Trajectories of health-related quality of life and symptom burden in patients with advanced cancer towards the end of life: Longitudinal results from the eQuiPe study.

Autor: Versluis MAJ; Research & Development, The Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.; Graduate School of Social & Behavioral Sciences, Tilburg University, Tilburg, The Netherlands., Raijmakers NJH; Research & Development, The Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.; Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands., Baars A; Department of Internal Medicine, Hospital Gelderse Vallei, Ede, The Netherlands., van den Beuken-van Everdingen MHJ; Centre of Expertise in Palliative Care, Maastricht University Medical Centre, Maastricht, The Netherlands., de Graeff A; Department of Medical Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands., Hendriks MP; Department of Medical Oncology, Northwest Clinics, Alkmaar, The Netherlands., de Jong WK; Department of Pulmonology, Hospital Gelderse Vallei, Ede, The Netherlands., Kloover JS; Department of Medical Oncology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands., Kuip EJM; Department of Medical Oncology and Department of Anesthesiology, Pain and Palliative Care, Radboud University Medical Centre, Nijmegen, The Netherlands., Mandigers CMPW; Department of Medical Oncology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands., Sommeijer DW; Department of Medical Oncology, Amsterdam University Medical Centre, Amsterdam, The Netherlands.; Department of Internal Medicine, Flevoziekenhuis, Almere, The Netherlands., van der Linden YM; Research & Development, The Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.; Centre of Expertise in Palliative Care, Leiden University Medical Centre, Leiden, The Netherlands.; Department of Radiotherapy, Leiden University Medical Centre, Leiden, The Netherlands., van de Poll-Franse LV; Research & Development, The Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.; Department of Medical and Clinical Psychology, CoRPS - Center for Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands.; Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2024 Feb 15; Vol. 130 (4), pp. 609-617. Date of Electronic Publication: 2023 Oct 13.
DOI: 10.1002/cncr.35060
Abstrakt: Background: Support for health-related quality of life (HRQOL) is an essential part of cancer care in the final stages of life, yet empirical guidance regarding HRQOL and symptom trajectories is lacking.
Aim: To assess the change in HRQOL and symptom burden in the last year of life in patients with advanced cancer and its association with health care-related factors, cancer-specific treatment, and comorbidity.
Methods: A prospective, multicenter, observational study in patients with advanced cancer (eQuiPe). Three monthly questionnaires included European Organization for Research and Treatment of Cancer Quality of Life-C30 and reported continuity of care. Multivariable mixed-effects analysis was used to assess the association between HRQOL and health care-related factors.
Results: A total of 762 deceased patients were included with a mean age of 66 (SD, 10) years and 52% were male. The most common primary tumors were lung (29%), colorectal (20%), and breast cancer (13%). Mean overall HRQOL decreased in the last 9 months of life, with the greatest decrease in the last 3 months (β -16.2). Fatigue, pain, appetite loss, dyspnea, constipation, and nausea worsened significantly in the last year of life. Multimorbidity (β -7.5) and a better reported continuity of care (β 0.7) were both significantly associated with the trajectory of HRQOL.
Conclusion: Mean overall HRQOL begins to decline 9 months before death, highlighting the need for early identification and (re)assessment of different symptoms as aspects of HRQOL follow different trajectories. Multimorbidity and reported continuity of care may be associated with the trajectory of HRQOL.
(© 2023 American Cancer Society.)
Databáze: MEDLINE
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