title: Health-related quality of life before and during adjuvant interferon-α treatment for patients with malignant melanoma (DeCOG-trial).
abstract: Adjuvant treatment with interferon-α (IFN-α) for patients with malignant melanoma can improve relapse-free and overall survival, but IFN-associated side effects may reduce patient's quality of life. The aim of the study was to prospectively evaluate health-related quality of life (HRQoL) in patients with melanoma before and during Low-Dose IFN-α therapy. In a prospective multicenter trial conducted by the Dermatologic Cooperative Oncology Group, 850 patients with cutaneous stage II malignant melanoma received a standard Low-Dose of IFN-α-2a. We evaluated HRQoL using the European Organization for Research and Treatment of Cancer Quality of Life Core 30 questionnaire at baseline and after 3, 6, and 12 months of IFN-α treatment in 282 patients. Nine of 15 subscales showed significant poorer results after 3 months of adjuvant IFN treatment. Symptoms included reduced physical functioning, reduced cognitive functioning, fatigue, nausea, pain, dyspnea, insomnia, diarrhea, and loss of appetite. We did not find a significant change over time for role, emotional, or social functioning. Only cognitive functioning and dyspnea continuously worsened through the twelfth month. At baseline women had significantly lower scores for physical and emotional functioning and for fatigue compared with men. During treatment, women scored significantly poorer on physical functioning, emotional functioning, fatigue, pain, and constipation subscales. Patients who reported having a bad or very bad QoL before treatment were 5.8 times more likely to discontinue treatment early because of psychiatric problems. We conclude that adjuvant low-dose IFN treatment is associated with significant deterioration of HRQoL. Specific psychosocial care should be offered especially for patients who report lower HRQoL and emotional problems before treatment to prevent early discontinuation.
authors.affiliation: Department of Psychiatry, Charité Campus Mitte, Charité-University Medicine Berlin, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Ziefle
authors.forename: Friederike
authors.initials: F
authors.lastname: Egberts
authors.forename: Sarah
authors.initials: S
authors.lastname: Heinze
authors.forename: Matthias
authors.initials: M
authors.lastname: Volkenandt
authors.forename: Monika
authors.initials: M
authors.lastname: Schmid-Wendtner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Tilgen
authors.forename: Ruthild
authors.initials: R
authors.lastname: Linse
authors.forename: Jörg
authors.initials: J
authors.lastname: Boettjer
authors.forename: Thomas
authors.initials: T
authors.lastname: Vogt
authors.forename: Konstanze
authors.initials: K
authors.lastname: Spieth
authors.forename: Thomas
authors.initials: T
authors.lastname: Eigentler
authors.forename: Norbert H
authors.initials: NH
authors.lastname: Brockmeyer
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
authors.forename: Axel
authors.initials: A
authors.lastname: Hauschild
authors.forename: Martin
authors.initials: M
authors.lastname: Schaefer
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008545:Melanoma / Q000188:drug therapy*; D008875:Middle Aged; D011788:Quality of Life; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D007155:Immunologic Factors; D016898:Interferon-alpha