Integrating patient reported measures as predictive parameters into decisionmaking about palliative chemotherapy: a
Anna Creutzfeldt1, Anna Suling2, Karin Oechsle3
1Department of Oncology, Hematology, BMT with Section Pneumology, University Medical Center Hamburg-Eppendorf, Hubertus Wald Tumour Center - University Cancer Center Hamburg, Martinistr. 52, 20246, Hamburg, Germany. a.creutzfeldt@uke.de.
BMC Palliative Care
|March 2, 2016
Summary
Pretreatment quality of life (QoL) and symptom burden (SYB) predict chemotherapy outcomes in advanced cancer patients. Better QoL and less SYB correlate with improved treatment response and survival, aiding in personalized palliative care decisions.
Area of Science:
- Oncology
- Palliative Care
- Health Outcomes Research
Background:
- Systemic treatments can alleviate physical symptoms in advanced cancer.
- The link between quality of life (QoL), symptom burden (SYB), and treatment efficacy (tumor response, survival) is not well-defined.
- This study investigates the predictive power of pre-treatment QoL and SYB on treatment outcomes.
Purpose of the Study:
- To assess the predictive value of baseline quality of life (QoL) and symptom burden (SYB) on treatment efficacy in patients with advanced gastrointestinal cancers receiving palliative chemotherapy.
- To identify QoL and SYB patterns associated with treatment response and progression-free survival (PFS).
Main Methods:
- 47 patients with metastatic gastrointestinal cancers received 1st/2nd line palliative chemotherapy.
- QoL and SYB were measured using EORTC QLQ-C30 and MSKCC MSAS questionnaires pre-treatment and after 8-12 weeks.
- Logistic regression analyzed QoL and SYB for predicting objective treatment efficacy (response rate and PFS ratio).
Main Results:
- Better pre-treatment QoL and lower SYB were linked to objective treatment response and increased PFS.
- Patients with better future treatment efficacy (PFS ratio ≥ 1) had significantly better baseline role/emotional/cognitive/social functioning and less fatigue/appetite loss.
- Global health status, PSYCH subscale, and global distress index predicted PFS, independent of clinical factors.
- Subjective improvements in QoL and SYB were observed even in non-responders.
Conclusions:
- Distinct QoL patterns before chemotherapy may identify patients unlikely to benefit from survival prolongation.
- Early detection of non-responders can guide treatment decisions, potentially avoiding futile therapies.
- Integrating QoL and SYB assessments into palliative chemotherapy decision-making is crucial for improving patient outcomes.
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