Translation and validation of European Organization for Research and Treatment for Cancer quality of life questionnaire-OV-28 module into Indian languages (Hindi and Marathi) to study quality of life of ovarian cancer patients from a tertiary care cancer center

Integration of Ayurvedic and Allopathic treatment in hereditary breast and ovarian cancer patient with Germline BRCA1 mutation for long term disease free survival: A case report

Ovarian cancer patients with BRCA1 mutation have more susceptibility for secondary breast cancer. In females with BRCA1 mutation, the risk of developing breast carcinoma is 65% and of ovarian cancer is 39%, before 70 years of age. This is a case report of a 74 year old, post-menopausal woman diagnosed with metastatic retroperitoneal lymph node, high-grade papillary adenocarcinoma primary ovary stage IIIA in April 2004 at the age of 48 years. She underwent 3 cycles of neo-adjuvant chemotherapy Inj. Methotrexate and Inj. Carboplatin from June to August 2004 followed by optimum cytoreduction in September 2004. Later she completed 3 more cycles of chemotherapy of the same protocol from October to November 2004. Tab Etoposide was given from December 2004 to October 2006. In May 2006, during oral chemotherapy and with unremarkable radiological findings, the patient chose Ayurvedic treatment in view of immune boosting, and improving quality of life. The patient underwent 11 sets of Panchakarma treatment, almost every year, from December 2007 to September 2019. She was disease-free for 13 years leading a good quality of life with adjunct Ayurvedic treatment. In October 2019, she was diagnosed with Left breast duct carcinoma with ER, PR hormone positive status. Her genetic mutation analysis report at that time revealed BRCA 1 mutation. She underwent Left Modified Radical Mastectomy in October 2019, followed by prophylactic Right Breast Mastectomy and oral hormonal therapy. Now she is living with better quality of life with adjunct Ayurvedic treatment, including Oral Ayurvedic Medicines possessing Rasayana (immunomodulatory) and hepato-protective activity and 12 sets of Panchakarma Chikitsa. In this case of Stage IIIA Ovarian carcinoma and second primary Breast carcinoma with BRCA 1 genetic mutation (HBOC syndrome), a long-term 13 years of disease-free survival, and 20 years of overall survival is achieved with the integration of Ayurvedic treatment and conventional cancer treatment.

Tools to assess quality of life in adults with chronic conditions in India: A scoping review

Background

Chronic diseases are a major contributor to mortality, morbidity, and socio-economic costs globally, including in India. Quality of life (QoL) is an important patient-centered outcome for chronic disease. Measurement properties of tools for assessing QOL in the Indian context have not been assessed systematically.

Methods

A scoping review was conducted, and four major electronic databases were searched. Screening was conducted by at least two independent reviewers, with a third person acting as an arbiter. Data from the retrieved full texts were extracted by one reviewer, with a sample verified by another reviewer to reduce any data extraction errors. A narrative synthesis was done with a focus on measurement properties of tools, including but not limited to internal consistency, inter-rater reliability, test-retest reliability, validity, and acceptability.

Results

Out of 6706 records retrieved, a total of 37 studies describing 34 tools (both generic and disease-specific tools) for 16 chronic conditions were included. Most of the studies were cross-sectional (n = 23). Overall, most tools had acceptable internal consistency (Cronbach's alpha value ≥0.70) and good-to-excellent test-retest reliability (intra-class correlation coefficient = 0.75-0.9), but there was variability in acceptability. In terms of acceptability, seven tools were positively assessed (meeting psychometric property requirements), but all except the World Health Organization QoL tool were disease specific. Many tools have also been tested for local context, and many translated and tested in one or few languages only, thus limiting their usability across the nation. Women were underrepresented in many studies, and tools were not evaluated in other genders. Generalizability to tribal people is also limited.

Conclusion

The scoping review provides a summary of all QOL assessment tools for people with chronic diseases in India. It supports future researchers to make informed decisions for choosing tools. The study highlights the need for more research to develop QOL tools which are contextually applicable and enables the comparability across diseases, people, and regions within India and potentially in the South Asian region.

Validation of the Mexican-Spanish Version of the EORTC QLQ-OV28 Instrument for the Assessment of Quality of Life in Women with Ovarian Cancer

BACKGROUND

Health-related quality of life (HRQL) is an important outcome measure in Oncology.

AIM OF THE STUDY

To validate the Mexican-Spanish version of the QLQ-OV28 questionnaire to assess HRQL in women with ovarian cancer (OC).

METHODS

The QLQ-C30 and QLQ-OV28 instruments were applied to women with OC attending a cancer center in Mexico. The usual psychometric analyses were performed; the Spearman's method was used for correlation analysis, reliability analysis with the Cronbach's alpha, known-group comparisons with the Kruskal-Wallis test, responsiveness was tested employing repeated measures ANOVA, and the association of scale scores and overall survival (OS) were analyzed with the Kaplan-Meier method and Cox's model.

RESULTS

Two hundred fifty-two women with OC were included in this cohort. The instruments were well accepted and compliance rates were high; patients responded both instruments in <30 min. The QLQ-OV28 internal consistency tests demonstrated good convergent (Correlation coefficients [CC] 0.154‒0.694) and divergent validity (CC 0.003‒0.69). Cronbach's α coefficients of six of eight scales of the QLQ-OV28 instruments were >0.7 (range, 0.567‒0.857). Scales QLQ-OV28 instruments distinguished among clinically distinct groups of patients, particularly after basal serum albumin and basal Ca‒125 levels. The evaluation of responsiveness demonstrated that two scales of the QLQ-OV28 were sensitive to change over time during induction chemotherapy. Six scales of the QLQ-OV28 were associated with OS.

CONCLUSIONS

The Mexican-Spanish version of the QLQ-OV28 questionnaire is reliable and valid for the assessment of HRQL in patients with OC and can be broadly used in clinical trials.

Validation of the Turkish version of European Organization for Research and Treatment of Cancer QLQ-OV28 ovarian cancer specific quality of life questionnaire

OBJECTIVE

To examine reliability and validity of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-OV28 questionnaire into the Turkish language according to the instructions provided by EORTC.

MATERIALS AND METHODS

Ninety-seven patients who were diagnosed as having ovarian cancer and treated between January 2005 and June 2010 with an expected survival time of at least 3 months, were enrolled into the study. The exclusion criteria were diagnoses of any disease that could disrupt consciousness and concurrent malignancies. The EORTC QLQ-OV28 module was translated into Turkish by professional translators and physicians. The test-retest reliability of the Turkish version of the questionnaire was performed on 30 patients. Answers were scored according to the instructions provided by the EORTC. The total score was calculated as explained above and after scoring procedures, all subscale scores were linearly transformed to a 0-100 scale. All patients concomitantly completed the Spielberg State Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI). Patients were analyzed in two groups: on-treatment and off-treatment groups consisted of patients who did and did not undergo chemotherapy or surgery within the last two months, respectively. The demographic data of all patients were recorded. EORTC QLQ-OV28 scores of both groups were compared. Correlations between EORTC QLQ-OV28 subscales and total score of BDI and STAI were analyzed.

RESULTS

For test-retest reliability, Spearman's rho was 0.84 (p<0.001). The on-treatment group scored statistically significantly higher than the offtreatment group in peripheral neuropathies, attitude to disease and treatment, sexual function and other chemotherapy adverse effect subscales of the questionnaire. Correlations between EORTC QLQ-OV28 subscales and the total scores of BDI and STAI of the groups were statistically significant, except the sexual function subscale.

CONCLUSION

The Turkish translated version of EORTC QLQ-OV28 module is a reliable, consistent, and a valid instrument for assessing the impact of treatment modalities on QoL among Turkish speaking women with ovarian cancer.