title: Monitoring physical and psychosocial symptom trajectories in ovarian cancer patients receiving chemotherapy.
abstract: BACKGROUND
  Diagnosis and treatment of ovarian cancer (OC) entail severe symptom burden and a significant loss of quality of life (QOL). Somatic and psychological impairments may persist well beyond active therapy. Although essential for optimal symptom management as well as for the interpretation of treatment outcomes, knowledge on the course of QOL-related issues is scarce. This study aimed at assessing the course of depressive symptoms, anxiety, fatigue and QOL in patients with OC over the course of chemotherapy until early after-care.
  
  
  METHODS
  23 patients were assessed longitudinally (eight time points) with regard to symptom burden (depression, anxiety, fatigue, and QOL) by means of patient-reported outcome instruments (HADS, MFI-20, EORTC QLQ-C30/-OV28) and clinician ratings (HAMA/D) at each chemotherapy cycle and at the first two aftercare visits.
  
  
  RESULTS
  Statistically significant decrease over time was found for depressive symptoms and anxiety as well as for all fatigue scales. With regard to QOL, results indicated significant increase for 11 of 15 QOL scales, best for Social (effect size = 1.95; p < 0.001), Emotional (e.s. = 1.62; p < 0.001) and Physical Functioning (e.s. = 1.47; p < 0.001). Abdominal Symptoms (e.s. = 1.01; p = 0.009) decreased, Attitudes towards Disease and Treatment (e.s. = 1.80; p < 0.001) improved significantly over time. Analysis of Sexual Functioning was not possible due to a high percentage of missing responses (61.9%).
  
  
  CONCLUSIONS
  The present study underlines the importance of longitudinal assessment of QOL in order to facilitate the identification of symptom burden in OC patients. We found that patients show high levels of fatigue, anxiety and depressive symptoms and severely impaired QOL post-surgery (i.e. at start of chemotherapy) but condition improves considerably throughout chemotherapy reaching nearly general population symptoms levels until aftercare.
authors.affiliation: Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Verena
authors.initials: V
authors.lastname: Meraner
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Gamper
authors.forename: Anna
authors.initials: A
authors.lastname: Grahmann
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Giesinger
authors.forename: Petra
authors.initials: P
authors.lastname: Wiesbauer
authors.forename: Monika
authors.initials: M
authors.lastname: Sztankay
authors.forename: Alain G
authors.initials: AG
authors.lastname: Zeimet
authors.forename: Barbara
authors.initials: B
authors.lastname: Sperner-Unterweger
authors.forename: Bernhard
authors.initials: B
authors.lastname: Holzner
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology*; D017281:Cost of Illness; D003866:Depressive Disorder / Q000209:etiology*; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D018434:Sickness Impact Profile