title: Aggressive treatment of non-metastatic osteosarcoma improves health-related quality of life in children and adolescents.
abstract: BACKGROUND
  Health-related quality of life (HRQOL) of paediatric patients with osteosarcoma has not been documented longitudinally during treatment. Aims of this prospective study were to assess treatment effects on patients' HRQOL at diagnosis, during therapy and after completion of therapy, to assess sex- and age-related differences in HRQOL ratings and to assess differences between patients' and parents' reports.
  
  
  METHODS
  Sixty-six patients (median age, 13.4 years) with newly diagnosed, localised disease completed three HRQOL instruments, and their parents completed two of the same instruments at diagnosis, before surgery (Week 12), at Week 23 and a median of 20 weeks after treatment completion.
  
  
  RESULTS
  Significant improvements in most domains and worsening of nausea were reported by patients and parents from diagnosis to Weeks 12 and 23. Symptom distress decreased from diagnosis to Weeks 12 and 23 in 81% and 64% of patients, respectively. There were no sex- and few age-related differences in scores. Scores from patients and parents achieved good agreement.
  
  
  CONCLUSIONS
  The HRQOL of patients improves during aggressive treatment for non-metastatic osteosarcoma, except in the domain of nausea. Clinicians can use these findings to prepare their patients for the distressing symptoms that they will likely experience at certain time points and to provide reassurance that these will significantly improve.
authors.affiliation: Department of Nursing Research, Children's National Medical Center, Washington, DC 20010, USA. pshinds@cnmc.org
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Hinds
authors.forename: Jami S
authors.initials: JS
authors.lastname: Gattuso
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Billups
authors.forename: Nancy K
authors.initials: NK
authors.lastname: West
authors.forename: Jianrong
authors.initials: J
authors.lastname: Wu
authors.forename: Cecilia
authors.initials: C
authors.lastname: Rivera
authors.forename: Juan
authors.initials: J
authors.lastname: Quintana
authors.forename: Milena
authors.initials: M
authors.lastname: Villarroel
authors.forename: Najat C
authors.initials: NC
authors.lastname: Daw
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001007:Anxiety; D001859:Bone Neoplasms / Q000188:drug therapy / Q000523:psychology / Q000601:surgery*; D002648:Child; D005260:Female; D006304:Health Status; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D009325:Nausea / Q000209:etiology; D012516:Osteosarcoma / Q000188:drug therapy / Q000523:psychology / Q000601:surgery*; D010146:Pain / Q000209:etiology; D010290:Parents; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors