Improving quality of life in patients with pancreatic neuroendocrine tumor following peptide receptor radionuclide therapy assessed by EORTC QLQ-C30.

Abstract

Neuroendocrine tumors (NETs) have proven to be appropriate neoplasms for peptide receptor radionuclide therapy (PRRT), as the majority of these slow-growing malignancies overexpress somatostatin receptors. The aim of this study was to evaluate changes in quality of life (QoL) of patients with P-NET following PRRT. Sixty-eight patients with P-NET (31 female, mean age 61.4 y) underwent PRRT: 12 with NET of grade 1, 40 of grade 2, 8 of grade 3 (grade non-available n=8). Prior to treatment, 39 patients showed ECOG 0, 26 patients ECOG 1, and three patients ECOG 2. Clinical assessment included evaluation of QoL and symptom changes using a standardized questionnaire (EORTC QLQ-C30) and was performed at baseline and every three months following each therapy cycle up to 12months. Primary analysis compared QoL at baseline and after the fourth treatment cycle (N=53). Up to four treatment cycles PRRT were performed for each patient. The median cumulative administered activity was 28.2GBq. Primary analysis revealed that compared to baseline QoL was significantly improved revealing increased global health status (p=0.008) and social functioning (p=0.049) at the end of the study. Furthermore, fatigue and appetite loss showed a significant improvement after the last PRRT cycle (fatigue: p=0.029, appetite loss p=0.015). Sub-analyses showed that QoL was improved revealing increased global health status (3months after first, second, and third treatment cycle p=0.048, p=0.002, and p<0.001, respectively), emotional functioning (3months after first-third cycle p=0.003, p=0.049, and p=0.001, respectively) and social functioning (3months after the first and second p<0.001, and after the third cycle p=0.015, respectively). Furthermore, some symptoms were significantly alleviated compared with baseline: fatigue (after first-third cycle p=0.026, p=0.050, and p=0.008, respectively), nausea and vomiting (after first and second cycle p=0.006 and p=0.001, respectively), dyspnea (after third cycle p=0.025), appetite loss (after first-third cycle p=0.010, p=0.001, and p=0.009, respectively), constipation (after first-third cycle p=0.050, p=0.003, and p=0.060, respectively). PRRT is an effective treatment of P-NET improving QoL of patients in terms of increasing global health and mitigation of physical complaints.