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Title: Determinants of quality of life in advanced cancer patients with bone metastases undergoing palliative radiation treatment
Authors: Lam, Kinsey
Chow, Edward
Zhang, Liying
Wong, Erin
Bedard, Gillian
Fairchild, Alysa
Vassiliou, Vassilios
El-Din, Mohamed Alm
Jesus-Garcia, Reynaldo [UNIFESP]
Kumar, Aswin
Forges, Fabien
Tseng, Ling-Ming
Hou, Ming-Feng
Chie, Wei-Chu
Bottomley, Andrew
Univ Toronto
Univ Alberta
Bank Cyprus Oncol Ctr
Tanta Univ Hosp
Universidade Federal de São Paulo (UNIFESP)
Reg Canc Ctr
St Etienne Univ Hosp
Natl Yang Ming Univ
Kaohsiung Med Univ Hosp
Natl Taiwan Univ
European Org Res Treatment Canc
Keywords: Quality of life
Social determinants
Baseline factors
Bone metastases
Advanced cancer
Issue Date: 1-Nov-2013
Publisher: Springer
Citation: Supportive Care in Cancer. New York: Springer, v. 21, n. 11, p. 3021-3030, 2013.
Abstract: 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.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.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).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.
ISSN: 0941-4355
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