Does palliative chemotherapy really palliate?

29th October 2019

Soft tissue sarcoma (STS) is a rare cancer type. When the disease is advanced, patients are often given palliative chemotherapy to improve both quantity and quality of life.

Researchers decided to investigate what constitutes “health-related quality of life” and whether the most commonly used assessment tool (EORTC QLQ-C30) measures this accurately. The study also demonstrated how health-related quality of life changes during and after treatment.  

The researchers conducted a study of 66 sarcoma patients living with STS.  42 patients were commencing chemotherapy. 24 patients had recently completed chemotherapy. Interviews were analysed using the framework approach and statistical analysis was used to evaluate the results.

Five main factors, including control of pain, were identified by study participants as important components of health-related quality of life.  These are measured by the EORTC QLQ-C30.  However other factors, such as loss of independence and anxiety are not measured.  Control of physical symptoms was particularly important in maintaining health-related quality of life.  Patients experienced increased fatigue, however pain and sleep disturbance both improved.

A key finding was that the assessment tool EORTC QLQ-C30 assesses some but not all of the patient-reported components of health-related quality of life in sarcoma patients.  This highlights the need for either STS specific modules within the EORTC QLQ-C30 or a completely new STS specific tool.

Overall the research showed that first-line palliative chemotherapy does improve specific symptoms known to be prevalent in these patients and improves health-related quality of life. In some patients this may translate to sustained improvement in health-related quality of life. More research is needed.  

Gough N, Koffman J, Ross JR, Riley J, Judson I. Does palliative chemotherapy really palliate and are we measuring it correctly? A mixed methods longitudinal study of health related quality of life in advanced soft tissue sarcoma. PLoS One. 2019;14(9):e0210731. PLoS ONE:

https://doi.org/10.1371/journal.pone.0210731