Quality of life of locally advanced pancreatic cancer patients after FOLFIRINOX treatment

Fleur Van Der Sijde,Casper H J Van Eijck,Freek R Van ’T Land,Hanneke W M Van Laarhoven,Laura Schafthuizen,Miranda Moskie,Monique Van Dijk

doi:10.1007/s00520-021-06648-1

Fleur Van Der Sijde, Casper H J Van Eijck + Show 5 more

Open Access

https://doi.org/10.1007/s00520-021-06648-1

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Journal: Supportive Care in Cancer	Publication Date: Nov 11, 2021
Citations: 2	License type: open-access

Affiliation: Erasmus MC

Abstract

BackgroundQuality of life in cancer patients might be affected by chemotherapy-induced toxicity. Especially in patients with pancreatic ductal adenocarcinoma (PDAC), with a short life expectancy, fear of poor quality of life is often a reason for both patients and medical oncologists to refrain from further treatment. In this study, we investigated quality of life (QoL), pain, sleep, and activity levels in locally advanced pancreatic cancer (LAPC) patients after FOLFIRINOX treatment.MethodsA total of 41 LAPC patients with stable disease or partial response were included after completion of at least four cycles of FOLFIRINOX. QoL was measured with the EORTC QLQ-C30 and NRS pain scores. Patients completed the Richards-Campbell Sleep Questionnaire (RCSQ) for five consecutive nights and wore a GENEActiv tri-axial accelerometer (Actiwatch) for 7 days, registering sleep duration, efficiency, and activity.ResultsMean EORTC QLQ-C30 score for global health status was 78.3 (± 17.3), higher than reference values for cancer patients (P < 0.001) and general population (P = 0.045). LAPC patients reported few disease-related symptoms. Two patients (5%) reported pain scores > 3. Mean sleep duration was 8 h/night (± 1.2 h) and sleep efficiency 70% (± 9%) with high patient-reported quality of sleep (mean RCSQ score 72.0 ± 11.4). Mean duration of moderate-vigorous activity was 37 min/week (± 103 min/week).ConclusionsQoL is very good in most LAPC patients with disease control after FOLFIRINOX, measured with validated questionnaires and Actiwatch registration. The fear of clinical deterioration after FOLFIRINOX is not substantiated by this study and should not be a reason to refrain from treatment.Trial registrationDutch trial register NL7578.

Highlights

FOLFIRINOX chemotherapy, a combination of fluorouracil, leucovorin, irinotecan, and oxaliplatin, is standard of care for locally advanced pancreatic cancer (LAPC) patients with a1 3 Vol.:(0123456789)Supportive Care in Cancer and even be a reason to choose or switch to another, less toxic chemotherapy regimen or stop treatment completely
Whether or not diminished quality of life is worth the survival benefit is a very personal decision that should be made by patients themselves, but it is the treating physician that should properly inform them on the pros and cons of treatment
LAPC patients were selected from a single-center, prospective clinical trial (Dutch trial register NL7578) investigating the safety and efficacy of adding IMM-101 immunotherapy, a suspension of heat-killed whole cell Mycobacterium obuense, to the treatment for LAPC patients with FOLFIRINOX followed by stereotactic body radiation therapy (SBRT)

Summary

Introduction

FOLFIRINOX chemotherapy, a combination of fluorouracil, leucovorin, irinotecan, and oxaliplatin, is standard of care for locally advanced pancreatic cancer (LAPC) patients with a1 3 Vol.:(0123456789)Supportive Care in Cancer and even be a reason to choose or switch to another, less toxic chemotherapy regimen or stop treatment completely. FOLFIRINOX chemotherapy, a combination of fluorouracil, leucovorin, irinotecan, and oxaliplatin, is standard of care for locally advanced pancreatic cancer (LAPC) patients with a. If patients still report these symptoms, and what their quality of life is after chemotherapy, has not been studied yet. Quality of life in cancer patients might be affected by chemotherapy-induced toxicity. In patients with pancreatic ductal adenocarcinoma (PDAC), with a short life expectancy, fear of poor quality of life is often a reason for both patients and medical oncologists to refrain from further treatment. We investigated quality of life (QoL), pain, sleep, and activity levels in locally advanced pancreatic cancer (LAPC) patients after FOLFIRINOX treatment. Conclusions QoL is very good in most LAPC patients with disease control after FOLFIRINOX, measured with validated questionnaires and Actiwatch registration.

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