Quality of life, symptoms and care needs in patients with persistent or recurrent platinum-resistant ovarian cancer: An NRG Oncology/Gynecologic Oncology Group study.

Autor: von Gruenigen VE; Division of Gynecologic Oncology, Summa Health System, NEOMED, Akron, OH 44310, United States. Electronic address: vvongrue@neomed.edu., Huang HQ; NRG Oncology Statistics & Data Center, Roswell Park Cancer Institute, Buffalo, NY 14263, United States. Electronic address: hhuang@gogstats.org., Cella D; Department of Medical Social Sciences, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60612, United States. Electronic address: d-cella@northwestern.edu., Zevon M; Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY 14263, United States. Electronic address: michael.zevon@roswellpark.org., LaChance JA; Program in Women's Oncology, Women and Infants Hospital, Providence, RI 02905, United States. Electronic address: lachaj1@mmc.org., Walker JL; Stephenson Cancer Center, Department of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States. Electronic address: joan-walker@ouhsc.edu., Salani R; Division of Gynecologic Oncology, The Ohio State University Medical Center, Columbus, OH 43210, United States. Electronic address: ritu.salani@osumc.edu., Modesitt SC; Gynecologic Oncology Division, OB/GYN Department, University of Virginia, Charlottesville, VA 22908, United States. Electronic address: scm6h@virginia.edu., Morris RT; Gynecologic Oncology Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, United States. Electronic address: rmorris@med.wayne.edu., Bradley WH; Department of OB/GYN; Medical College of Wisconsin, Milwaukee, WI 53226, United States. Electronic address: wbradley@mcw.edu., Boente MP; U.S. Medical Affairs, Gyn-Oncology, Genentech, South San Francisco, CA 94080-4990, United States. Electronic address: boente.matthew@gene.com., Wenzel L; Population Science and Cancer Control/Chao Family Comprehensive Cancer Center at University of California at Irvine, Irvine, CA 92697, United States. Electronic address: lwenzel@uci.edu.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2018 Jul; Vol. 150 (1), pp. 119-126. Date of Electronic Publication: 2018 May 18.
DOI: 10.1016/j.ygyno.2018.05.017
Abstrakt: Objectives: The goals of treating recurrent platinum-resistant ovarian cancer are palliative, aimed at reducing symptoms and improving progression free survival. A prospective trial was conducted to determine the prevalence and severity of symptoms, and associated care needs.
Methods: Eligible women included those with persistent or recurrent platinum-resistant ovarian cancer with an estimated life expectancy of at least 6 months. The Needs at the End-of-Life Screening Tool (NEST), FACIT-Fatigue (FACIT-F), NCCN-FACT Ovarian Symptom Index [NFOSI-18]; Disease Related Symptoms (DRS), Treatment Side Effects (TSE), and Function/Well Being (F/WB) were collected at study entry, 3 and 6 months.
Results: We enrolled 102 evaluable patients. Initiation of Do Not Resuscitate (DNR) discussions increased over time from 28% at study entry to 37% at 6 months. At study entry, the most common disease-related symptoms were fatigue (92%), worry (89%), and trouble sleeping (76%); 73% reported being "bothered by treatment side effects", which included nausea (41%) and hair loss (51%) neither of which changed over time. The most common NEST unmet needs were in the symptom dimension. The social dimension was associated with F/WB (p = 0.002) and FACIT-F (p = 0.006); symptoms were associated with DRS (p = 0.04), TSE (p = 0.03), and FACIT-F (p = 0.04); existential was not associated with any of the patient-reported symptoms; therapeutic was associated with F/WB (p = 0.02).
Conclusions: In patients nearing the end of life, there are significant associations between disease and treatment related symptoms and unmet patient needs, which do not change substantially over time. Careful exploration of specific end-of-life care needs can improve patient-centered care and QOL.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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