Advertisement

Clinical & Experimental Metastasis

, Volume 36, Issue 5, pp 441–448 | Cite as

Factors related to the quality of life in patients with bone metastases

  • Yusuke ShinodaEmail author
  • Ryoko Sawada
  • Futaba Yoshikawa
  • Takahiro Oki
  • Toshihide Hirai
  • Hiroshi Kobayashi
  • Ko Matsudaira
  • Hiroyuki Oka
  • Sakae Tanaka
  • Hirotaka Kawano
  • Nobuhiko Haga
Research Paper
  • 168 Downloads

Abstract

Treatment for bone metastases aims to preserve patients’ quality of life (QOL). Therefore, assessment of patients’ reported QOL is important, especially in this field. This cross-sectional study sought to investigate the clinical factors of QOL in patients with bone metastasis in different cancer settings, at any treatment status, and examined the effect of these factors on systemic symptoms and psychological disorders. This study was conducted by a multidisciplinary team for bone metastases at a university hospital in Japan. One-hundred seventy-four patients who could complete the self-report questionnaires were selected. The questionnaire included the EQ-5D, EORTC QLQ-C15-PAL, BM22, and K6 distress scale. We obtained clinical data on tumor progression, bone metastasis, pain, and ECOG-PS. The mean (SD) EQ-5D score was 0.58 (0.24), which was lower than that of the general Japanese and US population (0.85). Skeletal-related events (SREs), pain, and ECOG-PS were significantly related to lower EQ-5D scores in the multivariable analysis (p < 0.01), whereas primary lesion or expected prognosis at the first examination was not. These three factors were also related to systemic symptoms and emotional functioning. Radiologically lytic bone metastasis and lower limb/acetabular metastases were related to SREs and ECOG-PS, respectively. In conclusion, for improving the QOL of patients with bone metastases, we should focus on SRE prevention, treatment for pain, and modifying ADL, and a multidisciplinary team might be useful.

Keywords

Bone metastasis Quality of life Skeletal-related events Pain Performance status Multidisciplinary approach 

Abbreviations

QOL

Quality of life

EQ-5D

EuroQOL-5dimension

EORTC

The European Organization for Research and Treatment of Cancer

QLQ-C15-PAL

QOL Questionnaire Core-15 Palliative

QLQ-BM22

QOL Questionnaire Bone Metastases module 22

K6 distress scale

The Kessler Psychological Distress Scale 6

ECOG

The Eastern Cooperative Oncology Group

PS

Performance Status

SREs

Skeletal related events

ADL

Activities of daily living

CT

Computed tomography

BMI

Body mass index

Hb

Hemoglobin

Plt

Platelets

Alb

Albumin

T.bil

Total bilirubin

ALP

Alkaline phosphatase

CRP

C reactive protein

NRS

Numerical rating scale

BMA

Bone-modifying agents

Notes

Acknowledgements

This work was supported by a Grant from Japan Orthopaedics and Traumatology Foundation, Inc. No 318 and KAKENHI (Grants-in-Aid for Scientific Research©) Grant Number 15K10388. We would like to thank Editage (www.editage.jp) for English language editing. The study was approved by the University of Tokyo Medical Research Center Ethics Committee (approval number: 2373).

Compliance with ethical standards

Ethical approval

The study was approved by the University of Tokyo Medical Research Center Ethics Committee (approval number: 2373).

Conflict of interest

The authors declare no conflicts of interest regarding the publication of this paper.

Supplementary material

10585_2019_9983_MOESM1_ESM.docx (21 kb)
Supplementary material 1 (DOCX 18 kb)

References

  1. 1.
    Maemondo M, Inoue A, Kobayashi K et al (2010) Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med 362:2380–2388CrossRefPubMedGoogle Scholar
  2. 2.
    Robert C, Long GV, Brady B et al (2015) Nivolumab in previously untreated melanoma without BRAF mutation. N Engl J Med 372:320–330CrossRefPubMedGoogle Scholar
  3. 3.
    Hage WD, Aboulafia AJ, Aboulafia DM (2000) Incidence, location, and diagnostic evaluation of metastatic bone disease. Orthop Clin N Am 31:515–528CrossRefGoogle Scholar
  4. 4.
    Hosono N, Yonenobu K, Fuji T, Ebara S, Yamashita K, Ono K (1995) Orthopaedic management of spinal metastases. Clin Orthop Relat Res 312:148–159Google Scholar
  5. 5.
    Coleman RE (2001) Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 27:165–167CrossRefPubMedGoogle Scholar
  6. 6.
    Zeng L, Chow E, Bedard G et al (2012) Quality of life after palliative radiation therapy for patients with painful bone metastases: results of an international study validating the EORTC QLQ-BM22. Int J Radiat Oncol Biol Phys 84(3):e337–e342CrossRefPubMedGoogle Scholar
  7. 7.
    Caissie A, Zeng L, Nguyen J et al (2012) Assessment of health-related quality of life with the European Organization for Research and Treatment of Cancer QLQ-C15-PAL after palliative radiotherapy of bone metastases. Clin Oncol 24(2):125–133CrossRefGoogle Scholar
  8. 8.
    Badia X, Schiaffino A, Alonso J, Herdman M (1998) Using the EuroQol 5-D in the Catalan general population: feasibility and construct validity. Qual Life Res 7:311–322CrossRefPubMedGoogle Scholar
  9. 9.
    Katagiri H, Okada R, Takagi T, Takahashi M, Murata H, Harada H, Nishimura T, Asakura H, Ogawa H (2014) New prognostic factors and scoring system for patients with skeletal metastasis. Cancer Med 3(5):1359–1367CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Groenvold M, Petersen MA, Aaronson NK et al (2006) The development of the EORTC QLQ-C15-PAL: a shortened questionnaire for cancer patients in palliative care. Eur J Cancer 42(1):55–64CrossRefPubMedGoogle Scholar
  11. 11.
    Chow E, Hird A, Velikova G et al (2009) The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire for patients with bone metastases: the EORTC QLQ-BM22. Eur J Cancer 45(7):1146–1152CrossRefPubMedGoogle Scholar
  12. 12.
    Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM (2002) Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 32(6):959–976CrossRefPubMedGoogle Scholar
  13. 13.
    van Roij J, Fransen H, van de Poll-Franse L, Zijlstra M, Raijmakers N (2018) Measuring health-related quality of life in patients with advanced cancer: a systematic review of self-administered measurement instruments. Qual Life Res 27(8):1937–1955CrossRefPubMedGoogle Scholar
  14. 14.
    Yamada K, Matsudaira K, Takeshita K, Oka H, Hara N, Takagi Y (2014) Prevalence of low back pain as the primary pain site and factors associated with low health-related quality of life in a large Japanese population: a pain-associated cross-sectional epidemiological survey. Mod Rheumatol 24(2):343–348CrossRefPubMedGoogle Scholar
  15. 15.
    van der Vliet QM, Pereira NP, Janssen SJ, Hornicek FJ, Ferrone ML, Bramer JA, van Dijk CN, Schwab JH (2017) What factors are associated with quality of life, pain interference, anxiety, and depression in patients with metastatic bone disease? Clin Orthop Relat Res 475(2):498–507CrossRefPubMedGoogle Scholar
  16. 16.
    McCabe RM, Grutsch JF, Nutakki SB, Braun DP, Markman M (2014) Can quality of life assessments differentiate heterogeneous cancer patients? PLoS ONE 9(6):e99445.  https://doi.org/10.1371/journal.pone.0099445 CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    McDonald R, Ding K, Chow E et al (2016) Classification of painful bone metastases as mild, moderate, or severe using both EORTC QLQ-C15-PAL and EORTC QLQ-BM22. Support Care Cancer 24(12):4871–4878CrossRefPubMedGoogle Scholar
  18. 18.
    Kunikane H, Yokota I, Katakami N et al (2019) Prospective analysis of the association between skeletal-related events and quality of life in patients with advanced lung cancer (CSP-HOR13). Oncol Lett 17(1):1320–1326PubMedGoogle Scholar
  19. 19.
    Rustøen T, Moum T, Padilla G, Paul S, Miaskowski C (2005) Predictors of quality of life in oncology outpatients with pain from bone metastasis. J Pain Symptom Manag 30(3):234–242CrossRefGoogle Scholar
  20. 20.
    Manabe J, Kawaguchi N, Matsumoto S, Tanizawa T (2005) Surgical treatment of bone metastasis: indications and outcomes. Int J Clin Oncol 10(2):103–111CrossRefPubMedGoogle Scholar
  21. 21.
    Ruff RL, Ruff SS, Wang X (2007) Persistent benefits of rehabilitation on pain and life quality for nonambulatory patients with spinal epidural metastasis. J Rehabil Res Dev 44(2):271–278CrossRefPubMedGoogle Scholar
  22. 22.
    Kimura T (2018) Multidisciplinary approach for bone metastasis: a review. Cancers.  https://doi.org/10.3390/cancers10060156 CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Lipton A, Fizazi K, Stopeck AT et al (2016) Effect of denosumab versus zoledronic acid in preventing skeletal-related events in patients with bone metastases by baseline characteristics. Eur J Cancer 53:75–83CrossRefPubMedGoogle Scholar
  24. 24.
    Saad F, Gleason DM, Murray R et al (2002) A randomized, placebo-controlled trial of zoledronic acid in patients with hormone-refractory metastatic prostate carcinoma. J Natl Cancer Inst 94(19):1458–1468CrossRefPubMedGoogle Scholar
  25. 25.
    Vassiliou V, Kalogeropoulou C, Petsas T, Leotsinidis M, Kardamakis D (2007) Clinical and radiological evaluation of patients with lytic, mixed and sclerotic bone metastases from solid tumors: is there a correlation between clinical status of patients and type of bone metastases? Clin Exp Metastasis 24(1):49–56CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Yusuke Shinoda
    • 1
    Email author
  • Ryoko Sawada
    • 1
    • 2
  • Futaba Yoshikawa
    • 1
    • 2
  • Takahiro Oki
    • 1
    • 2
  • Toshihide Hirai
    • 2
  • Hiroshi Kobayashi
    • 2
  • Ko Matsudaira
    • 3
  • Hiroyuki Oka
    • 3
  • Sakae Tanaka
    • 2
  • Hirotaka Kawano
    • 4
  • Nobuhiko Haga
    • 1
  1. 1.Department of Rehabilitation MedicineThe University of Tokyo HospitalTokyoJapan
  2. 2.Department of Orthopaedic Surgery, Faculty of MedicineThe University of TokyoTokyoJapan
  3. 3.Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of MedicineThe University of TokyoTokyoJapan
  4. 4.Department of Orthopaedic Surgery, School of MedicineTeikyo UniversityTokyoJapan

Personalised recommendations