Assessment of quality of life in pediatric cancer patients at diagnosis and during therapy

Abstract

The aim of this study was to assess the quality of life (QoL) of patients with cancer at diagnosis and during the therapy and to obtain effects of sex, age, diagnosis, stage of disease and treatment on QoL. Thirty (16 male, 14 female) newly diagnosed patients with cancer were evaluated at diagnosis and three months after initiation of the treatment. The performance status of children were obtained according to Lansky play-performance scale. The Health Utilities Index-2 (HUI-2) health status classification system was used for the assessment of health related quality of life (HRQL). The global and single attribute utility scores and Lansky scores were evaluated according to age, sex and diagnosis of patients, stage of disease, treatment modality and response to treatment. The mean performance score and global utility scores of patients at diagnosis were significantly worse than those at third months of therapy (p=0.01 and p=0.04, respectively). Almost all of our patients (96.7%) suffered from a deficit of one or more attribute. Additionally, it is important to note that emotional deficit is reported in 96% of patients and pain was also an important problem for most of the patients. The type of cancer did not seem to have important effect on HRQL except brain tumor. The stage of disease had considerable importance on performance and HRQL scores. Treatment modality had also an impact on performance status and HRQL. Surgical intervention, intensive chemotherapy and hospitalization had negative effects on QoL. We did not find any effect of radiotherapy on QoL. Good responder to the treatment has better HRQL. In conclusion, we obtained that children with cancer had significant deficit in almost all domains of life. The health related quality of life was better at third months of therapy than that at diagnosis, despite the negative effect of treatment on QoL. This suggested that cancer itself is a more important factor affecting the QoL compared with its treatment. (Turk J Cancer 2001;31(4):139-149)