Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Sep 6:12:390.
doi: 10.1186/1471-2407-12-390.

Quality of life across chemotherapy lines in patients with cancers of the pancreas and biliary tract

August Zabernigg  1 , Johannes M Giesinger, Georg Pall, Eva-Maria Gamper, Klaus Gattringer, Lisa M Wintner, Monika J Sztankay, Bernhard Holzner
Affiliations

Quality of life across chemotherapy lines in patients with cancers of the pancreas and biliary tract

August Zabernigg et al. BMC Cancer. .

Abstract

Background: In patients with cancers of the pancreatic and biliary tract quality of life (QOL) improvement is the main treatment goal, since survival can be prolonged only marginally. Up to date, knowledge on QOL impairments throughout the entire treatment process, often including several chemotherapy lines, is scarce. Our study aimed at investigating QOL trajectories from adjuvant treatment to palliative 3rd-line therapy

Methods: Patients were included in routine electronic patient-reported outcome monitoring at Kufstein County Hospital at the time of diagnosis and assessed with the EORTC QLQ-C30 during each chemotherapy cycle.

Results: Eighty out of 147 patients with pancreatic cancer or cancer of the bile ducts treated at the Kufstein County Hospital, fulfilled inclusion criteria and could be included in the study (mean age 67.4 years; 53.8% women). Physical, Emotional and Cognitive Functioning, and Global QOL deteriorated across chemotherapy lines, whereas Fatigue, Pain, Dyspnoea, Sleeping Disturbances, Diarrhoea, and Taste Alterations increased. With regard to Physical Functioning, Global QOL, Fatigue, Dyspnoea, Diarrhoea and Taste Alterations, the patients receiving adjuvant or 1st-line palliative chemotherapy did not differ significantly. Most patients in 2nd- or 3rd-line chemotherapy showed significantly higher impairments and symptom burden. However, patients under 1st and 2nd-line treatment showed stable QOL trajectories, whereas 3rd-line patients perceived substantial deteriorations.

Conclusions: The results suggest early palliative treatment initiation to stabilise QOL on a level as high as possible. The continuous QOL improvement during adjuvant treatment, probably reflecting post-operative recovery, may indicate that deleterious effects of adjuvant chemotherapy on QOL are highly unlikely.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Patient flow concerning chemotherapy lines.
Figure 2
Figure 2
Comparison of functioning and Global QOL between chemotherapy lines (PF=Physical Functioning, EF=Emotional Functioning, CF=Cognitive Functioning, QL=Global Quality of Life).
Figure 3
Figure 3
Comparison of symptom burden between chemotherapy lines (FA=Fatigue, PA=Pain, DY=Dyspnoea, SL=Sleeping Disturbance, DI=Diarrhoea, TA=Taste Alteration).
See this image and copyright information in PMC

References

    1. Glimelius B, Hoffman K, Sjoden PO. et al.Chemotherapy improves survival and quality of life in advanced pancreatic and biliary cancer. Ann Oncol. 1996;7(6):593–600. doi: 10.1093/oxfordjournals.annonc.a010676. - DOI - PubMed
    1. Burris HA, Moore MJ, Andersen J. et al.Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol. 1997;15(6):2403–13.T. - PubMed
    1. Koeberle D, Saletti P, Borner M. et al.Patient-reported outcomes of patients with advanced biliary tract cancers receiving gemcitabine plus capecitabine: a multicenter, phase II trial of the Swiss Group for Clinical Cancer Research. J Clin Oncol. 2008;26(22):3702–8. doi: 10.1200/JCO.2008.16.5704. - DOI - PubMed
    1. Conroy T, Desseigne F, Ychou M. et al.FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364(19):1817–25. doi: 10.1056/NEJMoa1011923. - DOI - PubMed
    1. Moore MJ, Goldstein D, Hamm J. et al.Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol. 2007;25(15):1960–6. doi: 10.1200/JCO.2006.07.9525. - DOI - PubMed

Publication types

MeSH terms