Anorexia, pain and peripheral neuropathy are associated with a decrease in quality of life in patients with advanced pancreatic cancer receiving outpatient chemotherapy \u2014 a retrospective observational study

Hironori Fujii,Takuji Iwashita,Hirotoshi Iihara,Shiori Sadaka,Masahito Shimizu,Shinya Uemura,Maaya Koda,Takuma Ishihara,Hideki Hayashi,Tadashi Sugiyama,Koichi Ohata,Hiroko Kato-Hayashi,Akio Suzuki,Ryo Kobayashi

doi:10.1186/s40780-021-00210-1

Abstract

BackgroundCancer chemotherapy usually improves clinical outcomes in patients with advanced pancreatic cancer (APC), but can also cause moderate-to-severe adverse events (AEs). We investigated the relationship between moderate-to-severe AEs and quality of life (QOL) in patients with APC who received outpatient chemotherapy.MethodsWe recruited APC patients who received outpatient chemotherapy in Gifu University Hospital between September 2017 and December 2018. Adverse events related to chemotherapy were assessed by a pharmacist collaborating with a physician using common terminology criteria for AEs (CTCAE) ver 4.0, and QOL of patients was self-assessed by patients using the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L Japanese edition 2). Associations between the EQ-5D-5L utility value and serious AEs were assessed using proportional odds logistic regression.ResultsA total of 59 patients who received 475 chemotherapy cycles were included. The proportional odds logistic regression indicated that grade ≥ 2 anorexia, pain and peripheral neuropathy were significantly correlated with a decreased EQ-5D-5L utility value. Pharmaceutical intervention for these AEs significantly improved the patients’ EQ-5D-5L utility value.ConclusionsAnorexia, pain and peripheral neuropathy were significantly associated with a decrease in QOL. It is assumed that appropriate pharmaceutical intervention with particular emphasis on these AEs can improve the QOL of pancreatic cancer patients receiving outpatient chemotherapy.

Highlights

Cancer chemotherapy usually improves clinical outcomes in patients with advanced pancreatic cancer (APC), but can cause moderate-to-severe adverse events (AEs)
FOLFIRINOX therapy and gemcitabine + nab-paclitaxel (GnP) therapy exhibited clinical superiority over gemcitabine monotherapy with respect to overall survival (OS), progression-free survival (PFS), and tumor response rate (RR) in patients with metastatic pancreatic cancer; severe adverse events (AEs) such as neuropathy, nausea/vomiting, diarrhea, fatigue, alopecia, and neutropenia were more frequent with FOLFIRINOX or GnP than with gemcitabine [2,3,4,5]
We investigated the association between AEs and deterioration in quality of life (QOL) for patients with APC

Summary

Introduction

Cancer chemotherapy usually improves clinical outcomes in patients with advanced pancreatic cancer (APC), but can cause moderate-to-severe adverse events (AEs). We investigated the relationship between moderate-to-severe AEs and quality of life (QOL) in patients with APC who received outpatient chemotherapy. FOLFIRINOX therapy and GnP therapy exhibited clinical superiority over gemcitabine monotherapy with respect to overall survival (OS), progression-free survival (PFS), and tumor response rate (RR) in patients with metastatic pancreatic cancer; severe adverse events (AEs) such as neuropathy, nausea/vomiting, diarrhea, fatigue, alopecia, and neutropenia were more frequent with FOLFIRINOX or GnP than with gemcitabine [2,3,4,5]. Chemotherapy for pancreatic cancer, such as FOLFIRINOX therapy and GnP therapy, is often administered in an outpatient setting; appropriate monitoring and supportive care are required. Identifying which AEs cause deterioration in QOL is useful to maintain the patient’s QOL

Methods

Results

Conclusion