Patient-Reported Quality of Life in Adolescents and Young Adults With Cancer Who Received Radiation Therapy

Authors

Kelsey L Corrigan
Bryce B Reeve
John M Salsman
Elizabeth J Siembida
Grace L Smith
Maria C Swartz
Kamaria L Lee
Faraz Afridi
Lauren M Andring
Andrew J Bishop
Jillian R Gunther
J Andrew Livingston
Susan K Peterson
Michael Roth

Publication Date

7-1-2023

Journal

Cancer Medicine

Abstract

BACKGROUND: Radiation therapy (RT) is a common treatment for adolescents and young adults (AYAs, 15-39 years old) with cancer; however, it may cause toxicities that affect health-related quality-of-life (HRQOL). Thus, we assessed HRQOL in AYAs before, during, and after RT.

METHODS: We identified 265 AYAs who completed HRQOL PROMIS® surveys before (n = 87), during (n = 84), or after (n = 94) RT. Higher PROMIS® score represents more of the concept. Mean scores were compared to the general US population and minimally important differences (MIDs) were used to evaluate the impact of cancer on HRQOL. Linear regression modeling was used to evaluate the effect of clinical and demographic factors on PROMIS scores.

RESULTS: Median [IQR] age was 26 [20-31] years. Cancer types varied; most had sarcoma (26%) or CNS malignancy (23%). Compared to the general US population, the before RT cohort had worse anxiety (mean score 55.2 vs. 50, MID 3, p < 0.001) and the during RT cohort had worse global physical health (mean score 44.9 vs. 50, MID 5, p < 0.001). In the during RT cohort, patients with regional/distant disease had significantly worse pain (B = 15.94, p < 0.01) and fatigue (B = 14.20, p = 0.01) than patients with localized disease. In the after RT cohort, adolescents (15-18 years) and young adults (26-39 years) had worse global physical health (B = -6.87, p < 0.01, and B = -7.87, p < 0.01, respectively) and global mental health (B = -6.74, p < 0.01, and B = -5.67, p = 0.01, respectively) than emerging adults (19-25 years).

CONCLUSIONS: AYAs with cancer receiving RT experience impairments in various domains of HRQOL. Advanced cancer stage may contribute to poorer short-term HRQOL and developmental stage may contribute to differing long-term HRQOL.

Keywords

Humans, Adolescent, Young Adult, Adult, Quality of Life, Surveys and Questionnaires, Mental Health, Sarcoma, Patient Reported Outcome Measures

Comments

Supplementary Materials

Data Availability Statement

PMID: 37199075