Health-Related Quality of Life in Chemotherapy Patients Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30): A Single-Institution-Based Study From Lahore, Pakistan

TL;DR

This study used a quality of life questionnaire to assess chemotherapy patients in Lahore, Pakistan, finding that age, metastasis, and cancer type significantly affect their well-being.

Contribution

The study provides insights into QoL factors specific to chemotherapy patients in a Pakistani hospital setting.

Findings

Age significantly affected physical and social functioning, as well as nausea and financial difficulties.

Metastasis was linked to reduced physical functioning, increased fatigue, pain, and financial difficulties.

Cancer type was associated with diarrhea scores, but gender and chemotherapy cycles had no significant impact on QoL.

Abstract

Objective

The objective of this study was to assess health-related quality of life (QoL) in patients receiving injectable chemotherapy using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) at the Oncology Department of a teaching hospital in Lahore, Pakistan.

Methods

This cross-sectional observational study was carried out at the Department of Medical Oncology, Nawaz Sharif Social Security Teaching Hospital, Lahore, Pakistan, between January and April 2025. A total of 150 patients receiving injectable chemotherapy were enrolled using a non-probability consecutive sampling method. Inclusion criteria required participants to be 18 years or older, of either gender, with a confirmed cancer diagnosis of any stage for at least three months, a life expectancy exceeding six months, and the ability to provide informed consent. Life expectancy exceeding six months was estimated by the treating oncologist based on clinical judgment, considering cancer type and stage, performance status, treatment response, and overall health condition. Patients were excluded if they were undergoing radiotherapy; were bedbound, disabled, or too unwell to participate as judged by the clinical team; had coexisting chronic conditions such as chronic liver disease, chronic kidney disease, or congestive heart failure; had psychiatric comorbidities; or declined to participate. The EORTC QLQ-C30 (v3.0) was used to assess health-related QoL. Following institutional ethical approval and written informed consent, demographic and clinical data, including age, gender, cancer type, presence and location of metastases, and number of injectable chemotherapy cycles, were collected. Data analysis was performed using Statistical Product and Service Solutions (SPSS, v23; IBM SPSS Statistics for Windows, Armonk, NY). Group comparisons were conducted using independent t-tests and one-way analysis of variance (ANOVA), with a p-value ≤0.05 considered statistically significant.

Results

The mean age of the patients was 52.7±12.5 years, with 114 (6.0%) females. The most common malignancy was breast carcinoma, seen in 74 (49.3%) patients, followed by hematological malignancies (21, 14.0%) and periampullary cancer (17, 11.3%). Metastatic disease was reported in 42 patients (28.0%), with 24 (10.0%) having bone metastasis. Seventy-four (49.4%) had received three to four injectable chemotherapy cycles, whereas 62 (41.3%) had received ≥5 injectable chemotherapy cycles at the time of assessment. Age was notably linked to multiple domains of EORTC QLQ-C30, including physical functioning (p=0.017), social functioning (p=0.006), nausea/vomiting (p=0.029), appetite loss (p=0.035), constipation (p=0.040), and financial difficulties (p=0.045). The presence of metastasis significantly affected physical functioning (p=0.037), fatigue (p=0.025), pain (p=0.019), and financial difficulties (p=0.022), while the type of cancer showed a significant association with diarrhea scores (p=0.015). No significant association of gender and number of chemotherapy cycles was seen with QoL parameters.

Conclusion

This study highlights that health-related QoL in chemotherapy patients was significantly influenced by age, presence of metastasis, and type of cancer. These findings underscore the importance of individualized supportive care strategies, particularly for older patients and those with advanced disease, to improve their overall well-being.