Quality of life assessment in elderly patients with aggressive non-Hodgkin's Lymphoma treated with anthracycline-containing regimens. Report of a prospective study by the Intergruppo Italiano Linfomi.
OBJECTIVE
The aim of this study was to evaluate quality of life (QOL) in a group of elderly patients (> 65 years) with aggressive non-Hodgkin's lymphoma (NHL) treated with chemotherapy regimens containing anthracyclines.


METHODS
QOL was evaluated in a population of elderly patients with aggressive NHL enrolled in a phase III clinical trial run by the Intergruppo Italiano Linfomi (IIL) from 1996 to 1999 to compare two different anthracycline-containing regimens (mini-CEOP vs P-VEBEC). The EORTC-QLQ-C30 questionnaire, which has already been validated in oncology, was used. The questionnaire was administered at the time of diagnosis, half way through the chemotherapy and at the time of restaging.


RESULTS
Ninety-one patients completed pre-therapy and post-therapy questionnaires and they are the subject of this report. Baseline QOL assessment showed a strong correlation of poor values of QOL with anemia and high risk according to the International Prognostic Index (IPI). At the end of treatment no functional scales showed worse values. A significant improvement was observed for pain (p=0.003), appetite (p=0.006), sleep (p=0.015) and global health (p=0.027). Considering only the 50 patients who achieved a complete remission (CR), an improvement was also recorded for emotional state (p=0.10), role (p=0.05), constipation (p=0.04) and global QOL (p=0.05).


CONCLUSIONS
The EORTC-QLQ-C30 is feasible even in a population of elderly patients, in whom it had never been tested before. The improvement of QOL at the end of the treatment demonstrated that the symptoms of the disease have a greater negative influence on the patient's life than do the side effects of the therapy.
Merli
Francesco
F
Unità Operativa di Ematologia, Ospedale S.Maria Nuova, Reggio Emilia, Italy. merli.francesco@asmn.re.it
Bertini
Marilena
M
Luminari
Stefano
S
Mozzana
Ruggero
R
Bertè
Raffaella
R
Trottini
Massimo
M
Stelitano
Caterina
C
Botto
Barbara
B
Pizzuti
Michele
M
Quintana
Gianni
G
De Paoli
Alberto
A
Federico
Massimo
M
D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001066:Appetite; D001761:Bleomycin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D009367:Neoplasm Staging; D010146:Pain; D011241:Prednisone / Q000008:administration & dosage; D011788:Quality of Life; D012890:Sleep; D011795:Surveys and Questionnaires; D014747:Vinblastine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
D018943:Anthracyclines; D001761:Bleomycin; D015251:Epirubicin; D014750:Vincristine; D014747:Vinblastine; D005047:Etoposide; D003520:Cyclophosphamide; D011241:Prednisone