Psychosocial Challenges and Health-Related Quality of Life in Elderly Cancer Patients Receiving Chemotherapy: Insights From a Prospective Cohort Study

接受化疗的老年癌症患者的心理社会挑战和健康相关生活质量:一项前瞻性队列研究的启示

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Abstract

BACKGROUND: Geriatric cancer patients (age ≥65 years) suffer a decline in psychosocial well-being and quality of life (QoL). AIM: To study social support, depression, QoL domains, and their association with clinicopathological and treatment parameters in Indian geriatric cancer patients. METHODS: QoL, depression, and social support at presentation were studied using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), Geriatric Depression Scale-4 (GDS-4), and Medical Outcomes Study Social Support Survey (MOS SSS) forms, respectively. An assessment of QoL and treatment outcome against baseline psychosocial domains was done. RESULTS: A total of 150 patients were enrolled in the study. The mean score for Global Health Status was 53.94; mean scores for Physical, Role, Emotional, Cognitive, and Social Functioning were 77.16, 83.44, 78.39, 86.33, and 69.67, respectively. Global Health Status scores were lower in patients with increasing age, male gender, Eastern Cooperative Oncology Group performance status-2 (ECOG PS-2), BMI ≤18.5, MOS SSS ≤80, renal dysfunction, and head and neck cancer (p-value ≤0.05). A MOS SSS score ≤80 was associated with severe grade Common Terminology Criteria for Adverse Events (CTCAE), recurrence, primary progression, and death (p-value ≤0.05). The mean GDS score was 4.99, with no statistically significant difference in the worst study outcome parameters. CONCLUSION: Several clinical and demographic factors significantly influence patient-reported Global Health Status scores. A significant proportion of geriatric cancer patients reported depression and suboptimal social support. Patients with poor social support had a statistically significantly higher incidence of severe grade CTCAE, recurrence, primary progression, and death.

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