Quality of life across chemotherapy lines in patients with cancers of the pancreas and biliary tract

Abstract

BackgroundIn patients with cancers of the pancreatic and biliary tract quality of life (QOL) improvement is the main treatment goal, since survival can be prolonged only marginally. Up to date, knowledge on QOL impairments throughout the entire treatment process, often including several chemotherapy lines, is scarce. Our study aimed at investigating QOL trajectories from adjuvant treatment to palliative 3rd-line therapyMethodsPatients were included in routine electronic patient-reported outcome monitoring at Kufstein County Hospital at the time of diagnosis and assessed with the EORTC QLQ-C30 during each chemotherapy cycle.ResultsEighty out of 147 patients with pancreatic cancer or cancer of the bile ducts treated at the Kufstein County Hospital, fulfilled inclusion criteria and could be included in the study (mean age 67.4 years; 53.8% women). Physical, Emotional and Cognitive Functioning, and Global QOL deteriorated across chemotherapy lines, whereas Fatigue, Pain, Dyspnoea, Sleeping Disturbances, Diarrhoea, and Taste Alterations increased. With regard to Physical Functioning, Global QOL, Fatigue, Dyspnoea, Diarrhoea and Taste Alterations, the patients receiving adjuvant or 1st-line palliative chemotherapy did not differ significantly. Most patients in 2nd- or 3rd-line chemotherapy showed significantly higher impairments and symptom burden. However, patients under 1st and 2nd-line treatment showed stable QOL trajectories, whereas 3rd-line patients perceived substantial deteriorations.ConclusionsThe results suggest early palliative treatment initiation to stabilise QOL on a level as high as possible. The continuous QOL improvement during adjuvant treatment, probably reflecting post-operative recovery, may indicate that deleterious effects of adjuvant chemotherapy on QOL are highly unlikely.

Quality of life across chemotherapy lines in patients with advanced colorectal cancer: a prospective single-center observational study

“…The latter patients reported a substantially higher symptom burden. Similar results have been shown in a few other studies of patients with lung, pancreas, and biliary tract cancers [18][19][20]. Traditionally, objective end points such as response and survival rates have been used to evaluate the efficacy of chemotherapy in patients with advanced CRC.…”

Untitled

“…Also in accordance with other studies. [15,[25][26][27][28][29]31,32] Otherwise, of our findings, there are other studies [24,30] who have concluded that Fol significantly reduces QOL impairment in patients with metastatic pancreatic cancer, because of the increased toxicity of Fol.…”

“…Other authors also concluded that Gem did not improve QOL for patients who respond to treatment, so it did affect their emotional and functional status. [31,32] The functional well-being is also better in fol arm compared to Gem arm. Patients in fol arm claimed that it helped them to cope better with depression and anxiety.…”

“…Even though there are differences in the above studies, [19][20][21][22][23][24][25][26][27][28][29][30][31][32] most of them conclude that Fol compared to Gem improves the overall QOL.…”

Thromboprophylaxis in Pancreatic Cancer: Why isn’t Prime Time Here Compared to Multiple Myeloma?

“…Therefore these patients deserve particular emphasis on best supportive management especially those which will improve their QoL [30]. While most first line palliative chemotherapies in APC are known to stabilize QoL, the numbers of patients benefiting from these treatments are limited and second and third line treatments show no significant improvement in this global QoL [31]. Therefore in APC patients, balancing the trade-offs between QoL and survival takes priority [32].…”