Cancer treatment regimens and their impact on the patient-reported outcome measures health-related quality of life and perceived cognitive function

Niklas Paul Grusdat; Alexander Stäuber; Marion Tolkmitt; Jens Schnabel; Birgit Schubotz; Peter Richard Wright; Marc Heydenreich; Dirk-Henrik Zermann; Henry Schulz

doi:10.1186/s41687-022-00422-5

Cancer treatment regimens and their impact on the patient-reported outcome measures health-related quality of life and perceived cognitive function

J Patient Rep Outcomes. 2022 Feb 21;6(1):16. doi: 10.1186/s41687-022-00422-5.

Authors

Niklas Paul Grusdat¹, Alexander Stäuber², Marion Tolkmitt³, Jens Schnabel³, Birgit Schubotz⁴, Peter Richard Wright⁵, Marc Heydenreich⁶, Dirk-Henrik Zermann⁶, Henry Schulz²

Affiliations

¹ Professorship of Sports Medicine/Sports Biology, Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, Thüringer Weg 11, 09126, Chemnitz, Saxony/Sachsen, Germany. niklas.grusdat@hsw.tu-chemnitz.de.
² Professorship of Sports Medicine/Sports Biology, Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, Thüringer Weg 11, 09126, Chemnitz, Saxony/Sachsen, Germany.
³ Rotes Kreuz Krankenhaus, Red Cross Hospital, Chemnitz-Rabenstein, Germany.
⁴ Clinical Cancer Registry, Tumorzentrum Chemnitz e.V., Chemnitz, Germany.
⁵ Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford, UK.
⁶ Department of Urology and Urooncology, Vogtland-Klinik, Bad Elster, Germany.

Abstract

Background and purpose: Breast cancer can be a significant challenge for those affected. Knowledge of physical function, social-emotional challenges, and perceived cognitive function based on the cancer treatment regimens may help to inform adequate support.

Methods: For this prospective observational pilot study, we collected data of seventy-nine women (mean age 54.6 ± 9.5 years) before (T0) and after (T1) initial breast cancer treatment. Functional Assessment of Cancer Therapy-Breast (FACT-B) and Functional Assessment of Cancer Therapy-Cognitive-Function (FACT-Cog) were used to collect data of four treatment subgroups: SCR = Surgery + Chemotherapy + Radiation Therapy; SC = Surgery + Chemotherapy; SR = Surgery + Radiation Therapy; S = Surgery. A mixed ANOVA and posthoc analysis (Tukey, Games-Howell) were used to detect interactions (group by time) and the main effect. A repeated-measures ANOVA displayed individual group differences (time).

Results: Significant interaction showed more deterioration was experienced with SC and SCR than SR and S for FACT-B (p < 0.01) and FACT-Cog (p < 0.001). The longitudinal comparison between T0 and T1 indicated a significant group main effect on all subscales (p < 0.001) except for Emotional Well-Being. Significant reductions (p < 0.05) in FACT-B, (- 19%); FACT-Cog, (- 21%) with most pronounced effect in Physical Well-Being (- 30%), Functional Well-Being (- 20%), Breast Cancer Subscale (- 20%), Perceived Cognitive Impairments (- 18%) and Impact of Cognitive Impairments on Quality of Life (- 39%) were detected for SCR.

Conclusion: Our study showed that the extent of change in health-related quality of life (HRQoL) and perceived cognitive function (PCF) depends on the treatment regimen. Multidisciplinary support initiated early in breast cancer therapy is needed, especially for women undergoing combined cancer treatment. Routine assessment of patient-reported outcomes (PROs) in oncology practice may increase the transparency of patients' perceived circumstances, leading to personalized and optimized acute and survivorship care.

Keywords: Cognitive function; HRQoL; Support; Survivorship.