Assessment of factors that contribute to decreased quality of life in Gynecologic Oncology Group ovarian cancer trials

Abstract

BACKGROUND: The objective of this study was to assess which quality‐of‐life (QOL) line items on the Functional Assessment of Cancer Therapy‐Ovarian (FACT‐O) were associated with low QOL in women who were receiving chemotherapy for ovarian cancer. METHODS: Patients with stage III or IV ovarian cancer on Gynecologic Oncology Group Protocols 152 and 172 who underwent primary surgery followed by intravenous paclitaxel and cisplatin completed the FACT‐O. The FACT scale includes the 4 domains of physical, functional, social, and emotional well being (PWB, FWB, SWB, EWB, respectively). Women who had overall FACT‐O scores in the lowest quartile (Q1) were compared with women in the upper 3 quartiles (Q2‐Q4). The proportions of women in each group that selected the 2 worst categories for each item were compared. The level of significance was set at P < .005. RESULTS: Before Cycle 4, 361 patients (86.4%) provided valid QOL assessments. For PWB, a significantly greater proportion of women in Q1 versus Q2 through Q4 selected the 2 worst categories of several physical symptoms (nausea, pain, feeling ill, and being bothered by the side effects of treatment). For FWB, significant differences included being able to work, being content with the quality of their life, and sleeping well. For EWB, there were significant differences in feeling nervous and worrying about dying. There were virtually no differences between groups in SWB. Low interest in sex was reported by 56% to 88% of all patients (Q1‐Q4). CONCLUSIONS: A large proportion of women with FACT‐O scores in the lowest quartile reported problems that potentially were amenable to clinical interventions, such as symptom management and psychosocial support. Cancer 2009. © 2009 American Cancer Society.

Patient-reported outcomes in relapsed ovarian cancer: Results from a randomized Phase III study of trabectedin with pegylated liposomal doxorubicin (PLD) versus PLD Alone

“…Baseline compliance with questionnaire completion was 95% in this study, which is comparable to that observed in other studies of patients with ovarian cancer [11][12][13][14]. Not unexpectedly, the completion rate dropped off significantly at later time points-especially after 21 cycles of therapy.…”

“…The primary concerns to advanced ovarian cancer patients include alopecia, peripheral neuropathy, pain, neutropenia, fatigue and anxiety, in addition to the effects of their disease on physical and social functioning [19,20]. Evaluating these patient concerns is now considered to be widely advocated for the overall assessment of risks and benefits of new drugs for the treatment of recurrent/relapsed ovarian cancer [14].…”

“…A range of treatments have shown activity in the recurrent setting in randomized trials including, carboplatin/cisplatin, paclitaxel altretamine, topotecan, pegylated liposomal doxorubicin (PLD), and gemcitabine (with carboplatin) [4][5][6][7][8][9][10]. However, despite improved efficacy outcomes with these new therapeutic regimens, chemotherapy can have a significant effect on the functional status and symptoms of patients with recurrent/relapsed ovarian cancer enduring many rounds of treatment [11][12][13][14]. One example is the use of PLD either as a single agent or in combination [15,16].…”

Ten-Year Relative Survival for Epithelial Ovarian Cancer

“…The knowledge of improved relative survival after the 5-year point can provide important prognostic information for patients facing survivorship. 24 In this study, patients undergoing primary cytoreductive surgery had drastically improved survival compared with those patients undergoing an alternative primary therapy. Across all stages, relative survival rates at 5 and 10 years were 53% and 42% for those who had surgery and 8% and 6% for those who did not.…”

Physical Activity and Gynecologic Cancer Survivorship

“…Understanding that all women are not equally able to tolerate treatment and providing support during what is often very rigorous treatment may increase treatment effectiveness. A promising line of research is the identification of QOL items that may signal reduced ability to optimally undergo treatment (Gil et al 2007;von Gruenigen et al 2009). …”