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Health-related quality of life among cancer patients in their last year of life: results from the PROFILES registry

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Abstract

Purpose

The aim of this study was to assess health-related quality of life (HRQoL) in the last year of life of cancer patients stratified by four periods of time before death.

Patients and methods

Between 2008 and 2015, cancer patients were invited to participate in PROFILES (Patient Reported Outcomes Following Initial Treatment and Long-term Evaluation of Survivorship) registry studies. Patients were eligible for inclusion in this secondary analysis if they had been invited to complete the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) in their last year of life (N = 892). Four hundred fifty-eight patients (51%) responded. Descriptive statistics were used to describe the HRQoL of cancer patients in the last 3 months of life (N = 61), the last 3–6 months (N = 110), the last 6–9 months (N = 138), or the last 9–12 months of their life (N = 129).

Results

Patients in the last 3 months report a significant lower HRQoL, lower functioning, and higher symptom burden of fatigue and appetite loss compared to patients in different time periods before death (p < 0.008). Clinical relevance of the differences for global QoL, cognitive, and social functioning was large. Patients’ HRQoL in the last year of life was significantly lower than that of the normative population (p < 0.001).

Conclusions

All aspects of HRQoL are considerably impaired in patients with advanced cancer, with a marked lower HRQoL in the final months of life. This marked decline of HRQoL in the final months of life may be an indicator of approaching death and serve as an important trigger for end-of-life communication and decision-making about subsequent treatment and supportive care.

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Funding

The PROFILES registry was funded by an Investment Grant (no. 480-08-009) of the Netherlands Organization for Scientific Research (The Hague, The Netherlands). Dr. Olga Husson is supported by a Social Psychology Fellowship from the Dutch Cancer Society (no. KUN2015-7527). These funding agencies had no further role in conducting the study.

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Authors and Affiliations

  1. The Netherlands Comprehensive Cancer Organisation (IKNL), PO Box 19079, 3501 DB, Utrecht, The Netherlands

    Natasja J. H. Raijmakers, M. Zijlstra, J. van Roij, S. Oerlemans & L. V. van de Poll-Franse

  2. Department of Medical Oncology, Radboud MC, Nijmegen, The Netherlands

    M. Zijlstra

  3. Department of Medical Psychology, Radboud University MC, Nijmegen, The Netherlands

    O. Husson

  4. Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK

    O. Husson

  5. CoRPS—Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands

    L. V. van de Poll-Franse

  6. Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    L. V. van de Poll-Franse

Authors
  1. Natasja J. H. Raijmakers
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  2. M. Zijlstra
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  3. J. van Roij
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  4. O. Husson
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  5. S. Oerlemans
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  6. L. V. van de Poll-Franse
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Corresponding author

Correspondence to Natasja J. H. Raijmakers.

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Ethical approval was obtained for all study samples separately.

Conflict of interest

The authors have declare that they have no conflicts of interest.

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Raijmakers, N.J.H., Zijlstra, M., van Roij, J. et al. Health-related quality of life among cancer patients in their last year of life: results from the PROFILES registry. Support Care Cancer 26, 3397–3404 (2018). https://doi.org/10.1007/s00520-018-4181-6

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  • DOI: https://doi.org/10.1007/s00520-018-4181-6

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