Pretreatment factors significantly influence quality of life in cancer patients: a Radiation Therapy Oncology Group (RTOG) analysis.
OBJECTIVE
The purpose of this analysis was to assess the impact of pretreatment factors on quality of life (QOL) in cancer patients.


METHODS
Pretreatment QOL (via Functional Assessment of Cancer Therapy [FACT], version 2) was obtained in 1,428 patients in several prospective Radiation Therapy Oncology Group (RTOG) trials including nonmetastatic head-and-neck (n = 1139), esophageal (n = 174), lung (n = 51), rectal (n = 47), and prostate (n = 17) cancer patients. Clinically meaningful differences between groups were defined as a difference of 1 standard error of measurement (SEM).


RESULTS
The mean FACT score for all patients was 86 (20.7-112) with SEM of 5.3. Statistically significant differences in QOL were observed based on age, race, Karnofsky Performance Status, marital status, education level, income level, and employment status, but not by gender or primary site. Using the SEM, there were clinically meaningful differences between patients </=50 years vs. >/=65 years. Hispanics had worse QOL than whites. FACT increased linearly with higher Karnofsky Performance Status and income levels. Married patients (or live-in relationships) had a better QOL than single, divorced, or widowed patients. College graduates had better QOL than those with less education.


CONCLUSIONS
Most pretreatment factors meaningfully influenced baseline QOL. The potentially devastating impact of a cancer diagnosis, particularly in young and minority patients, must be addressed.
Radiation Oncology, Henry Ford Health System, Detroit, MI, USA. bmovasas1@hfhs.org
Benjamin
B
Movsas
Charles
C
Scott
Deborah
D
Watkins-Bruner
D000230:Adenocarcinoma / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy; D004938:Esophageal Neoplasms / Q000532:radiotherapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000532:radiotherapy*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012004:Rectal Neoplasms / Q000532:radiotherapy; D012959:Socioeconomic Factors; D016896:Treatment Outcome