PMID- 30214296
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 1179-1322 (Print)
IS  - 1179-1322 (Electronic)
IS  - 1179-1322 (Linking)
VI  - 10
DP  - 2018
TI  - The predictive value of cumulative toxicity for quality of life in patients with 
      metastatic colorectal cancer during first-line palliative chemotherapy.
PG  - 3015-3021
LID - 10.2147/CMAR.S166468 [doi]
AB  - BACKGROUND: Studies evaluating new systemic agents tend to report severe 
      toxicities only, while the cumulative effect of multiple lower grade adverse 
      events (AEs) may have an additional negative impact on patient quality of life 
      (QOL). In the current observational cohort study, we evaluated whether, in 
      patients with metastatic colorectal cancer receiving first-line chemotherapy, 
      cumulative toxicity comprising all grades of AEs is more predictive for QOL than 
      cumulative toxicity due to only high-grade AEs. METHODS: One hundred and five 
      patients starting treatment completed the European Organization for the Research 
      and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) 
      questionnaire at baseline and 10 weeks. AEs, clinical outcomes, and demographics 
      were retrieved from patient records. Cumulative toxicity scores were calculated 
      in three ways: total number of high-grade AEs, total number of all-grade AEs, and 
      total number of AEs multiplied by their grade (the severity score). Relations 
      between cumulative toxicity scores and QOL were studied using multivariable 
      linear regression analyses. RESULTS: The mean age of patients was 65 years, 68% 
      were male, and 84% received oxaliplatin-based chemotherapy. A higher total number 
      of AEs of all grades (B=-2.4, 95% CI=-3.9; -0.9) and the severity score (B=-1.4, 
      95% CI=-2.3; -0.5) were predictive for clinically relevant changes in physical 
      QOL, whereas the total high-grade AEs was not. None of the cumulative toxicity 
      scores were predictive for global QOL. CONCLUSION: Cumulative toxicity scores 
      comprising all grades of AEs provide a better measure of treatment burden than a 
      toxicity score comprising high-grade AEs only. Physical QOL seems to be more 
      affected by AEs than global QOL. Our results emphasize that future clinical 
      trials should present cumulative toxicity scores comprising all AE grades as well 
      as physical QOL instead of global QOL.
FAU - Schuurhuizen, Claudia Sew
AU  - Schuurhuizen CS
AD  - Department of Medical Oncology, VU University Medical Center, Cancer Center 
      Amsterdam, Amsterdam, The Netherlands, h.verheul@vumc.nl.
AD  - Department of Psychiatry, Amsterdam Public Health Research Institute, VU 
      University Medical Center, Amsterdam, The Netherlands.
FAU - Verheul, Henk Mw
AU  - Verheul HM
AD  - Department of Medical Oncology, VU University Medical Center, Cancer Center 
      Amsterdam, Amsterdam, The Netherlands, h.verheul@vumc.nl.
FAU - Braamse, Annemarie Mj
AU  - Braamse AM
AD  - Department of Medical Psychology, Academic Medical Center Amsterdam, Cancer 
      Center Amsterdam, Amsterdam, The Netherlands.
FAU - Buffart, Laurien M
AU  - Buffart LM
AD  - Department of Medical Oncology, VU University Medical Center, Cancer Center 
      Amsterdam, Amsterdam, The Netherlands, h.verheul@vumc.nl.
AD  - Department of Psychiatry, Amsterdam Public Health Research Institute, VU 
      University Medical Center, Amsterdam, The Netherlands.
AD  - Department of Medical Psychology, Academic Medical Center Amsterdam, Cancer 
      Center Amsterdam, Amsterdam, The Netherlands.
AD  - Department of Epidemiology and Biostatistics, VU University Medical Center, 
      Cancer Center Amsterdam, Amsterdam, The Netherlands.
FAU - Bloemendal, Haiko J
AU  - Bloemendal HJ
AD  - Department of Medical Oncology, Meander Medical Center, Amersfoort, The 
      Netherlands.
FAU - Dekker, Joost
AU  - Dekker J
AD  - Department of Psychiatry, Amsterdam Public Health Research Institute, VU 
      University Medical Center, Amsterdam, The Netherlands.
AD  - Department of Rehabilitation Medicine, VU University Medical Center, Cancer 
      Center Amsterdam, Amsterdam, The Netherlands.
FAU - Konings, Inge Rhm
AU  - Konings IR
AD  - Department of Medical Oncology, VU University Medical Center, Cancer Center 
      Amsterdam, Amsterdam, The Netherlands, h.verheul@vumc.nl.
LA  - eng
PT  - Journal Article
DEP - 20180829
PL  - New Zealand
TA  - Cancer Manag Res
JT  - Cancer management and research
JID - 101512700
PMC - PMC6124444
OTO - NOTNLM
OT  - adverse events
OT  - cumulative toxicity
OT  - metastatic colorectal cancer
OT  - quality of life
OT  - treatment-related toxicity
COIS- Disclosure JD and HV received a grant from the Alpe d'Huzes/Dutch Cancer Society 
      (VU 2011-5279) during the conduction of the study. HV receives grants from Roche, 
      Vitromics Healthcare System, Novartis, Immunovo B.V., Amgen, non-financial 
      support from Pfizer, and honoraria from Boehringer Ingelheim. These resources 
      were all received outside the submitted work. The authors report no other 
      conflicts of interest in this work.
EDAT- 2018/09/15 06:00
MHDA- 2018/09/15 06:01
PMCR- 2018/08/29
CRDT- 2018/09/15 06:00
PHST- 2018/09/15 06:00 [entrez]
PHST- 2018/09/15 06:00 [pubmed]
PHST- 2018/09/15 06:01 [medline]
PHST- 2018/08/29 00:00 [pmc-release]
AID - cmar-10-3015 [pii]
AID - 10.2147/CMAR.S166468 [doi]
PST - epublish
SO  - Cancer Manag Res. 2018 Aug 29;10:3015-3021. doi: 10.2147/CMAR.S166468. 
      eCollection 2018.