C Quinten1,2, C Kenis3,4, L Decoster5, P R Debruyne6, I De Groof7, C Focan8, F Cornelis9, V Verschaeve10, C Bachmann11, D Bron12, S Luce13, G Debugne14, H Van den Bulck15, J C Goeminne16, A Baitar17, K Geboers18, B Petit19, C Langenaeken20, R Van Rijswijk21, P Specenier22, G Jerusalem23, J P Praet24, K Vandenborre25, M Lycke6, J Flamaing3,26, K Milisen4,27, J P Lobelle28, H Wildiers3,29. 1. Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, Leuven, Belgium. chantal.quinten@kuleuven.be. 2. Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. chantal.quinten@kuleuven.be. 3. Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium. 4. Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium. 5. Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. 6. Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium & Positive Ageing Research Institute (PARI), Anglia Ruskin University, Chelmsford, UK. 7. Department of Geriatric Medicine, Iridium Cancer Network Antwerp, St. Augustinus, Wilrijk, Belgium. 8. Department of Oncology, Clinique Saint-Joseph, CHC-Liège Hospital Group, Liege, Belgium. 9. Department of Medical Oncology, Cliniques Universitaires Saint-Luc, UCL, Brussels, Belgium. 10. Department of Medical Oncology, GHDC Grand Hôpital de Charleroi, Charleroi, Belgium. 11. Department of Geriatric Medicine, AZ Sint-Lucas, Ghent, Belgium. 12. Department of Hematology, ULB Institut Jules Bordet, Brussels, Belgium. 13. Department Medical Oncology, University Hospital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium. 14. Department of Geriatric Medicine, Centre Hospitalier de Mouscron, Mouscron, Belgium. 15. Department of Medical Oncology, Imelda Hospital, Bonheiden, Belgium. 16. Department of Medical Oncology, CHU-UCL-Namur, site Sainte-Elisabeth, Namur, Belgium. 17. Department of Medical Oncology, ZNA Middelheim, Antwerp, Belgium. 18. Centre for Oncology and Hematology, AZ Turnhout, Turnhout, Belgium. 19. Department of Medical Oncology, Centre Hospitalier Jolimon, La Louvière, Belgium. 20. Department of Medical Oncology, Iridium Cancer Network Antwerp, AZ Klina, Brasschaat, Belgium. 21. Department of Medical Oncology, ZNA Stuivenberg, Antwerp, Belgium. 22. Department of Medical Oncology, University Hospital Antwerp, Antwerp, Belgium. 23. Department of Medical Oncology, Centre Hospitalier Universitaire Sart Tilman and Liege University, Liege, Belgium. 24. Department of Geriatric Medicine, CHU St-Pierre, Free Universities Brussels, Brussels, Belgium. 25. Department of Medical Oncology, AZ Vesalius, Tongeren, Belgium. 26. Department of Chronic Diseases, Metabolism and Ageing - CHROMETA, KU Leuven, Leuven, Belgium. 27. Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium. 28. , Beernem, Belgium. 29. Department of Oncology, KU Leuven, Leuven, Belgium.
Abstract
PURPOSE: Using the EORTC Global Health Status (GHS) scale, we aimed to determine minimal clinically important differences (MCID) in health-related quality of life (HRQOL) changes for older cancer patients with a geriatric risk profile, as defined by the geriatric 8 (G8) health screening tool, undergoing treatment. Simultaneously, we assessed baseline patient characteristics prognostic for HRQOL changes. METHODS: Our analysis included 1424 (G8 ≤ 14) older patients with cancer scheduled to receive chemotherapy (n = 683) or surgery (n = 741). Anchor-based methods, linking the GHS score to clinical indicators, were used to determine MCID between baseline and follow-up at 3 months. A threshold of 0.2 standard deviation (SD) was used to exclude MCID estimates too small for interpretation. Logistic regressions analysed baseline patient characteristics prognostic for HRQOL changes. RESULTS: The 15-item Geriatric Depression Scale (GDS15), Visual Analogue Scale (VAS) for Fatigue and ECOG Performance Status (PS) were selected as clinical anchors. In the surgery group, MCID estimates for improvement and deterioration were ECOG PS (5*, 11*), GDS15 (5*, 2) and VAS Fatigue (3, 9*). In the chemotherapy group, MCID estimates for improvement and deterioration were ECOG PS (8*, 7*), GDS15 (5, 4) and VAS Fatigue (5, 5*). Estimates with * were > 0.2 SD threshold. Patients experiencing pain or malnutrition (surgery group) or fatigue (chemotherapy group) at baseline showed a significantly stable or improved HRQOL (p < 0.05) after their treatment. CONCLUSION: The reported MCID for improvement and deterioration depended on the anchor used and treatment received. The estimates can be used to evaluate significant changes in HRQOL and to determine sample sizes in clinical trials.
PURPOSE: Using the EORTC Global Health Status (GHS) scale, we aimed to determine minimal clinically important differences (MCID) in health-related quality of life (HRQOL) changes for older cancerpatients with a geriatric risk profile, as defined by the geriatric 8 (G8) health screening tool, undergoing treatment. Simultaneously, we assessed baseline patient characteristics prognostic for HRQOL changes. METHODS: Our analysis included 1424 (G8 ≤ 14) older patients with cancer scheduled to receive chemotherapy (n = 683) or surgery (n = 741). Anchor-based methods, linking the GHS score to clinical indicators, were used to determine MCID between baseline and follow-up at 3 months. A threshold of 0.2 standard deviation (SD) was used to exclude MCID estimates too small for interpretation. Logistic regressions analysed baseline patient characteristics prognostic for HRQOL changes. RESULTS: The 15-item Geriatric Depression Scale (GDS15), Visual Analogue Scale (VAS) for Fatigue and ECOG Performance Status (PS) were selected as clinical anchors. In the surgery group, MCID estimates for improvement and deterioration were ECOG PS (5*, 11*), GDS15 (5*, 2) and VAS Fatigue (3, 9*). In the chemotherapy group, MCID estimates for improvement and deterioration were ECOG PS (8*, 7*), GDS15 (5, 4) and VAS Fatigue (5, 5*). Estimates with * were > 0.2 SD threshold. Patients experiencing pain or malnutrition (surgery group) or fatigue (chemotherapy group) at baseline showed a significantly stable or improved HRQOL (p < 0.05) after their treatment. CONCLUSION: The reported MCID for improvement and deterioration depended on the anchor used and treatment received. The estimates can be used to evaluate significant changes in HRQOL and to determine sample sizes in clinical trials.
Entities:
Keywords:
Cancer; Elderly patients with cancer; Geriatric assessment; Minimal important differences; Quality of life
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