Changes in quality of life during palliative chemotherapy for solid cancer.
BACKGROUND
We conducted this prospective study to assess the changes in quality of life (QOL), anxiety and depression in patients receiving palliative chemotherapy for solid cancers.


METHODS
Patients were eligible if they had histologically confirmed metastatic or recurrent cancer and a life expectancy of more than 6 months, and were able to complete the self-administered questionnaires. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) and Hospital Anxiety and Depression Scale (HADS) were used to measure the effects of chemotherapy on the patients' QOL, anxiety and depression at baseline and three times after every three cycles of chemotherapy.


RESULTS
From July 2001 to October 2003, 146 patients were recruited, and of these 98 completed the questionnaires and 48 were withdrawn from the trial (27 lost to follow-up, 11 withdrew consent, 5 for toxicity, 5 for progression of the cancer). Their median age was 58 years (range 28-78 years) and the male to female ratio was 1.6. Of the 146 patients, 52 had gastric cancer, 39 non-small-cell cancer, 29 colorectal cancer, 11 breast cancer, and 15 had other cancers. Initial QOL scores were closely related to performance status. Compared with baseline, clinically meaningful relief (score decreased by more than 10) of symptoms such as pain and sleep disturbance was observed. There was significant improvement (score increased by more than 10) in the functional scales after the first cycle of chemotherapy, but these effects did not persist throughout the whole course of therapy. The incidences of probable anxiety and depression disorder before chemotherapy were 20% and 29%, respectively. The anxiety scores decreased throughout the period of intervention. Pretreatment anxiety and depression were negatively correlated with baseline QOL scores.


CONCLUSIONS
Palliative chemotherapy treatment in patients with solid cancer improved cancer-related symptoms, lessened anxiety and did not disturb the QOL of cancer patients.
Bang
Soo-Mee
SM
Department of Internal Medicine, Ghil Medical Center, Gachon Medical School, 405-760 Incheon, South Korea. smbang@ghil.com
Park
Se Hoon
SH
Kang
Hee Geun
HG
Jue
Jung In
JI
Cho
In Hee
IH
Yun
Young Ho
YH
Cho
Eun Kyung
EK
Shin
Dong Bok
DB
Lee
Jae Hoon
JH
D000328:Adult; D000368:Aged; D001007:Anxiety; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D010166:Palliative Care; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life