Affiliation:
1. Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA
2. Department of Population Health Sciences, Department of Pediatrics, Center for Health Measurement Duke University School of Medicine Durham North Carolina USA
3. Department of Social Sciences and Health Policy Wake Forest University Winston‐Salem North Carolina USA
4. Institution of Health System Science, Northwell Health Manhasset New York USA
5. Department of Pediatrics The University of Texas MD Anderson Cancer Center Houston Texas USA
6. Department of Sarcoma Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA
7. Department of Behavioral Science The University of Texas MD Anderson Cancer Center Houston Texas USA
Abstract
AbstractBackgroundRadiation therapy (RT) is a common treatment for adolescents and young adults (AYAs, 15–39 years old) with cancer; however, it may cause toxicities that affect health‐related quality‐of‐life (HRQOL). Thus, we assessed HRQOL in AYAs before, during, and after RT.MethodsWe identified 265 AYAs who completed HRQOL PROMIS® surveys before (n = 87), during (n = 84), or after (n = 94) RT. Higher PROMIS® score represents more of the concept. Mean scores were compared to the general US population and minimally important differences (MIDs) were used to evaluate the impact of cancer on HRQOL. Linear regression modeling was used to evaluate the effect of clinical and demographic factors on PROMIS scores.ResultsMedian [IQR] age was 26 [20–31] years. Cancer types varied; most had sarcoma (26%) or CNS malignancy (23%). Compared to the general US population, the before RT cohort had worse anxiety (mean score 55.2 vs. 50, MID 3, p < 0.001) and the during RT cohort had worse global physical health (mean score 44.9 vs. 50, MID 5, p < 0.001). In the during RT cohort, patients with regional/distant disease had significantly worse pain (B = 15.94, p < 0.01) and fatigue (B = 14.20, p = 0.01) than patients with localized disease. In the after RT cohort, adolescents (15–18 years) and young adults (26–39 years) had worse global physical health (B = ‐6.87, p < 0.01, and B = ‐7.87, p < 0.01, respectively) and global mental health (B = ‐6.74, p < 0.01, and B = ‐5.67, p = 0.01, respectively) than emerging adults (19–25 years).ConclusionsAYAs with cancer receiving RT experience impairments in various domains of HRQOL. Advanced cancer stage may contribute to poorer short‐term HRQOL and developmental stage may contribute to differing long‐term HRQOL.
Subject
Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology