# Health-related quality of life in patients with gastrointestinal stromal tumor: data from a real-world cohort compared with a normative population

## TL;DR

This study compares the quality of life of gastrointestinal stromal tumor patients with a general population, finding that those in palliative care face greater challenges.

## Contribution

The study provides real-world HRQoL data for GIST patients across treatment phases and identifies key factors affecting their quality of life.

## Key findings

- Patients in palliative settings had worse global quality of life and functioning compared to normative populations.
- Fatigue, pain, dyspnea, and financial difficulties were most associated with reduced HRQoL in palliative care.
- GIST survivors who completed curative treatment had higher global QoL than the normative population.

## Abstract

Treatment and follow-up (FU) care procedures for gastrointestinal stromal tumors (GISTs) impose great challenges on patients and could potentially affect their health-related quality of life (HRQoL). The aims of our study were to (i) assess HRQoL among patients with GIST in different treatment phases and settings and to compare this with the HRQoL of an age- and sex-matched normative population, (ii) determine the occurrence of disease- and treatment-specific symptoms, and (iii) investigate which sociodemographic and clinical characteristics and symptoms were associated with HRQoL.

A total of 328 Dutch patients with GIST (response rate 63%) completed a one-time survey including the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), which was used to assess HRQoL. HRQoL scores are presented as means and standard deviations (mean ± SD), and were compared with those of an age- and sex-matched normative population.

The global QoL of patients receiving imatinib in a curative setting (mean ± SD 81.2 ± 12.6) was comparable with the normative population (mean ± SD 77.1 ± 18.2), while patients who had completed their curative treatment [including those discharged from FU (mean ± SD 85.2 ± 14.0) and still in FU (mean ± SD 82.7 ± 15.0)] had a significant better global QoL with comparable functioning scores. Patients on tyrosine kinase inhibitors in a palliative setting scored significantly lower on global QoL (mean ± SD 71.6 ± 19.4) and all functioning scales compared with the normative population. HRQoL was most affected by fatigue, in addition to pain, dyspnea, and financial difficulties, which all occurred more often in patients treated in a palliative setting compared with patients in the curative setting.

With these results, medical oncologists can reassure patients with GIST treated in an adjuvant setting that their HRQoL will not be permanently affected by imatinib and provide appropriate support to patients in the palliative setting.

•Patients on palliative tyrosine kinase inhibitor treatment had worse global QoL and functioning.•Patients in a palliative setting more often suffer from symptoms that affect HRQoL.•HRQoL was most affected by fatigue, pain, dyspnea, and financial difficulties.•Patients with GIST on tyrosine kinase inhibitors reported lower scores on cognitive functioning.•GIST survivors who had completed their curative treatment scored higher on global QoL than the normative population.

Patients on palliative tyrosine kinase inhibitor treatment had worse global QoL and functioning.

Patients in a palliative setting more often suffer from symptoms that affect HRQoL.

HRQoL was most affected by fatigue, pain, dyspnea, and financial difficulties.

Patients with GIST on tyrosine kinase inhibitors reported lower scores on cognitive functioning.

GIST survivors who had completed their curative treatment scored higher on global QoL than the normative population.