Patient Reported Outcomes/Quality of Life

PV QA 4 - Poster Viewing Q&A 4

TU_43_3735 - Emotional Quality of Life Among Patients with Oropharyngeal Carcinoma Treated with Radiation Therapy

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Emotional Quality of Life Among Patients with Oropharyngeal Carcinoma Treated with Radiation Therapy
G. Rajeev-Kumar1, J. Moreno1, A. Kelley1, V. Gupta1, and R. L. Bakst2; 1Icahn School of Medicine at Mount Sinai, New York, NY, 2Icahn School of Medicine at Mount Sinai Department of Radiation Oncology, New York, NY

Purpose/Objective(s): While substantial research exists on physical toxicities from radiotherapy (RT) for oropharyngeal cancers (OPC), emotional quality of life (EQoL) is understudied. The purpose of this study was to investigate the effects and time course of radiation on self-reported mood and anxiety. Given that older age is associated with greater resilience, we hypothesized that mood and anxiety would improve faster in this cohort.

Materials/Methods: We collected University of Washington Quality of Life (UWQOL) questionnaires, a previously validated instrument, prospectively and identified OPC patients treated with curative intent with RT from 2013 to 2016 who had completed questionnaires post RT for up to 3 years of follow-up (n=69). Our primary outcomes were anxiety and mood scores, scaled from 1-4 and 1-5 respectively (higher scores representing more severe symptoms) created from responses to the questionnaire. We performed a paired sample t-test to compare mean mood and anxiety scores before and after RT within the cohorts.  

Results: Anxiety improved from baseline (before RT) in all patients by 6 months following RT. It improved faster among older patients: difference in mean scores before and after RT (D1) = -0.60 in older patients (>60 years) vs -0.39 in younger patients at 6-month follow-up (P < 0.01), -0.61 vs -0.47 at 12-month follow-up (P < 0.01), and -0.78 vs. -0.57 at 30-month follow-up (P < 0.01). In contrast, depressed mood significantly improved only among the younger cohort: initially worsened at first 3 month follow-up (D1 = 0.45, P < 0.05), mood significantly improved by 12 months (D1 = -0.63, P < 0.01) and continued improving at 36-months (D1 = -0.83, P < 0.01). Among the older cohort, there was no significant change in mood from the baseline. Mood differed the most between the two cohorts a year after treatment (D2 = -0.58, P < 0.01).  

Conclusion: Age is an important factor to be taken into account when considering the psychosocial well-being of OPC patients, specifically with regards to mood. While anxiety improved independent of age, mood improved only among the younger cohort. Contrary to our hypothesis, psychological recovery following RT with regards to mood is not evident among older patients. Integrative care to mitigate treatment toxicity and improve psychological outcomes is needed more amongst older patients with OPC.  
  Older (n=33) Frequency (%) Younger (n=36) Frequency (%) P-value
Age mean (SD) 66.21 (5.46) 50.36 (7.13) 0**
Gender Male Female  23 (69.70) 10 (30.30) 28 (77.78) 8 (22.22) 0.45 0.45
Cancer Stage I/II  III IVA  IVB 2 (7.14) 5 (17.86) 19 (67.86) 2 (7.14) 4 (15.38) 2 (7.69) 18 (69.23) 2 (7.69) 0.46 0.19 0.53 0.93
Pre-RT Surgery 15 (45.45) 25 (69.44) 0.04*
Induction Chemo 10 (31.25) 7 (19.44) 0.26
Radiation Adjuvant Definitive 15 (45.45) 18 (54.55) 22 (61.11) 14 (38.89) 0.19 0.19
Concurrent Chemo 18 (56.25) 18 (50) 0.61
*P < 0.05 **P < 0.01  

Author Disclosure: G. Rajeev-Kumar: None. J. Moreno: None. V. Gupta: None. R.L. Bakst: None.

Greeshma Rajeev-Kumar, BS

Biography:
My name is Greeshma Rajeev-Kumar, and I am a third-year medical student at Icahn School of Medicine at Mount Sinai with a Bachelor of Science in Psychology. I have expertise specifically in cognitive aspects of and emotional regulation in depression. For my thesis, I worked with Dr. Jutta Joormann at the Affect Regulation and Cognition Lab at Yale, investigating the association of explanation biases with changes in mood and anxiety. I also have publications and conference papers providing mechanistic details of aspects of human cognition. As a medical student, I am interested in applying my expertise in psychology to further understand psychosocial changes associated with multi-modality treatment in cancer.

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