Emotional well-being and quality of life in patients undergoing radiation therapy for pancreatic and hepatobiliary malignancies.

Abstract

297 Background: Therapy for GI malignancies has long been known to have a marked impact on quality of life, yet this relationship remains poorly understood. The specific aim of this analysis was to evaluate the impact of radiation therapy (RT) on emotional well-being and QOL in patients receiving RT for pancreatic and hepatobiliary malignancies. Methods: A retrospective, IRB-approved chart review was performed of 722 patients receiving RT for any cancer diagnosis between 1/1/2006 and 12/31/2008. Subjects completed the Functional Assessment of Cancer Therapy General (FACT-G) questionnaire before and after RT. Pre- and immediately post-RT course scores were compared using student t-tests with Bonferroni correction for multiple comparisons (7 comparisons, alpha =.007). Results: 722 of 1369 (52.7%) patients participated in the Patient Related Outcome database. Complete pre and post RT spirituality data were available for 73 (64.6%) patients with GI malignancies, including 24 (33%) with pancreatic or hepatobiliary disease. Average age was 61, 15 (63%) were male and 14 (58%) received definitive treatment. A decrease in both functional and physical well-being was demonstrated in post-RT scores as compared to pre-RT. Emotional well-being, however, increased (17.60 to 18.72, p=0.051), a trend not replicated in any of the other GI malignancies. Further analysis demonstrated this improvement was largely due to a decrease in positive response to the statements “I feel nervous” (1.21 to 0.67, p=0.009) and “I worry my condition will get worse” (1.58 to 1.25, p=0.043). A decrease in positive response to “I feel sad” and an increase in positive response to “I am satisfied with how I am coping with my illness” were also noted, but differences were not significant. Conclusions: Emotional well-being of those receiving RT for pancreatic and hepatobiliary malignancies appears to improve over the course of therapy, even while other measures of QOL decline. Additional investigations in larger populations are warranted to further elucidate this relationship. Documentation of PROs may have potential for impact on QOL for patients with these and other malignancies. No significant financial relationships to disclose.