Abstract
Cancer treatment for elderly patients is often complicated by poor physical condition, impaired functioning and comorbidities. Patient reported health related quality of life (HRQOL) can contribute to decisions about treatment goals and supportive therapy. Knowledge about factors influencing HRQOL is therefore needed for the development of supportive measures and care pathways. An exploratory secondary data analysis on 518 assessments of the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire (EORTC QLQ-C30) and the elderly module (EORTC QLQ-ELD14) was performed to identify factors predictive for global HRQOL. Preliminary simple and multivariable regression analyses were conducted resulting in a final model comprising sociodemographic and disease specific variables and scales of the QLQ-C30 and QLQ-ELD14. Age, sex and disease related variables explained only part of the variance of global HRQOL (adjusted R2 = 0.203). In the final model (adjusted R2 = 0.504) fatigue, social function, burden of illness and joint stiffness showed possible influence on global HRQOL. Fatigue, social function and burden of illness seem to have the largest impact on global HRQOL of elderly cancer patients. Further prospective studies should examine these domains. Actionable symptoms should be given special attention to initiate targeted supportive measures aiming to maximize HRQOL of older cancer patients.
Highlights
As new therapeutic options improve survival rates in cancer [1], the maintenance of quality of life (QOL) has become a major therapeutic goal
This study explored factors that might influence global health related quality of life (HRQOL) in elderly cancer patients in a large international data set representative of elderly cancer patients with a wide range of cancers [27]
The stepwise approach for multivariable regression analyses resulted in a final model showing that fatigue, social functioning and burden of illness had the strongest association and possible influence on global HRQOL
Summary
As new therapeutic options improve survival rates in cancer [1], the maintenance of quality of life (QOL) has become a major therapeutic goal. In addition to the medical condition, patients’ individual preferences should be taken into account in the process of decision-making [4] In this context, maintenance of health related quality of life (HRQOL), which encompasses the effects of health, illness and treatment on QOL [5], independence and the ability to perform normal activities are key issues reported by cancer patients of all age groups [6]. Maintenance of HRQOL and functioning are integral parts of cancer care for older patients [10] and factors like the fear of side effects, treatment discomfort and the fear of losing independence are important aspects for accepting or declining cancer therapy [11] These issues should be considered in the decision-making process and throughout the treatment trajectory. A sound understanding of HRQOL in elderly cancer patients, of possible influencing factors and of differences in comparison to younger patients is required
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