Heterogeneity of patients with advanced solid tumors in terms of quality of life impairment

Abstract

20609 Grading of quality of life (QoL) impairment and analysis of symptom burden is worthwhile to provide adequate management of advanced cancer. According to the model of grading of QoL impairment, cancer patients may experience no, mild (25% decrease from a population norm), moderate (25–50%), severe (50–75%) or critical (>75%) QoL impairment. The goal of the research was to study heterogeneity of patients with advanced cancer in terms of their QoL and evaluate symptom burden in the groups with different QoL impairment. 350 patients with advanced solid tumors - breast cancer (44.6%), lung cancer (26.6%), gastrointestinal tumors (18.6%), gynecological tumors (5.4%), germinal tumors (1.7%), others (3.1 %)- were enrolled in the study (male/female - 131/219; mean age 56, stages III-IV). The SF-36 and M.D. Anderson Symptom Inventory were used for QoL and symptom assessment, respectively. Statistical significance of differences between groups was tested by Kruskall-Wallis ANOVA and Mann-Whitney U-test, correlation analysis was performed by Gamma-method. The majority of patients experienced critical(36%) or severe (19.7%) QoL impairment. Moderate and mild QoL impairment was observed in about 11.4 and 8.6% of patients. 24.3% of patients had no QoL impairment. The QoL indices differed significantly depending on the grade of QoL impairment (p=0.002). The number and severity of symptoms differed depending on the grade of QoL impairment (Gamma 0.6, p=0.01). In the group with no QoL impairment less than 50% of patients experienced symptoms; in the vast majority of patients they were mild. In the group with critical QoL impairment nearly all the patients had fatigue (97.6%) and pain (97.6%); in 80% these symptoms were moderate or severe. Sleep disturbance, distress and sadness were experienced by 93.7% of patients; in a half of them these symptoms were significant. The majority of patients with advanced solid tumors exhibit critical or severe QoL impairment as compared to a population norm. Identification of the grade of QoL impairment is the starting point in management of advanced solid tumors. Grading of QoL impairment is worthwhile to provide adequate management of advanced cancer. No significant financial relationships to disclose.