Regular Article

British Journal of Cancer (2001) 85, 1265–1272. doi:10.1054/bjoc.2001.2046 www.bjcancer.com
Published online 30 October 2001

Alternative methods of interpreting quality of life data in advanced gastrointestinal cancer patients

K Nordin1, J Steel2, K Hoffman2 and B Glimelius2

  1. 1Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
  2. 2Department of Oncology, Radiology and Clinical Immunology, Akademiska Sjukhuset, Uppsala, Sweden

Received 2 March 2001; Revised 22 June 2001; Accepted 13 July 2001.

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Abstract

Understanding of how to analyse and interpret quality of life (QoL) data from clinical trials in patients with advanced cancer is limited. In order to increase the knowledge about the possibilities of drawing conclusions from QoL data of these patients, data from 2 trials were reanalysed. A total of 113 patients with pancreatic, biliary or gastric cancer were included in 2 randomised trials comparing chemotherapy and best supportive care (BSC) with BSC alone. Patient benefit was evaluated by the treating physician (subjective response) and by using selected scales and different summary measures of the EORTC QLQ-C30 questionnaire. An increasing number of drop-outs (mainly due to death) with time did not occur in a random fashion. Therefore, the mean scores in the different subscales of the QLQ-C30 obtained during the follow-up of interviewed patients did not reflect the outcome of the randomised population. The scores of the patient-provided summary measure, 'Global health status/QoL', were stable in a rather high proportion of the patients and could not discriminate between the 2 groups. 3 other summary measures revealed greater variability, and they all discriminated between the 2 groups. A high agreement was also seen between the changes in the summary measures and the subjective response. A categorisation of whether an individual patient had benefited or not from the intervention could overcome the problem with the selective attrition. © 2001 Cancer Research Campaign http://www.bjcancer.com

Keywords:

quality of life, advanced gastrointestinal cancer, palliation, EORTC QLQ-C30

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