Evaluation by electronic patient-reported outcomes of cancer survivors’ needs and the efficacy of inpatient cancer rehabilitation in different tumor entities

Abstract

Objective We investigated cancer survivors’ health-related quality of life (HRQOL), specific deficiencies related to underlying disease or treatment, and benefits of rehabilitation in a large variety of cancer entities. Patients and methods Electronic patient-reported outcomes were performed as clinical routine procedures. Cancer survivors underwent a 3-week multidisciplinary inpatient rehabilitation. Twenty-one different cancer entities were analyzed separately before (T0) and by the end (T1) of rehabilitation. HRQOL, symptoms, and functions were assessed with EORTC-QLQ-C30 questionnaire, psychological distress with Hospital Anxiety and Depression Scale (HADS). Results Four thousand four hundred one of 5912 rehabilitants were evaluable, having completed both questionnaires at T0 and T1. All function mean scores and HRQOL were lower than in Austrian normal population, while levels of anxiety, depression, and all symptom scores were higher. HRQOL was particularly low in lung, liver, and bladder cancer patients. Maximum anxiety levels were observed in patients with breast and thyroid cancer patients, the highest levels of depression in liver and brain cancer patients. Fatigue was severe in patients with lung, liver, esophageal, bladder cancer, and myeloma patients. Mean scores were also high for pain and insomnia. In the group of all rehabilitants, a highly significant improvement of global HRQOL, anxiety, depression, and all function and symptom scores was observed at T1 (p < 0.001). We noted significant improvement of HRQOL, anxiety, depression, fatigue, emotional, social, role, and physical functions in each cancer entity with medium to large effect sizes. Other recorded symptoms were reduced in the majority of cancers. Conclusion Rehabilitation effectively improves psychological distress and HRQOL as a part of treatment for various cancers.

Integrating molecular biomarkers in breast cancer rehabilitation. What is the current evidence? A systematic review of randomized controlled trials

“…In this scenario, rehabilitation plays a key role in the management of BC survivors with growing evidence highlighting its positive effects in improving functional outcomes and psychosocial well-being of BC patients ( Reid-Arndt et al, 2009 ; Zaidi et al, 2017 ; Kudre et al, 2020 ; Sleight et al, 2022 ). Hence, rehabilitation might improve the symptoms of patients with breast cancer–related lymphedema ( Invernizzi et al, 2019 ; Michelotti et al, 2019 ; de Sire et al, 2021a ; Carretti et al, 2022 ; Muñoz-Alcaraz et al, 2022 ; Omar et al, 2022 ), cancer-related fatigue ( Wirtz and Baumann, 2018 ; Adams et al, 2019 ; Invernizzi et al, 2020b ; Marechal et al, 2020 ; Licht et al, 2021 ), axillary web syndrome ( de Sire et al, 2020 ; Ravichandran et al, 2020 ; Tay et al, 2021 ), aromatase inhibitor–induced arthralgia ( Harris et al, 2012 ; Winters-Stone et al, 2012 ; Grizzi et al, 2020 ), and cancer treatment–induced bone loss ( Invernizzi et al, 2020a ; de Sire et al, 2021b ; Pagnotti et al, 2021 ; Singh and Toohey, 2022 ). In addition to these encouraging approaches, the rehabilitation management of these disabling sequelae is still a challenge, and several questions remain unanswered about the most effective and tailored interventions in real-world clinical practice ( Invernizzi et al, 2020e ).…”

Associations of Age and Sex with the Efficacy of Inpatient Cancer Rehabilitation: Results from a Longitudinal Observational Study Using Electronic Patient-Reported Outcomes

“…The data for this study are part of an ongoing clinical routine data collection at the Oncological Rehabilitation Center St. Veit im Pongau, Austria. The data collection and assessment of PROs have been described elsewhere in detail [ 54 ] and are summarized herein. The sample consisted of adult cancer survivors who had completed their active oncological treatment before referral to an inpatient rehabilitation measure.…”

Nivolumab (Opdivo)

“…The changes in the scores of QLQ-C30 demonstrated a small to medium SRM in response to treatment over time with scores mostly deteriorating between 5 and 10 points. 69 Though the EORTC QLQ-C30 has been used to assess HRQoL among bladder cancer/tumor patients including MIUC, [70][71][72][73][74][75][76][77][78][79][80][81][82] it has not been specifically designed for this indication.…”