Quality-of-life of ovarian cancer patients with prolonged use of chemotherapy - a prospective comparative quantitative and qualitative study

Abstract

Aims: To assess the quality-of-life, perception and expectation of patients who received multiple courses of chemotherapy (Group A), and to compare with those who had complete response after adjuvant chemotherapy (Group B). Methods: Patients were recruited in a 1:1 ratio in July 2010 to October 2011. A mixed (quantitative and qualitative) approach, using questionnaires and interview, was used. Result: The EORTC-QLQ-C-30 Questionnaire showed lower level of physical (72.16±4.40 Vs 84.89±2.56, p=0.019), role (71.57±7.93 Vs 93.33±3.17, p=0.019) and social functioning (59.8±7.01 Vs 88.89±3.87, p=0.001), and more nausea and vomiting (17.65±6.92 Vs 1.11±1.11, p=0.031) and appetite loss (25.49±7.3, Vs 2.22±2.22, p=0.007), in Group A than Group B. The only difference in the EORTC-QLQ-OV28 was more hair loss in Group A than Group B (50.98±7.49 Vs 10.71±5.13, p<0.001). The Hospital Anxiety and Depression Scale showed more Group A patients were depressed than Group B (60.0% Vs 0%, p=0.001). In the interview, most Group B patients received chemotherapy because of their family, and were satisfied with it because there was no recurrence. However, in Group A, most expected a cure initially and so were disappointed when there were further recurrence or progressive diseases. Most were not willing to continue chemotherapy because of poor physical health or financial reason, but did so because of family members or symptoms. After prolonged use, a few still expected chemotherapy would prolong their survival. Conclusion: Prolonged chemotherapy was tolerable but it was necessary to have a proper counseling on its palliative intent to avoid unrealistic expectation and hence depression.