Assessment of factors that contribute to decreased quality of life in Gynecologic Oncology Group ovarian cancer trials.
BACKGROUND
The objective of this study was to assess which quality-of-life (QOL) line items on the Functional Assessment of Cancer Therapy-Ovarian (FACT-O) were associated with low QOL in women who were receiving chemotherapy for ovarian cancer.


METHODS
Patients with stage III or IV ovarian cancer on Gynecologic Oncology Group Protocols 152 and 172 who underwent primary surgery followed by intravenous paclitaxel and cisplatin completed the FACT-O. The FACT scale includes the 4 domains of physical, functional, social, and emotional well being (PWB, FWB, SWB, EWB, respectively). Women who had overall FACT-O scores in the lowest quartile (Q1) were compared with women in the upper 3 quartiles (Q2-Q4). The proportions of women in each group that selected the 2 worst categories for each item were compared. The level of significance was set at P<.005.


RESULTS
Before Cycle 4, 361 patients (86.4%) provided valid QOL assessments. For PWB, a significantly greater proportion of women in Q1 versus Q2 through Q4 selected the 2 worst categories of several physical symptoms (nausea, pain, feeling ill, and being bothered by the side effects of treatment). For FWB, significant differences included being able to work, being content with the quality of their life, and sleeping well. For EWB, there were significant differences in feeling nervous and worrying about dying. There were virtually no differences between groups in SWB. Low interest in sex was reported by 56% to 88% of all patients (Q1-Q4).


CONCLUSIONS
A large proportion of women with FACT-O scores in the lowest quartile reported problems that potentially were amenable to clinical interventions, such as symptom management and psychosocial support.
von Gruenigen
Vivian E
VE
Department of Reproductive Biology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio 44106, USA. vivian.vongruenigen@uhhospitals.org
Huang
Helen Q
HQ
Gil
Karen M
KM
Gibbons
Heidi E
HE
Monk
Bradley J
BJ
Rose
Peter G
PG
Armstrong
Deborah K
DK
Cella
David
D
Wenzel
Lari
L
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001007:Anxiety / Q000150:complications; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000523:psychology*; D017239:Paclitaxel / Q000008:administration & dosage; D011788:Quality of Life; D012944:Social Support
D017239:Paclitaxel; D002945:Cisplatin
Am J Clin Oncol. 1982 Dec;5(6):649-55
7165009
J Clin Oncol. 2004 Mar 1;22(5):881-9
14990644
Qual Life Res. 1996 Jun;5(3):321-9
8763800
N Engl J Med. 2004 Dec 9;351(24):2489-97
15590951
Support Cancer Ther. 2005 Apr 1;2(3):181-7
18628170
J Clin Oncol. 2008 Aug 10;26(23):3886-95
18688057
J Clin Oncol. 2005 Aug 20;23(24):5605-12
16110020
Support Care Cancer. 2005 Apr;13(4):219-27
15538640
J Clin Oncol. 2007 Feb 1;25(4):437-43
17264340
Gynecol Oncol. 2006 Oct;103(1):120-6
16556458
Psychooncology. 2002 Mar-Apr;11(2):142-53
11921330
J Support Oncol. 2007 Feb;5(2 Suppl 1):5-12
17366928
J Clin Oncol. 2001 Mar 15;19(6):1809-17
11251013
Eur J Oncol Nurs. 2008 Dec;12(5):443-8
18842457
J Natl Compr Canc Netw. 2007 Nov;5(10):1054-78
18053429
Expert Rev Anticancer Ther. 2008 Feb;8(2):227-41
18279064
J Clin Oncol. 2007 May 20;25(15):2049-56
17513809
J Clin Oncol. 1993 Mar;11(3):570-9
8445433
Health Qual Life Outcomes. 2003 Dec 16;1:79
14678568
N Engl J Med. 2006 Jan 5;354(1):34-43
16394300
Oncol Nurs Forum. 2008 Nov;35(6):909-15
18980921