Oral oncology · 2020
Frailty is associated with decline in health-related quality of life of patients treated for head and neck cancer.
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de Vries Julius, Bras Linda, Sidorenkov Grigory, Festen Suzanne, Steenbakkers Roel J H M, Langendijk Johannes A, Witjes Max J H, van der Laan Bernard F A M, de Bock Geertruida H, Halmos Gyorgy B
Аннотация
OBJECTIVE: To determine the effect of frailty on Health Related Quality of Life (HRQoL) after treatment for Head and Neck Cancer (HNC).
MATERIALS AND METHODS: Patients were prospectively included in OncoLifeS, a data-biobank. Before treatment, patients underwent geriatric screening, including the Groningen Frailty Indicator (GFI) and Geriatric 8 (G8). Patients' HRQoL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) at three, six, twelve and twenty four months after treatment. Linear mixed models were used for statistical analysis. All models were adjusted for baseline HRQoL values, relevant confounders at baseline and yielded estimates (β), 95% confidence intervals and p-values.
RESULTS: 288 patients were included. The mean age was 68.4 years and 68.8% were male. During follow-up, 84 patients had tumor recurrence and 66 died. Response to EORTC-QLQ-C30 ranged from 77.3% to 87.8%. Frail patients, defined by GFI, had significantly worse Global Health Status/Quality of Life (GHS/QoL) (β = -8.70(-13.54;-3.86), p < 0.001), physical functioning (β = -4.55(-8.70;-0.40), p < 0.032), emotional functioning (β = -20.06(-25.65;-15.86), p < 0.001), and social functioning (β = -8.44(-13.91;-2.98), p < 0.003) three months after treatment compared to non-frail patients. Furthermore, frail patients had a significantly worse course of GHS/QoL (β = -7.47(-11.23;-3.70), p = 0.001), physical functioning (β = -3.28(-6.26;-0.31), p = 0.031) and role functioning (β = -7.27(-12.26;-2.28), p = 0.005) over time, compared to non-frail patients. When frailty was determined by G8, frailty was significantly associated with worse GHS/QoL (β = -6.68(-11.00;-2.37), p = 0.003) and emotional functioning (β = -5.08(-9.43;-0.73), p = 0.022) three months after treatment.
CONCLUSION: Frail patients are at increased risk for decline in HRQoL, and further deterioration during follow-up after treatment for HNC.
MATERIALS AND METHODS: Patients were prospectively included in OncoLifeS, a data-biobank. Before treatment, patients underwent geriatric screening, including the Groningen Frailty Indicator (GFI) and Geriatric 8 (G8). Patients' HRQoL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) at three, six, twelve and twenty four months after treatment. Linear mixed models were used for statistical analysis. All models were adjusted for baseline HRQoL values, relevant confounders at baseline and yielded estimates (β), 95% confidence intervals and p-values.
RESULTS: 288 patients were included. The mean age was 68.4 years and 68.8% were male. During follow-up, 84 patients had tumor recurrence and 66 died. Response to EORTC-QLQ-C30 ranged from 77.3% to 87.8%. Frail patients, defined by GFI, had significantly worse Global Health Status/Quality of Life (GHS/QoL) (β = -8.70(-13.54;-3.86), p < 0.001), physical functioning (β = -4.55(-8.70;-0.40), p < 0.032), emotional functioning (β = -20.06(-25.65;-15.86), p < 0.001), and social functioning (β = -8.44(-13.91;-2.98), p < 0.003) three months after treatment compared to non-frail patients. Furthermore, frail patients had a significantly worse course of GHS/QoL (β = -7.47(-11.23;-3.70), p = 0.001), physical functioning (β = -3.28(-6.26;-0.31), p = 0.031) and role functioning (β = -7.27(-12.26;-2.28), p = 0.005) over time, compared to non-frail patients. When frailty was determined by G8, frailty was significantly associated with worse GHS/QoL (β = -6.68(-11.00;-2.37), p = 0.003) and emotional functioning (β = -5.08(-9.43;-0.73), p = 0.022) three months after treatment.
CONCLUSION: Frail patients are at increased risk for decline in HRQoL, and further deterioration during follow-up after treatment for HNC.
Предметные рубрики MeSH
AgedCognitionConfidence IntervalsFemaleFrailtyGeriatric AssessmentHead and Neck NeoplasmsHealth StatusHumansMaleNeoplasm Recurrence, LocalPhysical Functional PerformanceProspective StudiesQuality of LifeSalivary Gland NeoplasmsSkin NeoplasmsSocial InteractionSquamous Cell Carcinoma of Head and NeckSurveys and QuestionnairesTime Factors