Gail E Darling1, Joanne Sulman2,3, Osvaldo Espin-Garcia4, Julie G Trudel5, Eshetu G Atenafu6, Biniam Kidane7. 1. Department of Surgery, Division of Thoracic Surgery, Toronto General Hospital, University Health Network and the University of Toronto, 200 Elizabeth Street, 9N-955, Toronto, Ontario, M5G 2C4, Canada. Gail.Darling@uhn.ca. 2. Department of Surgery, Division of Thoracic Surgery, Toronto General Hospital, University Health Network and the University of Toronto, 200 Elizabeth Street, 9N-955, Toronto, Ontario, M5G 2C4, Canada. 3. Factor-Inwentash Faculty of Social Work, University of Toronto, , 246 Bloor Street W., Toronto, M5S 1V4, Canada. 4. Department of Biostatistics, Princess Margaret Cancer Center, University Health Network & Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, 610 University Avenue, Toronto, Ontario, M5G 2M9, Canada. 5. Department of Surgery, Division of Uro-Oncology, the Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, Ontario, K1V 4E9, Canada. 6. Department of Biostatistics, Princess Margaret Cancer Center, University Health Network, 610 University Avenue, Toronto, Ontario, M5G 2M9, Canada. 7. Department of Surgery, Section of Thoracic Surgery, University of Manitoba and the Research Institute in Oncology & Hematology, 820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.
Abstract
PURPOSE: To determine whether EORTC QLQ-C30/QLQ-OG25 and FACT-E compared longitudinally provide similar reflections of health-related quality of life (HRQOL). METHODS: Eighty-six esophageal cancer patients treated with curative intent, scheduled to complete both questionnaires at baseline and post-treatment time points until 36 months. A generalized estimating equation model utilizing a Gaussian family compared instruments longitudinally. The two-one-sided-test (TOST) method assessed equivalence between the instruments. RESULTS: Trajectories for social domain and overall quality of life differed significantly between instruments. Also, FACT-G's functional well-being post-treatment returns to baseline 3-6 months earlier than the EORTC QLQ-C30's role functioning subscale, suggesting measurement of different components. Trajectories for physical and esophageal symptom subscales are similar and are deemed equivalent. Emotional domains are comparable and bear little resemblance to the physical domain trajectories indicating reflection of emotional experience rather than a physical proxy. EORTC QLQ-C30 subscales have a trajectory similar to its physical functioning scale except for the emotional and esophageal symptoms scales. Overall HRQOL in both instruments showed a consistent return to baseline/pre-treatment levels by 6 months post-treatment. CONCLUSIONS: Overall HRQOL recovers earlier after curative-intent treatment than previously reported despite persistence of physical symptoms, with a consistent return to pre-treatment levels by 6 months after treatment. This supports the concept that HRQOL is not primarily defined by physical function. Based on this longitudinal comparison, FACT-E provides a more multidimensional assessment of HRQOL. IMPLICATIONS FOR CANCER SURVIVORS: Curative intent treatment for esophageal cancer has adverse effects on HRQOL but despite intense treatment, overall HRQOL recovers within 6 months.
PURPOSE: To determine whether EORTC QLQ-C30/QLQ-OG25 and FACT-E compared longitudinally provide similar reflections of health-related quality of life (HRQOL). METHODS: Eighty-six esophageal cancerpatients treated with curative intent, scheduled to complete both questionnaires at baseline and post-treatment time points until 36 months. A generalized estimating equation model utilizing a Gaussian family compared instruments longitudinally. The two-one-sided-test (TOST) method assessed equivalence between the instruments. RESULTS: Trajectories for social domain and overall quality of life differed significantly between instruments. Also, FACT-G's functional well-being post-treatment returns to baseline 3-6 months earlier than the EORTC QLQ-C30's role functioning subscale, suggesting measurement of different components. Trajectories for physical and esophageal symptom subscales are similar and are deemed equivalent. Emotional domains are comparable and bear little resemblance to the physical domain trajectories indicating reflection of emotional experience rather than a physical proxy. EORTC QLQ-C30 subscales have a trajectory similar to its physical functioning scale except for the emotional and esophageal symptoms scales. Overall HRQOL in both instruments showed a consistent return to baseline/pre-treatment levels by 6 months post-treatment. CONCLUSIONS: Overall HRQOL recovers earlier after curative-intent treatment than previously reported despite persistence of physical symptoms, with a consistent return to pre-treatment levels by 6 months after treatment. This supports the concept that HRQOL is not primarily defined by physical function. Based on this longitudinal comparison, FACT-E provides a more multidimensional assessment of HRQOL. IMPLICATIONS FOR CANCER SURVIVORS: Curative intent treatment for esophageal cancer has adverse effects on HRQOL but despite intense treatment, overall HRQOL recovers within 6 months.
Authors: Richard A Malthaner; Edward Yu; Michael Sanatani; Debra Lewis; Andrew Warner; A Rashid Dar; Brian P Yaremko; Joel Bierer; David A Palma; Dalilah Fortin; Richard I Inculet; Eric Fréchette; Jacques Raphael; Stewart Gaede; Sara Kuruvilla; Jawaid Younus; Mark D Vincent; George B Rodrigues Journal: Thorac Cancer Date: 2022-05-24 Impact factor: 3.223