Quality of Life Impacts on Overall Survival of Radiation Patients

Researchers with Roswell Park Comprehensive Cancer Center's Department of Radiation Medicine have found that quality of life is not only important to cancer patients during therapy, but can also determine their overall survival.

"Quality of life is obviously essential to all patients undergoing therapy and, in general, quality of life instruments were designed to look at acute and late toxicities of therapies, and in that way, what you could do is you could compare one therapy versus another and see which was better tolerated for patients," says Anurag Singh, MD, Professor of Oncology and Director of Radiation Research at Roswell Park Comprehensive Cancer Center. "We took a retrospective cohort of head and neck cancer patients on whom we had complete quality of life data. By using principal component analysis, we discovered that the cohort data did strongly correlate with overall survival."

To expand this theory beyond one cancer type, using the same methodology, the team then looked at a prospective data set from a lung cancer clinical trial. "The effect was even stronger. We showed that you could actually determine progression-free survival and overall survival by applying principal component analysis to the quality of life data," says Dr. Singh.

Roswell Park has begun conducting clinical trials to provide interventions on crucial quality of life factors during a patient's treatment, such as pain and financial toxicities.

"For example, impacting mucositis pain for head and neck cancer patients, in particular, can significantly alter and improve quality of life. This is the focus of ongoing clinical trials that we're conducting at Roswell Park," says Dr. Singh. "I'm happy to report that we've been able to show that increasing doses of Gabapentin have significantly reduced the need for narcotic medications to control oral mucositis pain.

"Another quality of life factor that we've looked at was financial toxicity, which we know is a significant factor in a patient's overall quality of life and that with that stress, a patient's actual outcome can be diminished. We've shown that by instituting financial counseling, we can decrease the change in financial toxicity during the course of treatment."

Dr. Singh and his team are currently looking at further research to understand if they can impact quality of life factors even more in the future.

"What we hope to do is to look at it prospectively and institute measures to improve quality of life so that we can actually quantify what impacts we can have by improving patient's quality of life in their overall survival and progression-free survival are," says Dr. Singh. "The takeaway from all of this is that the patient's subjective experience as captured in standard quality of life forms can be taken and correlated with overall survival. That's very important because it suggests that we have a different way of thinking about and potentially intervening in the patient's quality of life and that it could actually impact their outcomes from therapy."