title: Rankings and symptom assessments of side effects from chemotherapy: insights from experienced patients with ovarian cancer.
abstract: OBJECTIVE
  Although many patients with ovarian cancer achieve favorable responses to primary chemotherapy, the majority of women will experience recurrence of their cancer. Selection of second- or third-line chemotherapy ultimately depends on patient preferences for different side effects. To better understand this process, we evaluated preferences and symptom distress in patients with ovarian cancer.
  
  
  METHODS
  A total of 70 women with ovarian cancer who had previously received at least three cycles of platinum-based chemotherapy and currently undergoing chemotherapy for newly diagnosed or recurrent disease were interviewed in an outpatient chemotherapy clinic. The patients were asked to rank order 27 health states using a modified visual analog scale and to complete the Memorial Symptom Assessment Scale (MSAS).
  
  
  RESULTS
  Most favorable health states included perfect health, clinical remission and complete control of chemotherapy-induced nausea and vomiting (CINV). Least favorable health states included more severe CINV health states and death. Patients on first-line chemotherapy had less symptom distress, and rated sexual dysfunction, fatigue and memory loss more favorably than patients on second- or third-line chemotherapy (P<0.05). Married patients generally had less symptom distress compared to patients who were not married, but married patients indicated more distress with sexual dysfunction (P=0.04). Married patients rated alopecia less favorably than unmarried patients (P=0.03), but married patients viewed certain CINV health states more favorably (P=0.02-0.04).
  
  
  CONCLUSIONS
  CINV remains one of the most dreaded side effects of chemotherapy. Separate preference profiles exist for patients with newly diagnosed and recurrent disease, as well as for married versus unmarried patients. While MSAS scores and VAS rankings showed consistency across some health states, this was not true for CINV, suggesting that current symptom status may only influence patient preferences for selected side effects.
authors.affiliation: Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Unit 440, 1515 Holcombe Boulevard, Houston, Texas, 77030, USA. ccsun@mdanderson.org
authors.forename: Charlotte C
authors.initials: CC
authors.lastname: Sun
authors.forename: Diane C
authors.initials: DC
authors.lastname: Bodurka
authors.forename: Candice B
authors.initials: CB
authors.lastname: Weaver
authors.forename: Rafia
authors.initials: R
authors.lastname: Rasu
authors.forename: Judith K
authors.initials: JK
authors.lastname: Wolf
authors.forename: Michael W
authors.initials: MW
authors.lastname: Bevers
authors.forename: Judith A
authors.initials: JA
authors.lastname: Smith
authors.forename: J Taylor
authors.initials: JT
authors.lastname: Wharton
authors.forename: Edward B
authors.initials: EB
authors.lastname: Rubenstein
mesh_terms: D000328:Adult; D000368:Aged; D000505:Alopecia / Q000139:chemically induced; D064420:Drug-Related Side Effects and Adverse Reactions; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D019529:Sexuality; D014481:United States; D014839:Vomiting / Q000139:chemically induced