HRQoL measurements were included in the final analysis. Multivariable logistic regression analyses were used to identify risk factors and their weighting for the risk score. Modulation with cubic regression analyses revealed median survival and short-term mortality defined as 1-year mortality for each value. Results For exploration, 974 patients from three clinical studies of the NOGGO and for validation, 1235 patients from several clinical studies of the AGO were eligible. The risk score included platinum-free interval, performance status, age, global QoL and nausea/vomiting. Receiver operating characteristic analysis showed a good predictive value with an area under the curve of 0.81 for model 1 in the exploration and 0.74 in the validation. Short-term mortality in model 1 was 8.2%, 23.5% and 58.4% in the exploration sample, and 19.7%, 38.1% and 63.4% in the validation sample for patients under low, medium and high risk, respectively. Conclusions This risk score discriminates well between recurrent ovarian cancer patients under low, medium and high risk of short-term mortality. It may help to identify a risk group under high risk for short-term mortality that can be used for randomization in clinical trials and may support decision making for palliative chemotherapy. This newly developed NOGGO-AGO QoL prognosis score clearly discriminates recurrent ovarian cancer (rOC) patients under low, medium and high risk for short-term survival (<1 year). The risk score included platinum-free interval, performance status, age, global QoL and nausea/vomiting. NOGGO-AGO QoL score can be used for stratification or randomization in clinical trials and for identification of a group under high risk for short-term mortality. It may also help the decision making for chemotherapy and provide more precise information of further life expectation for rOC patients.
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Affiliation(s)
- R Armbrust
- Department of Gynecology with Center for Oncological Surgery, Virchow Campus Clinic, Charité Medical University, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - R Richter
- Department of Gynecology with Center for Oncological Surgery, Virchow Campus Clinic, Charité Medical University, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - H Woopen
- Department of Gynecology with Center for Oncological Surgery, Virchow Campus Clinic, Charité Medical University, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - F Hilpert
- Department of Gynecology, Krankenhaus Jerusalem Hamburg, Hamburg, Germany
| | - P Harter
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - J Sehouli
- Department of Gynecology with Center for Oncological Surgery, Virchow Campus Clinic, Charité Medical University, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
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Health-related quality of life of people living with HIV/AIDS: the role of social inequalities and disease-related factors. Health Qual Life Outcomes 2021; 19:63. [PMID: 33632270 PMCID: PMC7905594 DOI: 10.1186/s12955-021-01702-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 02/08/2021] [Indexed: 12/22/2022] Open
Abstract
Background Health-related quality of life (HRQoL) serves as a direct measure of individuals’ health, life expectancy and the impact that the utilization of health care has on quality of life. The purpose of this study is to assess the HRQoL of people living with HIV (PLHIV), and to ascertain its association with the social inequalities and clinical determinants among people living with HIV in Benishangul Gumuz Regional State, Ethiopia. Methods A cross-sectional study was conducted between December 2016 and February 2017; 390 people at two referral hospitals and three health centers participated in the study. The Patient-Reported Outcomes Measurement Information System Global Health Scale (PROMIS Global 10) was used to measure key HRQoL domains. Global Physical Health (GPH) and Global Mental Health (GPH) summary scores were employed. GPH and GMH summary scores below 50 (the standardized mean score) were determined as poor HRQoL. Bivariate and multivariate logistic regression analyses were used to identify factors associated with GPH and GMH summary scores. Results This study included 259 (66.4%) females and 131 (33.6%) males. The GPH summary scores ranged from 16.2 to 67.7 with a mean of 48.8 (SD = 8.9). Almost 44.6% of the study population has a GPH summary score of below 50; the GMH summary scores ranged from 28.4 to 67.6 with a mean of 50.8 (SD = 8.1). About 41.8% of the study population has a GMH summary score of below 50. Unemployment, household food insecurity and comorbidities with HIV were associated with both poor GPH and poor GMH summary scores. Age below 25 years and being a member of Christian fellowship were inversely associated with poor GPH. The least wealth index score and CD4 count below 350 cells/mL were also associated with poor GMH. Conclusion Overall, socioeconomic inequalities and HIV-related clinical factors play an important role in improving the HRQoL of PLHIV. Many of these determinants are alterable risk factors. Appropriate strategies can improve the holistic management of chronic HIV care and maximize PLHIVs’ HRQoL. Such strategies require the adoption of comprehensive interventions, including policies and programmes that would improve the health, wellbeing and livelihood of PLHIV.
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Working cancer survivors' physical and mental characteristics compared to cancer-free workers in Japan: a nationwide general population-based study. J Cancer Surviv 2021; 15:912-921. [PMID: 33433855 PMCID: PMC8519890 DOI: 10.1007/s11764-020-00984-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/08/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE This study compared working cancer survivors' self-rated health status (SRHS), physical functional capacity, depressive symptoms, and happiness to those of cancer-free workers. METHODS A nationwide general population-based cross-sectional study on a sample of Japanese was conducted. Prevalence of deteriorated SRHS, restricted physical functional capacity, depressive symptoms, and perceived happiness were compared between working cancer survivors and cancer-free workers with multivariable logistic regression analysis adjusted for age and sociodemographic and health-related backgrounds. RESULTS Of the 28,311 male and 26,068 female workers, 977 (3.5%) and 1267 (4.9%) were cancer survivors, respectively. Working cancer survivors reported deteriorated SRHS more frequently than cancer-free workers: 21.3% vs. 13.8%, multivariable-adjusted odds ratio (95% confidence interval), 1.64 (1.39-1.95) for men, 23.8% vs. 17.5%, 1.34 (1.16-1.54) for women. Restricted physical functional capacity was reported more frequently in working cancer survivors than cancer-free workers: 6.8% vs. 2.6%, 1.76 (1.34-2.32) for men, 4.9% vs. 2.0%, 2.06 (1.56-2.71) for women. No significant difference was found for depressive symptoms: 21.6% vs. 22.9% in men, 30.0% vs. 28.5% in women. Working cancer survivors felt happiness more frequently than cancer-free survivors in men (77.3% vs. 71.7%, 1.21 (1.01-1.45)) but not in women (76.1% vs. 74.9%). CONCLUSIONS Working cancer survivors had worse SRHS and more restricted physical functional capacity than cancer-free workers. In men, working cancer survivors felt happiness more frequently than cancer-free workers. IMPLICATIONS FOR CANCER SURVIVORS Continuous support to improve cancer survivors' SRHS and physical functional capacity would be necessary even while they are working.
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Ximenes CRC, Bergmann A, Lima JTDO, Lima WRP, de Britto MC, de Mello MJG, Thuler LCS. Prospective Analysis of Health-Related Quality of Life in Older Adults With Cancer. J Patient Exp 2020; 7:1519-1525. [PMID: 33457609 PMCID: PMC7786648 DOI: 10.1177/2374373519889246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate health-related quality of life (HRQoL) changes at 6 to 12 months after cancer diagnosis and to assess the impact of age in older adults with cancer. METHODS A cohort study using patients ≥60 years old diagnosed with cancer. Health-related quality of life scores were calculated according to the European Organisation for Research and Treatment of Cancer questionnaire. Student's t tests for paired samples and a binomial logistic regression were performed. RESULTS The study included 241 patients. At diagnosis, the affected HRQoL functions were physical and emotional functions, financial difficulties, pain, and insomnia. At follow-up, cognitive function (P < .001) and dyspnea (P = .004) worsened, while emotional function improved (P = .003). DISCUSSION At the 6 to 12 months of follow-up, older adult cancer patients showed worsening cognitive function and dyspnea and improved emotional function. These HRQoL changes were not associated with age.
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Affiliation(s)
| | - Anke Bergmann
- Research Center, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
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Ooki A, Morita S, Tsuji A, Iwamoto S, Hara H, Tanioka H, Satake H, Kataoka M, Kotaka M, Kagawa Y, Nakamura M, Shingai T, Ishikawa M, Miyake Y, Suto T, Hashiguchi Y, Yabuno T, Ando M, Sakamoto J, Yamaguchi K. Disagreement between patient- and physician-reported outcomes on symptomatic adverse events as poor prognosis in patients treated with first-line cetuximab plus chemotherapy for unresectable metastatic colorectal cancer: Results of Phase II QUACK trial. Cancer Med 2020; 9:9419-9430. [PMID: 33222406 PMCID: PMC7774728 DOI: 10.1002/cam4.3564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/27/2022] Open
Abstract
The status and prognostic value of the disagreement between physician and patient assessments of symptomatic adverse events (AEs) remain unclear for patients with metastatic colorectal cancer treated with first‐line cetuximab plus chemotherapy. Paired data on patient‐reported outcomes using the EORTC QLQ‐C30 and physician‐reported outcomes using the NCI‐CTCAE for eight symptomatic AEs (fatigue, pain, insomnia, dyspnea, constipation, appetite loss, nausea/vomiting, and diarrhea) were collected from a prospective trial assessing the relationships between treatment efficacy, AEs, and quality of life. The overall agreement rates between patient and physician reporting at 4 weeks ranged from 40.2% to 76.5% for 129 patients. The level of agreement based on Cohen's κ statistics was slight to poor for dyspnea, pain, fatigue, and insomnia, while it was moderate to fair for the remaining AEs. No clinicopathological characteristics of disagreement were found. The underreporting by physicians ranged from 12.5% (nausea/vomiting) to 56.7% (fatigue). The 2‐year overall survival (OS) rate was more favorable for patients with high agreement than for those with low agreement (71.2% vs. 46.5%, p = .016), and the agreement status was an independent factor of OS (HR, 2.31; 95% CI, 1.13–4.71; p = .022). For patients who were reported as asymptomatic by the physician, the presence of patient‐reported symptoms resulted in a trend toward poor prognostic outcomes for appetite loss, dyspnea, diarrhea, and constipation. These findings provide the clinical importance of the monitoring of patient‐reported symptoms that can be complementary to physician‐reported data to ensure more accurate clinical outcomes.
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Affiliation(s)
- Akira Ooki
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University, Kyoto, Japan
| | - Akihito Tsuji
- Department of Medical Oncology, Kagawa University, Kita, Japan
| | - Shigeyoshi Iwamoto
- Department of Surgery, Kansai Medical University Kouri Hospital, Neyagawa, Japan
| | - Hiroki Hara
- Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan
| | - Hiroaki Tanioka
- Department of Clinical Oncology, Kawasaki Medical School, Kurashiki, Japan
| | - Hironaga Satake
- Cancer Treatment Center, Kansai Medical University Hospital, Osaka, Japan
| | - Masato Kataoka
- Department of Surgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | | | | | - Masato Nakamura
- Comprehensive Cancer Center, Aizawa Hospital, Matsumoto, Japan
| | - Tatsushi Shingai
- Department of Surgery, Osaka Saiseikai Senri Hospital, Suita, Japan
| | - Masashi Ishikawa
- Department of Surgery, Shikoku Central Hospital, Shikokuchuo, Japan
| | - Yasuhiro Miyake
- Department of Surgery, Osaka Minato Central Hospital, Osaka, Japan
| | - Takeshi Suto
- Department of Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Yojiro Hashiguchi
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Taichi Yabuno
- Department of Surgery, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Masahiko Ando
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | | | - Kensei Yamaguchi
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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Wang W, Liu M, Ding B. Comparison of the short‐term efficacy and serum markers between lobaplatin/paclitaxel‐ And carboplatin/paclitaxel‐based adjuvant chemotherapy in patient with ovarian cancer. J Clin Pharm Ther 2020; 46:166-172. [PMID: 33098169 DOI: 10.1111/jcpt.13276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 08/24/2020] [Accepted: 09/07/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Wei Wang
- Department of Gynecology Shangluo Central Hospital Shanxi China
| | - Ming Liu
- Department of Anesthesiology Shangluo Central Hospital Shanxi China
| | - Boyong Ding
- Department of Oncology Shangluo Central Hospital Shanxi China
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Musoro JZ, Coens C, Singer S, Tribius S, Oosting SF, Groenvold M, Simon C, Machiels JP, Grégoire V, Velikova G, Cocks K, Sprangers MAG, King MT, Bottomley A. Minimally important differences for interpreting European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 scores in patients with head and neck cancer. Head Neck 2020; 42:3141-3152. [PMID: 32627261 DOI: 10.1002/hed.26363] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/08/2020] [Accepted: 06/16/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We aimed to estimate minimally important difference (MID) for interpreting group-level change over time for European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire core 30 (EORTC QLQ-C30) scores in head and neck cancer. METHODS Data were derived retrospectively from two published EORTC trials. Clinical anchors were selected using correlation strength and clinical plausibility of the given anchor/QLQ-C30 scale pair. MIDs for within-group and between-group change were estimated via the mean change method and linear regression, respectively. Distribution-based MIDs were also examined. MIDs for two of the scales, dyspnea and nausea/vomiting, are more uncertain considering their low correlations with the anchors. RESULTS Anchor-based MIDs could be determined for deterioration in 7 of the 14 QLQ-C30 scales assessed, and in 3 scales for improvement. MIDs varied by scale, direction of change, and anchor. Absolute MID values ranged from 5 to 15 points for within-group change and 4 to 12 for between-group change. Most MIDs were within 4 to 10 points. CONCLUSIONS Our findings, if confirmed, will aid interpreting changes in selected QLQ-C30 scale scores over time and inform sample size calculations in future clinical trials in head and neck cancer.
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Affiliation(s)
- Jammbe Z Musoro
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Corneel Coens
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Susanne Singer
- Division of Epidemiology and Health Services Research University Medical Centre, Institute of Medical Biostatistics, Epidemiology and Informatics, Mainz, Germany.,University Cancer Centre Mainz, Mainz, Germany
| | - Silke Tribius
- Department of Radiation Oncology, Asklepios Hospital St. Georg, Hamburg, Germany
| | - Sjoukje F Oosting
- University Medical Center Groningen, Department of Medical Oncology, University of Groningen, Groningen, The Netherlands
| | - Mogens Groenvold
- Department of Public Health, University of Copenhagen and Bispebjerg Hospital, Copenhagen, Denmark
| | - Christian Simon
- Department of Otolaryngology, Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Jean-Pascal Machiels
- Institut Roi Albert II, Service d'oncologie médicale, Cliniques universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale, U C Louvain, Brussels, Belgium
| | | | - Galina Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, St James's Hospital, Leeds, UK
| | - Kim Cocks
- Department of Health Sciences, University of York, York, UK.,Adelphi Values, Bollington, UK
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Cancer Center, Amsterdam, The Netherlands
| | - Madeleine T King
- Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew Bottomley
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
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Ghiasvand H, Higgs P, Noroozi M, Ghaedamini Harouni G, Hemmat M, Ahounbar E, Haroni J, Naghdi S, Nazeri Astaneh A, Armoon B. Social and demographical determinants of quality of life in people who live with HIV/AIDS infection: evidence from a meta-analysis. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2020; 65:57-72. [PMID: 30882251 DOI: 10.1080/19485565.2019.1587287] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim of this meta-analysis is to summarize the available evidence on the social and demographic determinants of health-related quality of life (QoL) for HIV-infected populations in order to provide a direction to policy makers, planners, and program developers on how best to use their resources to improve the QoL of HIV-infected people.PubMed, Science Direct, Web of Science, and Cochrane electronic databases were searched (up to February 2017) to identify the relevant studies. A meta-analysis was conducted with procreate polled odds ratios (ORs and β) and the confidence intervals of 95% on determining factors of QoL in social and demographic terms. Random effect model was applied to calculate pooled estimation, due to varied sampling methods of researches.In total, 5607 papers were identified from 4 databases and additional search in reference lists. Of these, 2107 articles were selected for full-text review. We included 19 studies that met the eligibility criteria. The pooled effect size shows a relative positive impact of social support for QoL among HIV/AIDS patients and its lower boundary is about 0.61 and the higher about 1.49. The pooled effect size has a considerable negative impact stigma on people who live with HIV/AIDS (PWLHs') QoL ranges from -0.34 to -0.32. Low socioeconomic status (poverty situation) was found to have a degenerative impact with PWLHs' QoL. Our finding indicates an association between younger 35 and QoL is negative with a relatively wide range, the minimum level of education has a weak association with PWLHs' QoL (ES: 0.14-0.2).There are several sociodemographic determinants of QoL among PWLHs and in this study, we found that stigma, low level of socioeconomic status, and being younger than 35 years old have a negative association with QoL, while the social support showed a positive association and a minimum level of education did not show a rigorous negative or positive association.
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Affiliation(s)
- Hesam Ghiasvand
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Peter Higgs
- Department of Public Health, La Trobe University, Melbourne, Australia
| | - Mehdi Noroozi
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Morteza Hemmat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
- School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran
| | - Elahe Ahounbar
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Javad Haroni
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Seyran Naghdi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Health Managers Development Institute, Ministry of Health and Medical Education, Tehran, Iran
| | - Ali Nazeri Astaneh
- Department of Psychiatry, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
- School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran
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12
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Patient-reported outcomes as predictors of survival in patients with bowel cancer: a systematic review. Qual Life Res 2019; 28:2871-2887. [DOI: 10.1007/s11136-019-02255-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2019] [Indexed: 12/30/2022]
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13
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Kargo AS, Coulter A, Jensen PT, Steffensen KD. Proactive use of PROMs in ovarian cancer survivors: a systematic review. J Ovarian Res 2019; 12:63. [PMID: 31307510 PMCID: PMC6631969 DOI: 10.1186/s13048-019-0538-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 07/04/2019] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION The use of patient reported outcome measures (PROMs) has increased during the past decade, and the focus on how to use them has resulted in a more proactive application. Studies have shown that proactive use of PROMs during treatment improves patient-clinician communication, leads to better symptom management and may prolong survival among advanced cancer patients. Ovarian cancer is a serious disease in which the majority of patients experience recurrence during the follow-up period and suffer from a number of severe symptoms from underlying disease. This systematic review was conducted to assess the evidence on the proactive use of PROMs as a dialogue tool during follow-up of ovarian cancer patients. RESULTS The following databases were searched for relevant literature; PubMed, EMBASE, CINAHL, and the Cochrane Library. The search was conducted in April 2019 without any filters or limits. A total of 643 publications were identified, and 48 studies were found to be potentially eligible. Of the 48 papers, none met the final inclusion criterion of using PROMs proactively as a dialogue tool for ovarian cancer patients during follow-up. CONCLUSION Studies have shown that PROMs can identify otherwise undetected symptoms. Using PROMs proactively during the consultation has been shown to improve symptom management for patients with some other types of cancer. However, we found no studies that had examined the proactive use of PROMs during follow-up of ovarian cancer patients. Future studies should evaluate if the proactive use of PROMs could facilitate a more individualized and more effective follow-up program tailored to the ovarian cancer patient's needs and preferences.
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Affiliation(s)
- Anette Stolberg Kargo
- Department of Clinical Oncology, Sygehus Lillebalt, Vejle Sygehus, Beriderbakken 4, DK-7100 Vejle, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense, Denmark
- Center for Shared Decision Making, Sygehus Lillebalt, Vejle Sygehus, Beriderbakken 4, 7100 Vejle, Denmark
| | - Angela Coulter
- Institute of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense, Denmark
- Center for Shared Decision Making, Sygehus Lillebalt, Vejle Sygehus, Beriderbakken 4, 7100 Vejle, Denmark
| | - Pernille Tine Jensen
- Department of Gynaecology and Obstetrics, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense, Denmark
| | - Karina Dahl Steffensen
- Department of Clinical Oncology, Sygehus Lillebalt, Vejle Sygehus, Beriderbakken 4, DK-7100 Vejle, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense, Denmark
- Center for Shared Decision Making, Sygehus Lillebalt, Vejle Sygehus, Beriderbakken 4, 7100 Vejle, Denmark
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14
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Morton RL, Lioufas N, Dansie K, Palmer SC, Jose MD, Raj R, Salmon A, Sypek M, Tong A, Ludlow M, Boudville N, McDonald S. Use of patient-reported outcome measures and patient-reported experience measures in renal units in Australia and New Zealand: A cross-sectional survey study. Nephrology (Carlton) 2019; 25:14-21. [PMID: 30838732 DOI: 10.1111/nep.13577] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2019] [Indexed: 11/29/2022]
Abstract
AIM Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are increasingly used in research to quantify how patients feel and function, and their experiences of care, however, knowledge of their utilization in routine nephrology is limited. METHODS The Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) PROMs working group conducted a prospective cross-sectional survey of PROMs/PREMs use among renal 'parent hospitals'. One survey per hospital was completed (August-November 2017). Descriptive statistics reported type and frequency of measures used and purpose of use. RESULTS Survey response rate was 100%. Fifty-five of 79 hospitals (70%) used at least one PROMs or PREMs for specific patient groups. PROMs were more likely to be collected from patients receiving comprehensive conservative care (45% of hospitals) than dialysis patients (32%, 31% and 28% of hospitals for home haemodialysis, peritoneal dialysis and facility dialysis, respectively). Few renal transplanting hospitals (3%) collected PROMs. The Integrated Palliative Outcome Scale-Renal (IPOS-Renal) (40% of units), and the Euro-Qol (EQ-5D-5 L) (25%), were most frequently used. The main reason for collecting PROMs was to inform clinical care (58%), and for PREMs was to fulfil private dialysis/hospital provider requirements (25%). The most commonly reported reason for not using PROMs in 24 hospitals was insufficient staff resources (79%). Sixty-two hospitals (78%) expressed interest in participating in a registry-based PROMs trial. CONCLUSION Many renal hospitals in Australia and New Zealand collect PROMs and/or PREMs as part of clinical care with use varying by treatment modality. Resources are a key barrier to PROMs use.
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Affiliation(s)
- Rachael L Morton
- NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicole Lioufas
- Department of Nephrology, Western Health, Sunshine Hospital, Melbourne, Victoria, Australia.,Western Clinical School, School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kathryn Dansie
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), Adelaide, South Australia, Australia.,University of Adelaide, Adelaide, South Australia, Australia
| | | | - Matthew D Jose
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), Adelaide, South Australia, Australia.,School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Rajesh Raj
- Launceston General Hospital, Launceston, Tasmania, Australia
| | - Andrew Salmon
- Renal Service, Waitemata District Health Board, Auckland, New Zealand
| | - Matthew Sypek
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), Adelaide, South Australia, Australia.,Department of Nephrology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Allison Tong
- Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Neil Boudville
- Medical School, University of Western Australia, Perth, Australia
| | - Stephen McDonald
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), Adelaide, South Australia, Australia.,University of Adelaide, Adelaide, South Australia, Australia.,Central and Northern Renal Transplant Service, Royal Adelaide Hospital, Adelaide, Australia
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15
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Gartland N, Long H, Skevington SM. Undiagnosed cancer symptoms in the community: does poor quality of life influence the decision to seek help? Qual Life Res 2019; 28:1327-1335. [PMID: 30671707 PMCID: PMC6470111 DOI: 10.1007/s11136-018-2088-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Although a cancer diagnosis is linked with decrements to quality of life (QoL), it is unknown exactly when QoL starts to deteriorate, and whether this occurs during the pre-diagnostic pathway. This study aimed to examine QoL during this phase, and in addition investigate whether QoL levels influence decisions about seeking professional help. This is important, because early diagnosis is linked to lower cancer mortality rates. METHODS Working alongside a Cancer Research UK Roadshow in socially deprived communities, the recent QoL of adult visitors was assessed, before attending primary care. Using a cross-sectional design, we compared QoL in those presenting a potential cancer symptom/sign, with others seeking lifestyle advice to reduce cancer risk. Self-reported QoL (WHOQOL-BREF), and intention to seek help, were measured. RESULTS Of 107 recruited, 50% were men. The potential cancer symptom group reported significantly poorer general QoL and psychological QoL, than lifestyle controls. Prior poorer physical QoL predicted stronger intentions to consult a general practitioner (GP) in the next 2 weeks, when controlling for symptom presence. CONCLUSIONS QoL is poorer for those with potential cancer symptoms, before they first seek advice from primary care. Poorer physical QoL is associated with stronger intentions to make a GP appointment. An implication for longer term health is that if public awareness about the impact of symptoms on QoL was raised, this could provide an impetus to seek help.
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Affiliation(s)
- Nicola Gartland
- Manchester Centre for Health Psychology and International Hub for Quality of Life Research (IHQoLR), Faculty of Biology, Medicine and Health, University of Manchester, Manchester, MP13 9PL, UK.
| | - Hannah Long
- Manchester Centre for Health Psychology and International Hub for Quality of Life Research (IHQoLR), Faculty of Biology, Medicine and Health, University of Manchester, Manchester, MP13 9PL, UK
| | - Suzanne M Skevington
- Manchester Centre for Health Psychology and International Hub for Quality of Life Research (IHQoLR), Faculty of Biology, Medicine and Health, University of Manchester, Manchester, MP13 9PL, UK
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16
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Quinten C, Kenis C, Decoster L, Debruyne PR, De Groof I, Focan C, Cornelis F, Verschaeve V, Bachmann C, Bron D, Luce S, Debugne G, Van den Bulck H, Goeminne JC, Baitar A, Geboers K, Petit B, Langenaeken C, Van Rijswijk R, Specenier P, Jerusalem G, Praet JP, Vandenborre K, Lycke M, Flamaing J, Milisen K, Lobelle JP, Wildiers H. Determining clinically important differences in health-related quality of life in older patients with cancer undergoing chemotherapy or surgery. Qual Life Res 2018; 28:663-676. [PMID: 30511255 DOI: 10.1007/s11136-018-2062-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Using the EORTC Global Health Status (GHS) scale, we aimed to determine minimal clinically important differences (MCID) in health-related quality of life (HRQOL) changes for older cancer patients with a geriatric risk profile, as defined by the geriatric 8 (G8) health screening tool, undergoing treatment. Simultaneously, we assessed baseline patient characteristics prognostic for HRQOL changes. METHODS Our analysis included 1424 (G8 ≤ 14) older patients with cancer scheduled to receive chemotherapy (n = 683) or surgery (n = 741). Anchor-based methods, linking the GHS score to clinical indicators, were used to determine MCID between baseline and follow-up at 3 months. A threshold of 0.2 standard deviation (SD) was used to exclude MCID estimates too small for interpretation. Logistic regressions analysed baseline patient characteristics prognostic for HRQOL changes. RESULTS The 15-item Geriatric Depression Scale (GDS15), Visual Analogue Scale (VAS) for Fatigue and ECOG Performance Status (PS) were selected as clinical anchors. In the surgery group, MCID estimates for improvement and deterioration were ECOG PS (5*, 11*), GDS15 (5*, 2) and VAS Fatigue (3, 9*). In the chemotherapy group, MCID estimates for improvement and deterioration were ECOG PS (8*, 7*), GDS15 (5, 4) and VAS Fatigue (5, 5*). Estimates with * were > 0.2 SD threshold. Patients experiencing pain or malnutrition (surgery group) or fatigue (chemotherapy group) at baseline showed a significantly stable or improved HRQOL (p < 0.05) after their treatment. CONCLUSION The reported MCID for improvement and deterioration depended on the anchor used and treatment received. The estimates can be used to evaluate significant changes in HRQOL and to determine sample sizes in clinical trials.
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Affiliation(s)
- C Quinten
- Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, Leuven, Belgium. .,Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - C Kenis
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.,Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - L Decoster
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - P R Debruyne
- Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium & Positive Ageing Research Institute (PARI), Anglia Ruskin University, Chelmsford, UK
| | - I De Groof
- Department of Geriatric Medicine, Iridium Cancer Network Antwerp, St. Augustinus, Wilrijk, Belgium
| | - C Focan
- Department of Oncology, Clinique Saint-Joseph, CHC-Liège Hospital Group, Liege, Belgium
| | - F Cornelis
- Department of Medical Oncology, Cliniques Universitaires Saint-Luc, UCL, Brussels, Belgium
| | - V Verschaeve
- Department of Medical Oncology, GHDC Grand Hôpital de Charleroi, Charleroi, Belgium
| | - C Bachmann
- Department of Geriatric Medicine, AZ Sint-Lucas, Ghent, Belgium
| | - D Bron
- Department of Hematology, ULB Institut Jules Bordet, Brussels, Belgium
| | - S Luce
- Department Medical Oncology, University Hospital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - G Debugne
- Department of Geriatric Medicine, Centre Hospitalier de Mouscron, Mouscron, Belgium
| | - H Van den Bulck
- Department of Medical Oncology, Imelda Hospital, Bonheiden, Belgium
| | - J C Goeminne
- Department of Medical Oncology, CHU-UCL-Namur, site Sainte-Elisabeth, Namur, Belgium
| | - A Baitar
- Department of Medical Oncology, ZNA Middelheim, Antwerp, Belgium
| | - K Geboers
- Centre for Oncology and Hematology, AZ Turnhout, Turnhout, Belgium
| | - B Petit
- Department of Medical Oncology, Centre Hospitalier Jolimon, La Louvière, Belgium
| | - C Langenaeken
- Department of Medical Oncology, Iridium Cancer Network Antwerp, AZ Klina, Brasschaat, Belgium
| | - R Van Rijswijk
- Department of Medical Oncology, ZNA Stuivenberg, Antwerp, Belgium
| | - P Specenier
- Department of Medical Oncology, University Hospital Antwerp, Antwerp, Belgium
| | - G Jerusalem
- Department of Medical Oncology, Centre Hospitalier Universitaire Sart Tilman and Liege University, Liege, Belgium
| | - J P Praet
- Department of Geriatric Medicine, CHU St-Pierre, Free Universities Brussels, Brussels, Belgium
| | - K Vandenborre
- Department of Medical Oncology, AZ Vesalius, Tongeren, Belgium
| | - M Lycke
- Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium & Positive Ageing Research Institute (PARI), Anglia Ruskin University, Chelmsford, UK
| | - J Flamaing
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.,Department of Chronic Diseases, Metabolism and Ageing - CHROMETA, KU Leuven, Leuven, Belgium
| | - K Milisen
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | | | - H Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, KU Leuven, Leuven, Belgium
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17
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Deliu N, Cottone F, Collins GS, Anota A, Efficace F. Evaluating methodological quality of Prognostic models Including Patient-reported HeAlth outcomes iN oncologY (EPIPHANY): a systematic review protocol. BMJ Open 2018; 8:e025054. [PMID: 30361409 PMCID: PMC6224737 DOI: 10.1136/bmjopen-2018-025054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/31/2018] [Accepted: 09/20/2018] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION While there is mounting evidence of the independent prognostic value of patient-reported outcomes (PROs) for overall survival (OS) in patients with cancer, it is known that the conduct of these studies may hold a number of methodological challenges. The aim of this systematic review is to evaluate the quality of published studies in this research area, in order to identify methodological and statistical issues deserving special attention and to also possibly provide evidence-based recommendations. METHODS AND ANALYSIS An electronic search strategy will be performed in PubMed to identify studies developing or validating a prognostic model which includes PROs as predictors. Two reviewers will independently be involved in data collection using a predefined and standardised data extraction form including information related to study characteristics, PROs measures used and multivariable prognostic models. Studies selection will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with data extraction form using fields from the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS) checklist for multivariable models. Methodological quality assessment will also be performed and will be based on prespecified domains of the CHARMS checklist. As a substantial heterogeneity of included studies is expected, a narrative evidence synthesis will also be provided. ETHICS AND DISSEMINATION Given that this systematic review will use only published data, ethical permissions will not be required. Findings from this review will be published in peer-reviewed scientific journals and presented at major international conferences. We anticipate that this review will contribute to identify key areas of improvement for conducting and reporting prognostic factor analyses with PROs in oncology and will lay the groundwork for developing future evidence-based recommendations in this area of research. PROSPERO REGISTRATION NUMBER CRD42018099160.
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Affiliation(s)
- Nina Deliu
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - Francesco Cottone
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - Gary S Collins
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Amélie Anota
- Methodology and Quality of Life in Oncology Unit (INSERM UMR 1098), University Hospital of Besançon, Besançon, France
| | - Fabio Efficace
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
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18
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Ediebah DE, Quinten C, Coens C, Ringash J, Dancey J, Zikos E, Gotay C, Brundage M, Tu D, Flechtner H, Greimel E, Reeve BB, Taphoorn M, Reijneveld J, Dirven L, Bottomley A. Quality of life as a prognostic indicator of survival: A pooled analysis of individual patient data from canadian cancer trials group clinical trials. Cancer 2018; 124:3409-3416. [DOI: 10.1002/cncr.31556] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 03/08/2018] [Accepted: 03/28/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Divine E. Ediebah
- Quality of Life Department, European Organization for Research and Treatment of CancerBrussels Belgium
- Department of Neurology and Brain Tumor Center AmsterdamVU University Medical CenterAmsterdam the Netherlands
| | - Chantal Quinten
- Epidemiological Methods Section, Surveillance and Response Support Unit, European Center for Disease Prevention and ControlStockholm Sweden
| | - Corneel Coens
- Quality of Life Department, European Organization for Research and Treatment of CancerBrussels Belgium
| | - Jolie Ringash
- Princess Margaret Cancer CentreUniversity of TorontoToronto Ontario Canada
- Canadian Cancer Trials GroupKingston Ontario Canada
| | - Janet Dancey
- Canadian Cancer Trials GroupKingston Ontario Canada
- Queen's UniversityKingston Ontario Canada
| | - Efstathios Zikos
- Quality of Life Department, European Organization for Research and Treatment of CancerBrussels Belgium
| | - Carolyn Gotay
- Canadian Cancer Trials GroupKingston Ontario Canada
- School of Population and Public HealthUniversity of British ColumbiaVancouver British Columbia Canada
| | - Michael Brundage
- Canadian Cancer Trials GroupKingston Ontario Canada
- Queen's UniversityKingston Ontario Canada
- Cancer Centre of Southeastern Ontario, Kingston General HospitalKingston Ontario Canada
| | - Dongsheng Tu
- Canadian Cancer Trials GroupKingston Ontario Canada
| | | | - Eva Greimel
- Obstetrics and GynecologyMedical University GrazGraz Austria
| | - Bryce B. Reeve
- Center for Health ManagementDuke University School of MedicineDurham North Carolina
- Department of Population Health SciencesDuke University School of MedicineDurham North Carolina
- Department of PediatricsDuke University School of MedicineDurham North Carolina
| | - Martin Taphoorn
- Department of NeurologyLeiden University Medical CenterLeiden the Netherlands
- Neurology, Haaglanden Medical Centerthe Hague the Netherlands
| | - Jaap Reijneveld
- Department of NeurologyLeiden University Medical CenterLeiden the Netherlands
- Department of NeurologyAcademic Medical CenterAmsterdam the Netherlands
| | - Linda Dirven
- Department of NeurologyLeiden University Medical CenterLeiden the Netherlands
- Neurology, Haaglanden Medical Centerthe Hague the Netherlands
| | - Andrew Bottomley
- Quality of Life Department, European Organization for Research and Treatment of CancerBrussels Belgium
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19
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Roncolato FT, Gibbs E, Lee CK, Asher R, Davies LC, Gebski VJ, Friedlander M, Hilpert F, Wenzel L, Stockler MR, King M, Pujade-Lauraine E. Quality of life predicts overall survival in women with platinum-resistant ovarian cancer: an AURELIA substudy. Ann Oncol 2018; 28:1849-1855. [PMID: 28595285 DOI: 10.1093/annonc/mdx229] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background Women with platinum-resistant ovarian cancer are a heterogeneous group whose median overall survival is 12 months. We hypothesized that their quality of life (QoL) scores would be prognostic. Patients and methods Data from AURELIA (n = 326), a randomized trial of chemotherapy with or without bevacizumab, were used to identify baseline QoL domains [EORTC (European Organisation for Research and Treatment of Cancer) QLQ-C30 and OV28] that were significantly associated with overall survival in multivariable Cox regression analyses. Patients were classified as having good, medium, or poor risk. Cutpoints were validated in an independent dataset, CARTAXHY (n = 136). Multivariable analyses of significant QoL domains on survival were adjusted for clinicopathological prognostic factors. The additional QoL information was assessed using C statistic. Results In AURELIA, all domains, except cognitive function, predicted overall survival in univariable analyses. Physical function (P < 0.001) and abdominal/gastrointestinal symptom (P < 0.001) scores remained significant in multivariable models. In high (score <67), medium (67-93), and low (>93) risk categories for physical function, median overall survival was 11.0, 14.7, and 19.3 months, respectively (P < 0.001). In CARTAXHY, median overall survival was 7.9, 16.2, and 23.9 months (P < 0.001), respectively. For high- (>44), medium- (13-44), and low- (<13) risk categories for abdominal/gastrointestinal symptoms, median overall survival was 11.9, 14.3, and 19.7 months in AURELIA (P < 0.001) and 10.5, 19.6, and 24.1 months in CARTAXHY (P = 0.02). Physical function (P = 0.02) and abdominal/gastrointestinal symptoms (P = 0.03) remained independent prognostic factors after adjustment for clinicopathological factors. The C statistic of the full model was 0.71. For QoL factors alone, patient factors alone and disease factors alone, the C statistics were 0.61, 0.61, and 0.67 respectively. Conclusions Physical function and abdominal/gastrointestinal symptom scores improved predictions of overall survival over clinicopathological factors alone in platinum-resistant ovarian cancer. This additional prognostic information could improve trial stratification, patient-doctor communication about prognosis, and clinical decision-making. Clinical trial registration NCT00976911.
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Affiliation(s)
- F T Roncolato
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
- Macarthur Cancer Therapy Centre, Campbelltown
| | - E Gibbs
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - C K Lee
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
- Medical Oncology, St George Hospital, Sydney
| | - R Asher
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - L C Davies
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - V J Gebski
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - M Friedlander
- Medical Oncology, Prince of Wales Hospital, Sydney, Australia
| | - F Hilpert
- Gynecology & Obstetrics, University of Schleswig-Holstein, Kiel, Germany
| | - L Wenzel
- Public Health, University of California, Irvine, USA
| | - M R Stockler
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney
| | - M King
- Psycho-oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia
| | - E Pujade-Lauraine
- Hematology & Medical Oncology, Hopital Hôtel-Dieu de Paris, Paris, France
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20
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General health-related quality of life scores from head and neck squamous cell carcinoma patients obtained throughout the first year following diagnosis predicted up to 10-year overall survival. Eur Arch Otorhinolaryngol 2017; 275:207-217. [PMID: 29159750 DOI: 10.1007/s00405-017-4800-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 11/02/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To evaluate the 5- and 10-year survival prediction of health-related quality of life (HRQoL) scores obtained at diagnosis and at 6, 9 and 12 months after diagnosis in a cohort of curable head and neck squamous cell carcinoma (HNSCC) patients. MATERIALS AND METHODS HNSCC patients (n = 109) reported their HRQoL measured by the EORTC Quality of Life Questionnaire (QLQ) general (C30) questionnaire. At diagnosis, the included patients were below 78 years of age and at diagnosis planned treated with curative intent. Clinical variables and self-reported smoking, alcohol consumption and socio-demographic information were registered. From diagnostic blocks, we found 22 patients to be human papillomavirus (HPV) positive. New HRQoL scores were not obtained if the patient treatment changed from curative to palliative throughout the HRQoL data acquisition. Survival was determined from the National Population Register of Norway. RESULTS Decreased survival with low HRQoL scores from EORTC QLQ scores was demonstrated with HRQoL scores obtained from different time points of the four time points studied. These survival predictions were mostly independent of HPV status, gender, age, TNM stage, tumor site, alcohol consumption, present smoking status and whether comorbidities were present at diagnosis; as well as to some extent with an adjustment of the same HRQoL score/index obtained at diagnosis. The specific indices "physical function", "general pain" and "sleep disturbance" were in particular predictive of survival. CONCLUSION HRQoL scores obtained throughout the first year after diagnosis contained prognostic power to overall survival when measured both at 5 and 10 years of observation.
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21
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Abstract
Introduction A main goals of palliative care is to improve the health-related quality of life (QOL) of patients with advanced illnesses. The objective of this narrative review is to provide an updated synopsis on the use of QOL questionnaires in the palliative care setting. Areas covers Focusing on the palliative cares setting, we will define QOL, discuss how QOL instruments can be used clinically and in research, review approaches to validate these questionnaires, and how they can be used in utility analyses. Expert opinion/commentary Several QOL questionnaires, such as EORTC-QLQ-C30, McGill QOL questionnaire and EQ-5D have been validated in the palliative care setting. However, significant gaps impede their application, including lack of determination of their responsiveness to change and minimal clinically important differences, the need to conduct more psychometric validation on QOL questionnaires among patients at various stages of disease trajectory, and the paucity of studies examining utility and cost-effectiveness. Further research is needed to address these knowledge gaps so QOL questionnaires can be better used to inform clinical practice and research.
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Affiliation(s)
| | - David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD D Anderson Cancer Center, Houston, TX, USA, 77030
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Leensen MCJ, Groeneveld IF, van der Heide I, Rejda T, van Veldhoven PLJ, van Berkel S, Snoek A, van Harten W, Frings-Dresen MHW, de Boer AGEM. Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise in cancer patients: a prospective study in the Netherlands. BMJ Open 2017; 7:e014746. [PMID: 28619770 PMCID: PMC5623345 DOI: 10.1136/bmjopen-2016-014746] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To support return to work (RTW) among cancer patients, a multidisciplinary rehabilitation programme was developed which combined occupational counselling with a supervised physical exercise programme during chemotherapy. The aim was to investigate RTW rates of cancer patients and to evaluate changes in work-related quality of life and physical outcomes. DESIGN Longitudinal prospective intervention study using a one-group design. SETTING Two hospitals in the Netherlands. PARTICIPANTS Of the eligible patients, 56% participated; 93 patients with a primary diagnosis of cancer receiving chemotherapy and on sick leave were included. Patients completed questionnaires on RTW, the importance of work, work ability (WAI), RTW self-efficacy, fatigue (MFI), and quality of life (EORTC QLQ C-30) at baseline and 6, 12 and 18 months follow-up. Before and after the exercise programme 1-repetition maximum (1RM) muscle strength and cardiorespiratory fitness (VO2 peak) were assessed. RESULTS Six months after the start of a multidisciplinary rehabilitation programme that combined occupational counselling with a supervised physical exercise programme, 59% of the cancer patients returned to work, 86% at 12 months and 83% at 18 months. In addition, significant improvements (p<0.05) in the importance of work, work ability, RTW self-efficacy, and quality of life were observed, whereas fatigue levels were significantly reduced. After completing the exercise programme, 1RM muscle strength was significantly increased but there was no improvement in VO2 peak level. CONCLUSIONS RTW rates of cancer patients were high after completion of the multidisciplinary rehabilitation programme. A multidisciplinary rehabilitation programme which combines occupational counselling with a supervised physical exercise programme is likely to result in RTW, reduced fatigue and increased importance of work, work ability, and quality of life.
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Affiliation(s)
- Monique C J Leensen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | | | - Iris van der Heide
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Tomas Rejda
- Leiden University Medical Center, Leiden, The Netherlands
| | | | - Sietske van Berkel
- Department of Sports Medicine, Isala Medical Center, Zwolle, The Netherlands
| | - Aernout Snoek
- Department of Sports Medicine, Isala Medical Center, Zwolle, The Netherlands
| | - Wim van Harten
- University Twente, Enschede, The Netherlands
- Rijnstate Hospital, Arnhem, The Netherlands
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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Abstract
Chronotherapeutics aim at treating illnesses according to the endogenous biologic rhythms, which moderate xenobiotic metabolism and cellular drug response. The molecular clocks present in individual cells involve approximately fifteen clock genes interconnected in regulatory feedback loops. They are coordinated by the suprachiasmatic nuclei, a hypothalamic pacemaker, which also adjusts the circadian rhythms to environmental cycles. As a result, many mechanisms of diseases and drug effects are controlled by the circadian timing system. Thus, the tolerability of nearly 500 medications varies by up to fivefold according to circadian scheduling, both in experimental models and/or patients. Moreover, treatment itself disrupted, maintained, or improved the circadian timing system as a function of drug timing. Improved patient outcomes on circadian-based treatments (chronotherapy) have been demonstrated in randomized clinical trials, especially for cancer and inflammatory diseases. However, recent technological advances have highlighted large interpatient differences in circadian functions resulting in significant variability in chronotherapy response. Such findings advocate for the advancement of personalized chronotherapeutics through interdisciplinary systems approaches. Thus, the combination of mathematical, statistical, technological, experimental, and clinical expertise is now shaping the development of dedicated devices and diagnostic and delivery algorithms enabling treatment individualization. In particular, multiscale systems chronopharmacology approaches currently combine mathematical modeling based on cellular and whole-body physiology to preclinical and clinical investigations toward the design of patient-tailored chronotherapies. We review recent systems research works aiming to the individualization of disease treatment, with emphasis on both cancer management and circadian timing system–resetting strategies for improving chronic disease control and patient outcomes.
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Affiliation(s)
- Annabelle Ballesta
- Warwick Medical School (A.B., P.F.I., R.D., F.A.L.) and Warwick Mathematics Institute (A.B., D.A.R.), University of Warwick, Coventry, United Kingdom; Warwick Systems Biology and Infectious Disease Epidemiological Research Centre, Senate House, Coventry, United Kingdom (A.B., P.F.I., R.D., D.A.R., F.A.L.); INSERM-Warwick European Associated Laboratory "Personalising Cancer Chronotherapy through Systems Medicine" (C2SysMed), Unité mixte de Recherche Scientifique 935, Centre National de Recherche Scientifique Campus, Villejuif, France (A.B., P.F.I., R.D., D.A.R., F.A.L.); and Queen Elisabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Cancer Unit, Edgbaston Birmingham, United Kingdom (P.F.I., F.A.L.)
| | - Pasquale F Innominato
- Warwick Medical School (A.B., P.F.I., R.D., F.A.L.) and Warwick Mathematics Institute (A.B., D.A.R.), University of Warwick, Coventry, United Kingdom; Warwick Systems Biology and Infectious Disease Epidemiological Research Centre, Senate House, Coventry, United Kingdom (A.B., P.F.I., R.D., D.A.R., F.A.L.); INSERM-Warwick European Associated Laboratory "Personalising Cancer Chronotherapy through Systems Medicine" (C2SysMed), Unité mixte de Recherche Scientifique 935, Centre National de Recherche Scientifique Campus, Villejuif, France (A.B., P.F.I., R.D., D.A.R., F.A.L.); and Queen Elisabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Cancer Unit, Edgbaston Birmingham, United Kingdom (P.F.I., F.A.L.)
| | - Robert Dallmann
- Warwick Medical School (A.B., P.F.I., R.D., F.A.L.) and Warwick Mathematics Institute (A.B., D.A.R.), University of Warwick, Coventry, United Kingdom; Warwick Systems Biology and Infectious Disease Epidemiological Research Centre, Senate House, Coventry, United Kingdom (A.B., P.F.I., R.D., D.A.R., F.A.L.); INSERM-Warwick European Associated Laboratory "Personalising Cancer Chronotherapy through Systems Medicine" (C2SysMed), Unité mixte de Recherche Scientifique 935, Centre National de Recherche Scientifique Campus, Villejuif, France (A.B., P.F.I., R.D., D.A.R., F.A.L.); and Queen Elisabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Cancer Unit, Edgbaston Birmingham, United Kingdom (P.F.I., F.A.L.)
| | - David A Rand
- Warwick Medical School (A.B., P.F.I., R.D., F.A.L.) and Warwick Mathematics Institute (A.B., D.A.R.), University of Warwick, Coventry, United Kingdom; Warwick Systems Biology and Infectious Disease Epidemiological Research Centre, Senate House, Coventry, United Kingdom (A.B., P.F.I., R.D., D.A.R., F.A.L.); INSERM-Warwick European Associated Laboratory "Personalising Cancer Chronotherapy through Systems Medicine" (C2SysMed), Unité mixte de Recherche Scientifique 935, Centre National de Recherche Scientifique Campus, Villejuif, France (A.B., P.F.I., R.D., D.A.R., F.A.L.); and Queen Elisabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Cancer Unit, Edgbaston Birmingham, United Kingdom (P.F.I., F.A.L.)
| | - Francis A Lévi
- Warwick Medical School (A.B., P.F.I., R.D., F.A.L.) and Warwick Mathematics Institute (A.B., D.A.R.), University of Warwick, Coventry, United Kingdom; Warwick Systems Biology and Infectious Disease Epidemiological Research Centre, Senate House, Coventry, United Kingdom (A.B., P.F.I., R.D., D.A.R., F.A.L.); INSERM-Warwick European Associated Laboratory "Personalising Cancer Chronotherapy through Systems Medicine" (C2SysMed), Unité mixte de Recherche Scientifique 935, Centre National de Recherche Scientifique Campus, Villejuif, France (A.B., P.F.I., R.D., D.A.R., F.A.L.); and Queen Elisabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Cancer Unit, Edgbaston Birmingham, United Kingdom (P.F.I., F.A.L.)
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van Coevorden-van Loon EMP, Coomans MB, Heijenbrok-Kal MH, Ribbers GM, van den Bent MJ. Fatigue in patients with low grade glioma: systematic evaluation of assessment and prevalence. J Neurooncol 2017; 133:237-246. [PMID: 28540668 PMCID: PMC5529493 DOI: 10.1007/s11060-017-2454-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 04/27/2017] [Indexed: 01/03/2023]
Abstract
Fatigue is the most prevalent and disabling symptom in cancer patients. Yet, scientific literature on this topic is scarce and reports disparate results. This study systematically reviews how fatigue is assessed in patients with low-grade glioma and evaluates its prevalence in LGG patients. A systematic literature search was performed in PubMed, Embase and PsychINFO for articles reporting on fatigue in patients with LGG. Two reviewers independently extracted data from selected articles. Inclusion criteria were: (1) patients with suspected or confirmed LGG; (2) fatigue was assessed as primary or secondary outcome measure; (3) age≥ 18 years; (4) full-length article written in English or Dutch. In total, 19 articles were selected, including 971 patients. Seven self-assessment instruments were identified. Prevalence rates ranged from 39 to 77%. Fatigue was found to be a common side effect of treatment. The prevalence rates ranged from 20 to 76% when fatigue was reported as a mild or moderate side effect and fatigue was prevalent in 4% when reported as a severe side effect. Fatigue is a common problem in LGG patients that warrants more therapeutic and scientific attention. Gaining deeper insight in the underlying mechanisms of fatigue is essential in targeting therapy to individual patients.
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Affiliation(s)
- Ellen M P van Coevorden-van Loon
- Rotterdam Neurorehabilitation Research (RoNeRes), Rijndam Rehabilitation Center, PO Box 23181, 3001 KD, Rotterdam, The Netherlands. .,Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands.
| | - Marijke B Coomans
- Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Majanka H Heijenbrok-Kal
- Rotterdam Neurorehabilitation Research (RoNeRes), Rijndam Rehabilitation Center, PO Box 23181, 3001 KD, Rotterdam, The Netherlands.,Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Gerard M Ribbers
- Rotterdam Neurorehabilitation Research (RoNeRes), Rijndam Rehabilitation Center, PO Box 23181, 3001 KD, Rotterdam, The Netherlands.,Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Martin J van den Bent
- Department of Neurology/Neuro-oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
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Wang XJ, Goh DYT, Dorajoo SR, Chan A. The prognostic performance of adding patient-reported outcomes to the MASCC risk index to identify low-risk febrile neutropenia patients with solid tumors and lymphomas. Support Care Cancer 2017; 25:2815-2822. [PMID: 28401314 DOI: 10.1007/s00520-017-3696-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 03/31/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aims to develop and validate a prognostic model (PROMASCC) by incorporating the Functional Assessment of Cancer Therapy-Neutropenia (FACT-N) elements, with the Multinational Association of Supportive Care in Cancer (MASCC) risk index, for identifying low-risk patients with febrile neutropenia (FN) for developing serious complications. METHODS This was a single-center, cross-sectional observational study. Either English or Chinese versions of the FACT-N were administered to the eligible patients according to their language preference within 7 days of FN onset. Univariate analyses and multivariate analyses were performed to construct the PROMASCC model. The prognostic performance was compared between the PROMASCC model and MASCC risk index. The internal validation of the PROMASCC model was examined by bootstrapping technique. RESULTS From August 2014 to April 2016, a total of 120 eligible patients were included in this study. In the univariate analyses, only the malaise subscale score has been significantly associated with the favorable outcome (without complications) (P = 0.024). Compared to the MASCC risk index, the PROMASCC model has shown advantages on the improved specificity (64.3 vs. 38.1%) and positive predictive value (81.0 vs. 73.7%), lower misclassification rate (24.2 vs. 25.8%), and increased area under receiver-operating characteristic curve (0.732 vs. 0.658). The bootstrapping procedure estimates the optimism-corrected area for the PROMASCC model to be 0.731 (95% CI 0.648 to 0.814). CONCLUSIONS This study has developed and validated a PROMASCC model and demonstrated that additional measurement on patient's fatigue level could improve the risk stratification of patients with FN.
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Affiliation(s)
- Xiao Jun Wang
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore.,Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore
| | - Denise Yun Ting Goh
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Sreemanee Raaj Dorajoo
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Alexandre Chan
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore. .,Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore.
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26
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In pursuit of empirically supported assessment for use in medical settings. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2016. [DOI: 10.1111/cpsp.12176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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