Quality of Life and Patient-Reported Outcomes During First-Line Chemotherapy in Older Patients with De Novo Metastatic Gastrointestinal Cancers: A Prospective Longitudinal Study.
- 1Department of Medical Oncology, Ankara Etlik City Hospital, Ankara 06170, Türkiye.
- 2Department of Medical Oncology, Ankara Etlik City Hospital, University of Health Sciences, Ankara 06170, Türkiye.
- 3Department of Medical Oncology, Gazi University, Ankara 06500, Türkiye.
Abstract
Background/objectives
This study was conducted to prospectively evaluate quality of life (QoL), patient-reported outcomes, and geriatric domains during the first 3 months of first-line systemic therapy in older patients with de novo metastatic gastrointestinal cancers.Methods
This prospective longitudinal study included 90 patients aged ≥65 years receiving first-line chemotherapy-based systemic therapy. Assessments were performed at baseline, Month 1, and Month 3 using validated QoL, sleep, anxiety, cognitive, and nutritional instruments. The primary endpoint was change in EORTC QLQ-C30 Global Health Status/QoL from baseline to Month 3. Treatment tolerability, initial radiologic response, and exploratory survival outcomes were also assessed.Results
Mean Global Health Status/QoL increased from 68.1 at baseline to 71.0 at Month 3; the model-estimated mean change was +3.0 points (95% CI, -0.3 to 6.2; p = 0.071). Fatigue and appetite loss improved significantly, and normal nutritional status increased from 31.1% to 62.2% (p < 0.001). Clinically meaningful QoL improvement and deterioration occurred in 38.9% and 18.9%, respectively. Treatment intolerance occurred in 46.7%. Disease control was associated with more favorable QoL change than progressive disease (difference, 17.8 points; 95% CI, 6.0-29.7; FDR-adjusted p = 0.008). Baseline nutritional impairment (adjusted HR, 3.58) and poor sleep quality (adjusted HR, 3.30) were associated with shorter progression-free survival.Conclusions
Mean global QoL did not change significantly during the first 3 months, while several symptom and nutritional domains improved. More favorable QoL trajectories were observed with disease control, and baseline nutritional impairment and poor sleep quality were associated with shorter progression-free survival.
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BibTeX
@article{sevim2026quality,
title = {{Quality of Life and Patient-Reported Outcomes During First-Line Chemotherapy in Older Patients with De Novo Metastatic Gastrointestinal Cancers: A Prospective Longitudinal Study.}},
author = {Hatice Ayyıldız Sevim and Hayriye Şahinli and Galip Can Uyar and Selahattin Çelik and Kadriye Bir Yücel and Osman Sütcüoğlu},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/healthcare14203458},
url = {https://europepmc.org/article/MED/42940505},
note = {CC BY},
}
RIS
TY - JOUR
TI - Quality of Life and Patient-Reported Outcomes During First-Line Chemotherapy in Older Patients with De Novo Metastatic Gastrointestinal Cancers: A Prospective Longitudinal Study.
AU - Hatice Ayyıldız Sevim
AU - Hayriye Şahinli
AU - Galip Can Uyar
AU - Selahattin Çelik
AU - Kadriye Bir Yücel
AU - Osman Sütcüoğlu
PY - 2026
DA - 2026/10/15
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14203458
UR - https://europepmc.org/article/MED/42940505
AB - Background/objectives This study was conducted to prospectively evaluate quality of life (QoL), patient-reported outcomes, and geriatric domains during the first 3 months of first-line systemic therapy in older patients with de novo metastatic gastrointestinal cancers.Methods This prospective longitudinal study included 90 patients aged ≥65 years receiving first-line chemotherapy-based systemic therapy. Assessments were performed at baseline, Month 1, and Month 3 using validated QoL, sleep, anxiety, cognitive, and nutritional instruments. The primary endpoint was change in EORTC QLQ-C30 Global Health Status/QoL from baseline to Month 3. Treatment tolerability, initial radiologic response, and exploratory survival outcomes were also assessed.Results Mean Global Health Status/QoL increased from 68.1 at baseline to 71.0 at Month 3; the model-estimated mean change was +3.0 points (95% CI, -0.3 to 6.2; p = 0.071). Fatigue and appetite loss improved significantly, and normal nutritional status increased from 31.1% to 62.2% (p < 0.001). Clinically meaningful QoL improvement and deterioration occurred in 38.9% and 18.9%, respectively. Treatment intolerance occurred in 46.7%. Disease control was associated with more favorable QoL change than progressive disease (difference, 17.8 points; 95% CI, 6.0-29.7; FDR-adjusted p = 0.008). Baseline nutritional impairment (adjusted HR, 3.58) and poor sleep quality (adjusted HR, 3.30) were associated with shorter progression-free survival.Conclusions Mean global QoL did not change significantly during the first 3 months, while several symptom and nutritional domains improved. More favorable QoL trajectories were observed with disease control, and baseline nutritional impairment and poor sleep quality were associated with shorter progression-free survival.
SN - 2227-9032
ER -