Health-related quality of life, fatigue, and depression under low-dose IFN-α therapy in melanoma patients.

Abstract

Adjuvant melanoma treatment with interferon-α (IFN-α) has proven to be accompanied by several side effects and to decrease patients' health-related quality of life (HRQOL), fatigue and depression being essential factors at that. Although a large body of evidence exists for HRQOL under IFN-α therapy, we now specifically address this topic combining the HRQOL survey in the first months of IFN-α low-dose treatment with a structured assessment of relevant neuropsychiatric side effects, fatigue and depression, with specific validated assessment tools. The present study is a longitudinal observational study assessing fatigue, depression, and HRQOL with specific assessment tools at 3 assessment points over 6 months. The IFN-α treatment group consisted of 48 patients with current IFN-α therapy (3 MU 3 times weekly) from a consecutively recruited melanoma collective and compared with a parallelized nontreatment group (n=48) in routine clinical practice. A descriptive analysis and generalized linear models were applied to compare the groups. Physical fatigue increased significantly within the first months of IFN-α treatment, whereas cognitive and emotional fatigue and depression symptoms did not show this increase. The hypothesis of a significant deterioration of HRQOL after IFN-α initiation was not confirmed. The treatment group did, however, show a different course of global HRQOL than the comparison group, with a significant improvement in the nontreatment group. Patients under low-dose IFN-α therapy primarily suffer from physical side effects, mainly physical fatigue, in the early phases of treatment. The HRQOL improvement evident in the nontreatment group was not observed in the IFN-α group.