Symptom interference with quality of life (QoL) in advanced solid tumors and hematological malignancies

Abstract

8202 Introduction: Patients with advanced cancer experience impaired QoL due to symptoms related to the disease itself and to treatment toxicity. We have developed the following grades of QoL impairment as compared to a population norm (PN): mild (25% decrease from a PN), moderate (25–50% decrease), severe (50–75% decrease) and critical (>75% decrease). Understanding of symptom interference with a patient’s QoL provides the basis for better cancer outcome measurement. The goal of research was to study the most prevalent symptoms in patients with advanced solid tumors (ST) and hematological malignancies (HM) with different grades of QoL impairment. Patients and Methods: 201 advanced cancer patients: 119 ST and 82 HM (male/female 80/121; mean age 61.5) were enrolled in the study. To compare with controls a gender- and age-adjusted sample from the St.Petersburg population norm was used. SF-36 and M.D. Anderson Symptom Inventory were used for patient-reported outcomes assessment. To obtain QoL Index the Integral profile method was used. Results: The majority of patients with ST and HM experienced critical (40 and 44%, respectively) and severe (21 and 20%, respectively) QoL impairment. Moderate and mild QoL impairment was observed in about 10 and 12% of patients in both groups. About 16% of patients had no QoL impairment. The QoL indices differed significantly depending on the grade of QoL impairment (p=0.00002). The most severe symptom was fatigue (prevalence of 95%) in both groups. Sleep disturbance was present in two thirds of patients. 60 and 75% of patients with HM and ST, respectively, experienced pain. Moderate -to- severe levels of symptoms led to critical and severe QoL impairment. Severe symptoms resulted in a critical decrease in QoL. Conclusion: The majority of patients with advanced ST and HM exhibit critical and severe QoL impairment as compared to a population norm. They experience moderate-to-severe fatigue, pain, or sleep disturbance. Grading of QoL impairment and analysis of symptom burden is worthwhile to provide adequate management of advanced cancer. No significant financial relationships to disclose.