Improvement In Quality Of Life Domains Research Articles

Association of plant-based diet index with quality of life in patients with prostate cancer.

5037 Background: Plant-based diets have many health benefits including a lower risk of fatal prostate cancer. Less is known about the relationship between diet and functional outcomes among prostate cancer survivors. We hypothesized that greater consumption of plant-based food after prostate cancer diagnosis is associated with improved quality of life (QOL). Methods: This prospective cohort study included 3,505 participants in the Health Professionals Follow-up Study with non-metastatic prostate cancer (1986-2016). Overall and healthful Plant-based Diet Indices were calculated from food frequency questionnaires with cumulative updating. QOL scores were calculated using the Expanded Prostate Cancer Index Composite. Generalized estimating equations were used to examine associations between Plant-based Diet Indices and 5 QOL domains, adjusted for clinical and demographic factors. Results: Higher Plant-Based Diet Index was associated with improved scores for sexual function, urinary irritation/obstruction, and urinary incontinence among men with prostate cancer. Consuming more healthful plant-based foods was also associated with better scores for bowel function and hormonal/vitality in the age-adjusted models. Results were similar in sensitivity analyses excluding patients with pre-existing erectile dysfunction or lower urinary tract symptoms, and adjusting for use of sexual or urinary medications. A limitation is that no participants followed a strict vegan diet. Conclusions: This prospective study suggests that greater consumption of healthful plant-based foods is associated with modest improvements in QOL domains among patients with prostate cancer. [Table: see text]

Quality of Life in Locally Advanced Head and Neck Cancer Patients with Different Radiotherapy Techniques after Definitive Chemo Radiotherapy - A Real-World Data Study with Indian Patients

BACKGROUND
 The standard of care in non-resectable locally advanced head and neck cancer with squamous cell histology is radical radiotherapy (RT) along with concurrent chemotherapy. Previously, these patients were treated with conventional radiotherapy techniques. Such conventional techniques can lead to morbidity with an impact on quality-of-life (QOL) in long-term survivors. Conformal radiotherapy experiences significant improvements in QOL domains versus conventional techniques. Radiotherapy planning and treatment with conformal techniques require advanced and relatively expensive equipment. Our study is aimed at evaluating the feasibility of conventional radiotherapy techniques in terms of quality of life in locally advanced head and neck cancer patients in comparison to the conformal technique in the Indian setting.
 METHODS
 Sixty patients with locally advanced head and neck cancer who received chemo-radiation therapy and came for follow-up after a minimum of two years were scheduled to complete the QOL questionnaire (QLQ-C30 and QLQ-H&N35 scores). These scores were compared between the patients who were treated with conventional and conformal techniques.
 RESULTS
 Results showed that when comparing EORTC QLQ–C30 scoring, patients who were treated with conventional RT had a significantly higher median score for emotional QOL and lower median scores for fatigue, pain, appetite loss, and financial difficulties as compared to the conformal RT group. But only the financial difficulties scale showed a significant p-value. When comparing EORTC QLQ–H&N35 scores, all QLQ-HN35 scores did not show any significant difference, except for speech problems. Patients treated with the conventional technique had a significantly lower median score for speech problems compared to the conformal RT group.
 CONCLUSIONS
 Based on these results, it is concluded that conventional radiotherapy techniques can be advised to locally advanced head and neck cancer patients when conformal radiotherapy techniques are not available, especially in developing or underdeveloped countries.

Quality of Life in Perspective to Treatment of Postoperative Edema After Peripheral Bypass Surgery

To examine the effects of peripheral bypass surgery on patients' quality of life (QoL) as well as to compare two treatment modalities to reduce postoperative edema with regard to patients' QoL. This was a randomized controlled trial set in the department of vascular surgery in a nonacademic teaching hospital. Ninety-three patients (mean age, 70 years; 33% Rutherford 5-6), enrolled between August 2006 and September 2009, who underwent peripheral bypass surgery (autologous 57, polytetrafluoroethylene 36). Patients were assigned to intermittent pneumatic compression (n = 46) or to compression stockings (n = 47). The main outcome measure was QoL, measured with the World Health Organization Quality of Life assessment instrument (short form: WHOQOL-BREF). QoL improved on the domain of Physical Health by 7.18 points (P < 0.001 [range, 0-100]) after 2 weeks and by 10.03 points (P < 0.001) after 3 months. Patients who received a polytetrafluoroethylene bypass scored 0.45 points (P = 0.0008 [range, 1-5]) lower at baseline on Global QoL than patients who received an autologous bypass. Type of bypass or edema treatment method did not affect the improvements. Edema did not correlate with QoL. Improvement in QoL on the domain Physical Health following femoropopliteal bypass surgery was found as soon as 2 weeks after surgery. Improvement in QoL domains was not influenced by the type of bypass reconstruction. No specific effects of edema on QoL were detected.

Patient and parent longitudinal reports of quality of life in children and adolescents with osteosarcoma

19562 Children and adolescents being treated for osteosarcoma are likely to experience physical, emotional, functional and possibly cognitive changes during the course of their treatment. The aims of this prospective study were to assess the effect of treatment on patients’ quality of life (QoL) at diagnosis and during therapy, compare patient and parent QoL reports, and examine relationships between patient QoL and tumor histologic response to preoperative chemotherapy and event-free survival (EFS) in children and adolescents in treatment for osteosarcoma. Newly diagnosed patients with localized disease completed three established patient reports (Symptom Distress Scale, and PedsQL v.3 and v.4). Parents completed two parent reports (PedsQL v.3 and v.4). QoL evaluations were done at diagnosis, prior to definitive surgery (Week 12), and postoperatively during treatment (Week 23). Sixty-two of 72 eligible patients and their parents completed QoL measures. Symptom distress (SD) decreased in 85% of patients from baseline to Week 12 (with 8/10 symptoms significantly improved) and from baseline to Week 23 in 74% of patients. Improvements in most domains of the PedsQL v. 3 were noted by patient and parent reports from baseline to Weeks 12 and 23 except for the nausea domain. Patient and parent reports differed, with parents reporting lower QoL scores on v. 3 than did patients, particularly in the domains of treatment anxiety, cognitive problems, and communication. QoL scores did not differ by patient gender but did by age in certain domains. Patients reported significant improvements in physical and emotional functioning from baseline to Weeks 12 and 23 using the PedsQL v.4. Parents reported significant improvements in emotional functioning from baseline to Weeks 12 and 23 using the PedsQL v.4. QoL scores were not associated with tumor histologic response or EFS. Significant improvements in QoL domains and in symptoms from diagnosis to Week 12 and to Week 23 were documented in both patient and parent reports. Treatment contributed to improvements in physical and emotional functioning and in symptoms except for nausea. QoL was not related to histologic response or EFS. No significant financial relationships to disclose.

Quality of life (QOL) of older adults with acute myeloid leukemia (AML): Effects of treatment and time

6566 Background: AML in older adults has a poor prognosis. Although intensive chemotherapy may be associated with a modest improvement in survival, this needs to be balanced against possible worsening of QOL. However, published research in this area is limited. Methods: English-speaking patients aged 60 or older presenting with newly diagnosed AML to our referral centre were enrolled. Patients were excluded if life expectancy was &lt;1 month. QOL was measured at baseline and at 1, 4, and 6 months. Questionnaires included the European Organization for the Research and Treatment of Cancer QLQ-C30 (global health and 5 QOL domains) and the Functional Assessment of Cancer Therapy Fatigue subscale. Patients were stratified into intensive (IT) and non-intensive treatment (NIT) groups. Baseline scores between groups were compared using Student’s T-test. Repeated measures modeling was used to compare the groups over time. Results: From June 2003 to December 2005, 63 patients (mean age 72, 46 IT, 17 NIT) were enrolled. At baseline, physical function and social function were the most affected domains and most patients had moderate fatigue. IT patients had better physical function and slightly less fatigue at baseline than NIT patients but were similar in 4 QOL domains and global health scores. By 6 months, 44% of IT and 60% of NIT patients had died. Over time, global health, role function, and emotional function improved but physical function, social function, and cognitive function did not change. Improvements in QOL domains were similar for IT and NIT patients for all measures. Fatigue scores remained unchanged over time. Conclusion: Intensive chemotherapy is not associated with worse QOL than NIT in older patients with AML, although our small sample size and attrition bias may overestimate QOL among survivors. Concerns about worse QOL with IT appear to be unfounded and this should not deter clinicians from considering IT for older adults with AML. No significant financial relationships to disclose.