Journal Article

Patient reported symptoms associated with quality of life during chemo‐ or immunotherapy for bladder cancer patients with advanced disease

Taarnhøj, Gry A., Johansen, Christoffer, Basch, Ethan, Lindberg, Henriette, Dueck, Amylou, Pappot, Helle

2020

Overview

Background Bladder cancer (BC) patients with advanced disease have poor outcomes. The use of patient‐reported outcomes (PROs) could lead to improvements in symptom management and hence quality of life (QoL). The aim of this study is to report correlations between selected PROs and QoL and thus to present symptoms that influence QoL. Identification of these symptoms during treatment can lead to earlier symptom management and thus secure improvements in QoL. Methods BC patients in chemo‐ or immunotherapy for locally advanced or metastatic disease reported weekly PROs for the duration of their treatment. The PROs included EORTC QLQ‐C30 and QLQ‐BLM30 and 45 selected PRO‐CTCAE items. Spearman's correlation analysis was performed for all PRO‐CTCAE items and QLQ‐C30 global QoL and subdomains. Results In this study, 78 BC patients reported 724 questionnaires. Spearman's analysis showed significant correlations between almost all PRO‐CTCAE items and the expected domain of QoL. The PRO‐CTCAE items with the strongest correlations with QoL were anxiety (F, frequency item) and emotional function (rs = −0.603, P < .0001), concentration (S, severity item) and cognitive function (rs = −0.704, P < .0001), discouraged (F) and emotional function (rs = −0.659, P < .0001), fatigue (S) and role function (rs = −0.659, P < .0001) and sad (F) and emotional function (rs = −0.711, P < .0001). The weakest correlations were found for the PRO‐CTCAE items urinary frequency, incontinence and urge, all with variations in the direction and significance of the correlations. Conclusions This study delivers information on which PROs may influence QoL for patients in clinical trials or daily clinic. Psychological issues have a strong impact on QoL and should be dealt with during treatment to secure the best possible QoL for BC patients. For bladder cancer patients, psychological items have a strong impact on the quality of life while urinary items have a weak impact on the quality of life. Toxicity reporting from clinical trials and supportive care in daily practice may be incomplete and not reflective of the full picture of symptomatology for bladder cancer patients.

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
• Subject: Adult / Aged / Aged, 80 and over / Antibodies, Monoclonal, Humanized - administration & dosage / Antineoplastic Combined Chemotherapy Protocols - therapeutic use / Bladder cancer / Carboplatin - administration & dosage / chemotherapy / Cisplatin - administration & dosage / Clinical Cancer Research / Clinical outcomes / Clinical trials / Cognitive ability / Communication / Correlation analysis / Denmark - epidemiology / Deoxycytidine - administration & dosage / Deoxycytidine - analogs & derivatives / Drug-Related Side Effects and Adverse Reactions - diagnosis / Drug-Related Side Effects and Adverse Reactions - epidemiology / Emotions / Female / Follow-Up Studies / Gemcitabine / Humans / Imidazoles - administration & dosage / Immunotherapy / Longitudinal Studies / Male / Medical treatment / Metastases / Metastasis / Middle Aged / Original Research / Patient Reported Outcome Measures / Patients / Patient‐reported outcomes / Population / Prognosis / Prospective Studies / Quality of Life / Questionnaires / Software / Studies / Surveys and Questionnaires / Symptom management / urinary bladder neoplasms / Urinary Bladder Neoplasms - drug therapy / Urinary Bladder Neoplasms - pathology