ANTICANCER RESEARCH 27: 1127-1132 (2007)
Evaluation of the Quality of Life Between Inpatients and Outpatients Receiving Cancer Chemotherapy in Japan HIDETAKA URAMOTO, SEIJI KAGAMI, ATSUSHI IWASHIGE and JUNICHI TSUKADA
Cancer Chemotherapy Center, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu 807-8555, Japan
Abstract. A quality of life (QOL) assessment has become increasingly common in cancer clinical trials. Seventy-four consecutive patients treated for cancer between August 2005 and January 2006 at the Cancer Chemotherapy Center in the University of Occupational and Environmental Health, Japan, were examined. The 8-Short form health survey (SF-8) was utilized as a comprehensive scale and quality of life questionnaire for cancer patients treated with anticancer drugs (QOL-ACD) as disease specific scale for the QOL evaluation. The QOL for outpatients was investigated in comparison with that for inpatients. All questionnaires were collected and baseline questionnaires were filled in by 98.1% of the subjects. The physical comprehensive score (PCS) of SF-8 for the outpatients was higher than that for the inpatients. The physical condition of the outpatients was better than that of inpatients. There was no difference in the baseline scores of the QOL-ACD scales in daily activity, psychological condition, social attitude, and face scale of the analyzed domains between the two groups. Furthermore, a longitudinal study from admission to outpatient was carried out on 27 patients who were treated on an outpatient basis in our clinic. No difference in the baseline scores of the SF-8 and QOLACD scales were observed in any of the analyzed domains. These data suggest that the present QOL study has a sufficient feasibility for the outpatients evaluated in our study, and QOL of outpatients after discharge is equal to that of inpatients receiving cancer chemotherapy.
Abbreviations: QOL, quality of life; SF-8, 8-Short form health survey; QOL-ACD, quality of life questionnaire for cancer patients treated with anticancer drugs; PCS, physical comprehensive score; MCS, mental comprehensive score. Correspondence to: Hidetaka Uramoto, Cancer Chemotherapy Center, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu 807-8555, Japan. Tel: +81 93 691 7376, Fax: +81 93 691 7551, e-mail:
[email protected] Key Words: QOL, chemotherapy, outpatient.
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Recently, medical investigators have shown a great deal of interest in the physical, psychological and social health of individuals suffering from disease and treatment-related toxicity (1, 2). Quality of life (QOL) is defined functionally by the patients' own perceptions of their performance in physical, occupational, psychological, social, financial and somatic areas (1). Cancer research had produced numerous QOL studies (3, 4) and this assessment has become an essential part of the cancer treatment process. One reason for this is that cancer treatments often involve such therapies as chemotherapy and radiation, which have high toxicities. Furthermore, new drugs have recently been developed to improve the QOL but they have not achieved high response rates (5-7). It is extremely important to judge the effects of cancer chemotherapy not only based on medical examination but also based on the patient’s point of view as an end-point for research. The aim of the present study was to evaluate the QOL for outpatients receiving cancer chemotherapy.
Patients and Methods Patients. Seventy-four consecutive patients who were treated for cancer between August 2005 and January 2006 at the Cancer Chemotherapy Center, the University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan, were examined. The clinicopathological data were obtained based on a prospective chart review. The subjects included 51 men and 23 women, with a mean age of 61.4 years (range, 18 to 79). The cancer types includes 47 lung carcinomas, 15 breast carcinomas, 3 gastric carcinomas, 2 colon carcinomas, 2 mediastinal tumors, 2 thymic carcinomas, 1 esophageal cancer, 1 tracheal cancer and 1 mesothelioma. Participation was not limited by the stage or site of disease. The performance status was 0 or 1. The chemotherapy regimens included 22 adjuvant therapies, 27 first line treatments, 18 second line treatments, 5 third line treatments, and 2 fourth line treatments. Follow-up was available for all the patients and involved an examination every week during chemotherapy and supportive care. The evaluations included a physical examination, chest roentgenography, an analysis of blood chemistry, and measurements of tumor markers. If any symptoms or signs of recurrence appeared based on these follow up studies, then additional examinations to evaluate the precise site of recurrence were performed. Informed consent was obtained either from the patient or from the patient’s legal guardian for the use of the questionnaires.
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ANTICANCER RESEARCH 27: 1127-1132 (2007) Table I. Baseline characteristics of patients. Characteristics
All cases Gender Male Female Age (y)
