title: Quality of life trajectory in patients with advanced cancer during the last year of life.
abstract: BACKGROUND
  Due to the high mortality of cancer a large number of patients pass a preterminal phase of their illness. Within this phase medical care aims at maintaining patients' quality of life (QOL) and reducing symptom burden. Our study investigated the patient-reported severity of QOL impairments during the last year of life, with a special focus on their course at the end of life.
  
  
  METHODS
  All patients with cancer receiving palliative care at Natters State Hospital (Austria) were considered as eligible for the study. QOL data were collected with the EORTC QLQ-C30 questionnaire as part of computerized patient-reported outcome monitoring (ePROM) within clinical routine. QOL was investigated longitudinally in regard to its course toward death as well as to changes in determinants of global QOL.
  
  
  RESULTS
  Eighty-five patients participated in the ePROM (255 assessments in total). Regarding trajectories, physical, role and cognitive functioning, fatigue and global QOL worsened sharply during the last 3 months of life. A steady decline was found for emotional functioning, pain, appetite loss and taste alterations. The impact of role functioning, sleep disturbances, and taste alterations on global QOL increased within the last 3 months of life.
  
  
  CONCLUSIONS
  Our results indicate that most aspects of QOL are considerably impaired in patients with advanced cancer. Furthermore, they highlight the importance of assessing QOL in general and taste alterations in particular within palliative care.
authors.affiliation: Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria. johannes.giesinger@i-med.ac.at
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Giesinger
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Wintner
authors.forename: Anne S
authors.initials: AS
authors.lastname: Oberguggenberger
authors.forename: Eva M
authors.initials: EM
authors.lastname: Gamper
authors.forename: Michael
authors.initials: M
authors.lastname: Fiegl
authors.forename: Hubert
authors.initials: H
authors.lastname: Denz
authors.forename: Georg
authors.initials: G
authors.lastname: Kemmler
authors.forename: August
authors.initials: A
authors.lastname: Zabernigg
authors.forename: Bernhard
authors.initials: B
authors.lastname: Holzner
mesh_terms: D000368:Aged; D001317:Austria; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology* / Q000523:psychology*; D010166:Palliative Care; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013727:Terminal Care