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Do elderly patients with metastatic cancer have worse quality of life scores?

https://arctichealth.org/en/permalink/ahliterature129678
Source
Support Care Cancer. 2012 Sep;20(9):2121-7
Publication Type
Article
Date
Sep-2012
Author
Kaitlin Koo
Liang Zeng
Emily Chen
Liying Zhang
Shaelyn Culleton
Kristopher Dennis
Amanda Caissie
Janet Nguyen
Lori Holden
Florencia Jon
May Tsao
Elizabeth Barnes
Cyril Danjoux
Arjun Sahgal
Edward Chow
Author Affiliation
Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Source
Support Care Cancer. 2012 Sep;20(9):2121-7
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Bone Neoplasms - radiotherapy - secondary
Brain Neoplasms - radiotherapy - secondary
Female
Humans
Male
Middle Aged
Ontario
Quality of Life
Questionnaires
Regression Analysis
Self Report
Young Adult
Abstract
The purpose of this study is to compare self-reported quality of life (QOL) scores in old and young patients with metastatic cancer using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C15-PAL questionnaire.
Patients receiving palliative radiotherapy (RT) for bone metastases and brain metastases completed the QLQ-C15-PAL questionnaire prior to treatment. Using multiple linear regression analysis, a parametric test, the QLQ-C15-PAL scores were compared using 65 and 70 years as cutoff ages.
A total of 340 patients were referred for palliative RT for bone metastases (n = 190) or brain metastases (n = 150). Physical functioning and appetite were worse in the older group using either 65 or 70 years as the cutoff age. Age-related differences in the QLQ-C15-PAL scores varied as a function of age cutoff used and location of metastatic site irradiated.
Based on the (EORTC) QLQ-C15-PAL, elderly advanced cancer patients have a different QOL profile. Similar observations have been reported with the (EORTC) QLQ-C30 questionnaire.
PubMed ID
22081058 View in PubMed
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A multicenter assessment of the adequacy of cancer pain treatment using the pain management index.

https://arctichealth.org/en/permalink/ahliterature144076
Source
J Palliat Med. 2010 May;13(5):589-93
Publication Type
Article
Date
May-2010
Author
Gunita Mitera
Alysa Fairchild
Carlo DeAngelis
Urban Emmenegger
Laura Zurawel-Balaura
Liying Zhang
Andrea Bezjak
Wilfred Levin
Michael Mclean
Nadil Zeiadin
Jocelyn Pang
Janet Nguyen
Emily Sinclair
Edward Chow
Rebecca Wong
Author Affiliation
Department of Radiation Therapy, Odette Cancer Center, University of Toronto, Toronto, Ontario, Canada. Gunita.Mitera@sunnybrook.ca
Source
J Palliat Med. 2010 May;13(5):589-93
Date
May-2010
Language
English
Publication Type
Article
Keywords
Aged
Canada
Female
Humans
Licensure, Medical
Male
Middle Aged
Neoplasms - complications
Pain - diagnosis - etiology
Pain Management
Pain Measurement
Palliative Care
Prospective Studies
Quality of Life - psychology
Severity of Illness Index
Treatment Outcome
Abstract
Determine adequacy of management of pain secondary to bone metastases by physicians referring to specialized outpatient palliative radiotherapy (RT) clinics in Canada; compare geographic differences in adequacy of pain management and pain severity between these cohorts; compare results with published international literature.
Prospectively collected data from three participating centers were used to calculate the Pain Management Index (PMI) by subtracting the patient-rated pain score at time of initial clinic visit from the analgesic score. Scores were 0, 1, 2, and 3 when patients reported no pain (0), mild (1-4), moderate (5-6), or severe pain (7-10), respectively, on the Edmonton Symptom Assessment System or Brief Pain Inventory. Analgesic scores of 0, 1, 2, and 3 were assigned for no pain medication, nonopioids, weak opioids, and strong opioids respectively. A negative PMI suggests inadequate pain management.
Overall incidence of negative PMI and moderate to severe pain was 25.1% and 70.9% respectively for 2011 patients. Comparing the three participating centers, the incidence of negative PMI was 31.0%, 20.0%, and 16.8% (p
PubMed ID
20408764 View in PubMed
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Quality of life in patients with brain metastases using the EORTC QLQ-BN20+2 and QLQ-C15-PAL.

https://arctichealth.org/en/permalink/ahliterature128723
Source
Int J Radiat Oncol Biol Phys. 2012 Jul 15;83(4):1238-45
Publication Type
Article
Date
Jul-15-2012
Author
Amanda Caissie
Janet Nguyen
Emily Chen
Liying Zhang
Arjun Sahgal
Mark Clemons
Marc Kerba
Palmira Foro Arnalot
Cyril Danjoux
May Tsao
Elizabeth Barnes
Lori Holden
Brita Danielson
Edward Chow
Author Affiliation
Rapid Response Radiotherapy Program, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Source
Int J Radiat Oncol Biol Phys. 2012 Jul 15;83(4):1238-45
Date
Jul-15-2012
Language
English
Publication Type
Article
Keywords
Aged
Brain Neoplasms - radiotherapy - secondary
Canada
Cognition - physiology - radiation effects
Cranial Irradiation - adverse effects - methods
Female
Forecasting
Humans
Male
Middle Aged
Quality of Life
Questionnaires - standards
Regression Analysis
Spain
Uncertainty
Abstract
The 20-item European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Brain Neoplasm (QLQ-BN20) is a validated quality-of-life (QOL) questionnaire for patients with primary brain tumors. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15 Palliative (QLQ-C15-PAL) core palliative questionnaire is a 15-item version of the core 30-item QLQ-C30 and was developed to decrease the burden on patients with advanced cancer. The combination of the QLQ-BN20 and QLQ-C30 to assess QOL may be too burdensome for patients. The primary aim of this study was to assess QOL in patients before and after treatment for brain metastases using the QLQ-BN20+2 and QLQ-C15-PAL, a version of the QLQ-BN20 questionnaire with 2 additional questions assessing cognitive functioning that were not addressed in the QLQ-C15-PAL.
Patients with brain metastases completed the QLQ-C15-PAL and QLQ-BN20+2 questionnaires to assess QOL before and 1 month after radiation. Linear regression analysis was used to assess changes in QOL scores over time, as well as to explore associations between the QLQ-BN20+2 and QLQ-C15-PAL scales, patient demographics, and clinical variables. Spearman correlation assessed associations between the QLQ-BN20+2 and QLQ-C15-PAL scales.
Among 108 patients, the majority (55%) received whole-brain radiotherapy only, with 65% of patients completing follow-up at 1 month after treatment. The most prominent symptoms at baseline were future uncertainty (QLQ-BN20+2) and fatigue (QLQ-C15-PAL). After treatment, significant improvement was seen for the QLQ-C15-PAL insomnia scale, as well as the QLQ-BN20+2 scales of future uncertainty, visual disorder, and concentration difficulty. Baseline Karnofsky Performance Status was negatively correlated to QLQ-BN20+2 motor dysfunction but positively related to QLQ-C15-PAL physical functioning and QLQ-BN20+2 cognitive functioning at baseline and follow-up. QLQ-BN20+2 scales of future uncertainty and motor dysfunction correlated with the most QLQ-C15-PAL scales, including overall QOL (negative association) at baseline and follow-up.
After radiation, the questionnaires showed maintenance of QOL and improvement of QOL scores such as future uncertainty, which featured prominently in this patient population. It is proposed that the 37-item QLQ-BN20+2 and QLQ-C15-PAL, as opposed to the 50-item QLQ-BN20 and QLQ-C30, may be used together as a universal QOL assessment tool in this setting.
PubMed ID
22172909 View in PubMed
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Self-reported rates of sleep disturbance in patients with symptomatic bone metastases attending an outpatient radiotherapy clinic.

https://arctichealth.org/en/permalink/ahliterature134687
Source
J Palliat Med. 2011 Jun;14(6):708-14
Publication Type
Article
Date
Jun-2011
Author
Luluel Khan
Cassandra Uy
Janet Nguyen
Edward Chow
Liying Zhang
Liang Zeng
Nadia Salvo
Shaelyn Culleton
Florencia Jon
Karrie Wong
Cyril Danjoux
May Tsao
Elizabeth Barnes
Arjun Sahgal
Lori Holden
Author Affiliation
Rapid Response Radiotherapy Program, Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Source
J Palliat Med. 2011 Jun;14(6):708-14
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Ambulatory Care
Bone and Bones - physiopathology
Female
Humans
Male
Middle Aged
Neoplasm Metastasis - radiotherapy
Ontario - epidemiology
Patients - psychology
Self Report
Sleep Disorders - epidemiology
Abstract
To examine the reported rates and predictive factors for sleep disturbance in patients with bone metastases.
Patients with symptomatic bone metastases treated with palliative radiotherapy (RT) were eligible. At initial consultation, demographic information, baseline Brief Pain Inventory (BPI) questionnaire, and analgesic consumption were recorded. The BPI functional interference sleep item was categorized into none (0), mild (1-3), moderate (4-6), and severe (7-10). Follow-up BPI was collected in person or via telephone post-RT at week 4, 8, and 12. Subgroup analysis for BPI between responders and nonresponders was performed. Ordinal logistic regression analysis was used to search for the relationship between sleep disturbance and other covariates.
Four hundred patients were enrolled between May 2003 and June 2007. Two hundred thirty-five males (59%) were accrued. The median age was 68 years old (range, 30-91). Within the study population, primary cancer sites included breast (25%), lung (25%), prostate (24%), bladder (4%), pancreas/gastric (3%), and other primaries (18%). In the BPI functional interference items, the mean baseline score for sleep disturbance was 4.8. When categorized in terms of severity, 99 (25%) patients had moderate sleep disturbance and 144 (36%) patients had severe sleep disturbance, respectively. There was an improvement in sleep scores for both responders and nonresponders at week 4 and 8, but scores worsened for nonresponders at week 12.
Age, Karnofsky Performance Scale (KPS), pain score, and lung primary were the significant variables associated with sleep disturbance. The scores for sleep disturbance improved significantly post-RT in responders at week 4 and 12.
PubMed ID
21554034 View in PubMed
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