Original Report

Adverse events from systemic treatment of cancer and patient-reported quality of life


 

Background Treatment-related adverse events have a negative impact the quality of life of cancer patients. Patient and general public views can help in the investigation of patient needs and preferences.

Objective To compare the impact on QoL reported by cancer patients who have experienced a particular AE with that envisioned by general public participants (hypothetical patients) who have not experienced AEs.

Methods Five AEs were selected: total alopecia (Common Terminology Criteria for Adverse Events grade 2), acneiform rash (CTCAE, grade 1 and grades 2-4), oxaliplatin-associated peripheral neuropathy (oxaliplatin-specific scale, grades 1, 2, and 4); diarrhea and vomiting (CTCAE, grades 1-2 and grades 3-4), resulting in 10 toxicity variables. Cancer patients and general public participants completed the Visual Analog Scale (VAS; 0 = poorest QoL; 100 = better QoL), and cancer patients also completed the EQ-5D-5L questionnaire (full range for Spanish population, -0.654-1.000).

Results 246 general public participants and 200 toxic events in 139 cancer patients were analyzed. For all 10 endpoints, the mean VAS was higher for patients than for the general public participants. That difference was statistically significant (Mann- Withney U test) for all endpoints except for grade 1 neuropathy and grade 1 rash. For both groups, alopecia had a lower impact on quality of life than did severe rash (mean VAS for patients, 77 [alopecia] vs 59 [rash], compared with 55 vs 47, respectively, for the general public group). There was a positive linear correlation between the EQ-5D-5L and VAS (Spearman rho, 0.681; P = .001).

Limitations Patients were asked to score AEs as separate and encapsulated from other concurrent symptoms. This exercise may be rather difficult for patients.

Conclusions The impact of therapy-related AEs on QoL was lower in patients who have experienced the AEs than it was for the general public participants who had not experienced the AEs. The EQ-5D-5L is a useful tool for evaluating AEs.

Funding/sponsorship Provided by the Oncologic Association Dr Amadeu Pelegrí (AODAP), a charitable organization led by cancer patients and based in Salou, Spain.

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