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Determinants of quality of life in advanced cancer patients with bone metastases undergoing palliative radiation treatment

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Abstract

Purpose

Assessment of health-related quality of life (HRQOL) is critical to effective delivery of palliative care in patients with advanced cancer. The current study analyzes relationships between baseline social determinants of health and medical factors, and self-reported HRQOL in patients with bone metastases receiving palliative radiotherapy.

Methods and materials

Advanced cancer patients referred for radiotherapy treatment of bone metastases completed the EORTC QLQ-C30 questionnaire in multiple outpatient clinics internationally. Demographics and social determinants were collected as baseline information. Univariate and Bonferroni-adjusted multivariate linear regression analyses were used to detect significant correlations between baseline determinants and different HRQOL domains.

Results

Karnofsky Performance Status (KPS) was correlated with better physical (p = 0.0002), role (p < 0.0001), emotional (p < 0.0001), and social (p < 0.0001) functioning, and global health scores (p = 0.0015) and predicted lower symptom scores for fatigue (p < 0.0001), pain (p < 0.0001), appetite loss (p < 0.0001), and constipation (p < 0.0001). Increased age was predictive of better social functioning (p < 0.0001) and less insomnia (p = 0.0036), higher education correlated with better global health status (p = 0.0043), and patients who were employed or retired had improved physical functioning (p = 0.0004 and p = 0.0030, respectively) and less financial challenges compared to patients who were unemployed (p = 0.0005).

Conclusions

Baseline KPS had the greatest influence on EORTC QLQ-C30 domain scores. Age, education level, and employment status had significant impacts, although on fewer domains. Further studies that investigate baseline determinants are worthwhile to clarify relationships in order to care for patients more effectively at the end of life.

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Acknowledgments

We thank the generous support of Bratty Family Fund, Michael and Karyn Goldstein Cancer Research Fund, Joseph and Silvana Melara Cancer Research Fund, and Ofelia Cancer Research Fund.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada, M4N 3M5

    Kinsey Lam, Edward Chow, Liying Zhang, Erin Wong & Gillian Bedard

  2. Department of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada

    Alysa Fairchild

  3. Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus

    Vassilios Vassiliou

  4. Department of Clinical Oncology, Tanta University Hospital, Tanta Faculty of Medicine, Tanta, Egypt

    Mohamed Alm El-Din

  5. Department of Orthopedic Oncology, Federal University of São Paulo, São Paulo, Brazil

    Reynaldo Jesus-Garcia

  6. Division of Gynaecology and Genitourinary Oncology, Department of Radiation Oncology, Regional Cancer Center, Trivandrum, India

    Aswin Kumar

  7. Inserm CIE3 and Unit of Clinical Research, Innovation, and Pharmacology, Saint Etienne University Hospital, Saint-Etienne, France

    Fabien Forges

  8. Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan

    Ling-Ming Tseng

  9. Department of Gastroenterologic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Ming-Feng Hou

  10. Department of Public Health and Institute of Epidemiology and Preventative Medicine, National Taiwan University, Taipei, Taiwan

    Wei-Chu Chie

  11. European Organisation for Research and Treatment of Cancer, EORTC Headquarters, Brussels, Belgium

    Andrew Bottomley

Authors
  1. Kinsey Lam
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  2. Edward Chow
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  3. Liying Zhang
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  4. Erin Wong
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  5. Gillian Bedard
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  7. Vassilios Vassiliou
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  8. Mohamed Alm El-Din
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  10. Aswin Kumar
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  13. Ming-Feng Hou
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  14. Wei-Chu Chie
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  15. Andrew Bottomley
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Corresponding author

Correspondence to Edward Chow.

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Lam, K., Chow, E., Zhang, L. et al. Determinants of quality of life in advanced cancer patients with bone metastases undergoing palliative radiation treatment. Support Care Cancer 21, 3021–3030 (2013). https://doi.org/10.1007/s00520-013-1876-6

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  • DOI: https://doi.org/10.1007/s00520-013-1876-6

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