Differences in symptom occurrence, severity, and distress ratings between patients with gastrointestinal cancers who received chemotherapy alone or chemotherapy with targeted therapy

Ilufredo Y. Tantoy, Anand Dhruva, Janine Cataldo, Alan Venook, Bruce A. Cooper, Steven M. Paul, Jon D. Levine, Yvette P. Conley, Frances Cartwright, Kathryn Lee, Fay Wright, Christine Miaskowski

Research output: Contribution to journalArticle

Abstract

Background: Approximately 28% of patients with gastrointestinal (GI) cancers will receive targeted therapy (TT) because of the associated increases in survival. Only four studies have examined the symptom experience of these patients. To date, no studies have evaluated for differences in symptom occurrence, severity, and distress between patients who received chemotherapy (CTX) alone (n=304) or CTX with TT (n=93). Methods: Patients completed self-report questionnaires, approximately one week after they received CTX. A modified version of the Memorial Symptom Assessment Scale (MSAS) was used to obtain data on symptom occurrence, severity, and distress. Binary logistic regression analyses were used to test for differences in symptom occurrence rates between the two treatment groups. Ordinal logistic regression analyses were used to test for differences in severity and distress ratings between the two treatment groups. Results: Patients who received CTX with TT were significantly younger (P=0.009); were diagnosed with cancer longer (P=0.004); had a higher number of prior treatments (P=0.024); had metastatic disease, specifically to the liver (P < 0.001); had a diagnosis of anal, colon, rectum, or colorectal cancer (CRC) (P < 0.001); and were positive for detection of B-Raf proto-oncogene, serine/threonine kinase (BRAF) and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations (both P < 0.001). In addition, CTX treatment regimens were significantly different between the two groups (P < 0.001). After controlling for significant covariates, patients who received TT reported lower occurrence rates for lack of energy, cough, feeling drowsy, and difficulty sleeping (all, P < 0.05). Patients who received TT reported lower severity scores for dry mouth (P=0.034) and change in the way food tastes (P=0.035). However, they reported higher severity scores for "I don't look like myself" (P=0.026). No differences in symptom distress scores were found between the two treatment groups. Conclusions: This study is the first to evaluate for differences in the symptom experience of GI cancer patients who received CTX alone or CTX with TT using a multidimensional symptom assessment scale. While between group differences in patients' symptom experiences were identified, both treatment groups warrant ongoing assessments to optimally manage their symptoms.

Original languageEnglish (US)
Pages (from-to)109-126
Number of pages18
JournalJournal of Gastrointestinal Oncology
Volume8
Issue number1
DOIs
StatePublished - 2017

Fingerprint

Gastrointestinal Neoplasms
Drug Therapy
Therapeutics
Symptom Assessment
Logistic Models
Regression Analysis
Proto-Oncogenes
Protein-Serine-Threonine Kinases
Rectal Neoplasms
Oncogenes
Cough
Sarcoma
Colonic Neoplasms
Self Report
Mouth
Colorectal Neoplasms
Emotions

Keywords

  • Chemotherapy (CTX)
  • Gastrointestinal cancer
  • Symptoms
  • Targeted therapy (TT)

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

Differences in symptom occurrence, severity, and distress ratings between patients with gastrointestinal cancers who received chemotherapy alone or chemotherapy with targeted therapy. / Tantoy, Ilufredo Y.; Dhruva, Anand; Cataldo, Janine; Venook, Alan; Cooper, Bruce A.; Paul, Steven M.; Levine, Jon D.; Conley, Yvette P.; Cartwright, Frances; Lee, Kathryn; Wright, Fay; Miaskowski, Christine.

In: Journal of Gastrointestinal Oncology, Vol. 8, No. 1, 2017, p. 109-126.

Research output: Contribution to journalArticle

Tantoy, Ilufredo Y. ; Dhruva, Anand ; Cataldo, Janine ; Venook, Alan ; Cooper, Bruce A. ; Paul, Steven M. ; Levine, Jon D. ; Conley, Yvette P. ; Cartwright, Frances ; Lee, Kathryn ; Wright, Fay ; Miaskowski, Christine. / Differences in symptom occurrence, severity, and distress ratings between patients with gastrointestinal cancers who received chemotherapy alone or chemotherapy with targeted therapy. In: Journal of Gastrointestinal Oncology. 2017 ; Vol. 8, No. 1. pp. 109-126.
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abstract = "Background: Approximately 28{\%} of patients with gastrointestinal (GI) cancers will receive targeted therapy (TT) because of the associated increases in survival. Only four studies have examined the symptom experience of these patients. To date, no studies have evaluated for differences in symptom occurrence, severity, and distress between patients who received chemotherapy (CTX) alone (n=304) or CTX with TT (n=93). Methods: Patients completed self-report questionnaires, approximately one week after they received CTX. A modified version of the Memorial Symptom Assessment Scale (MSAS) was used to obtain data on symptom occurrence, severity, and distress. Binary logistic regression analyses were used to test for differences in symptom occurrence rates between the two treatment groups. Ordinal logistic regression analyses were used to test for differences in severity and distress ratings between the two treatment groups. Results: Patients who received CTX with TT were significantly younger (P=0.009); were diagnosed with cancer longer (P=0.004); had a higher number of prior treatments (P=0.024); had metastatic disease, specifically to the liver (P < 0.001); had a diagnosis of anal, colon, rectum, or colorectal cancer (CRC) (P < 0.001); and were positive for detection of B-Raf proto-oncogene, serine/threonine kinase (BRAF) and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations (both P < 0.001). In addition, CTX treatment regimens were significantly different between the two groups (P < 0.001). After controlling for significant covariates, patients who received TT reported lower occurrence rates for lack of energy, cough, feeling drowsy, and difficulty sleeping (all, P < 0.05). Patients who received TT reported lower severity scores for dry mouth (P=0.034) and change in the way food tastes (P=0.035). However, they reported higher severity scores for {"}I don't look like myself{"} (P=0.026). No differences in symptom distress scores were found between the two treatment groups. Conclusions: This study is the first to evaluate for differences in the symptom experience of GI cancer patients who received CTX alone or CTX with TT using a multidimensional symptom assessment scale. While between group differences in patients' symptom experiences were identified, both treatment groups warrant ongoing assessments to optimally manage their symptoms.",
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T1 - Differences in symptom occurrence, severity, and distress ratings between patients with gastrointestinal cancers who received chemotherapy alone or chemotherapy with targeted therapy

AU - Tantoy, Ilufredo Y.

AU - Dhruva, Anand

AU - Cataldo, Janine

AU - Venook, Alan

AU - Cooper, Bruce A.

AU - Paul, Steven M.

AU - Levine, Jon D.

AU - Conley, Yvette P.

AU - Cartwright, Frances

AU - Lee, Kathryn

AU - Wright, Fay

AU - Miaskowski, Christine

PY - 2017

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N2 - Background: Approximately 28% of patients with gastrointestinal (GI) cancers will receive targeted therapy (TT) because of the associated increases in survival. Only four studies have examined the symptom experience of these patients. To date, no studies have evaluated for differences in symptom occurrence, severity, and distress between patients who received chemotherapy (CTX) alone (n=304) or CTX with TT (n=93). Methods: Patients completed self-report questionnaires, approximately one week after they received CTX. A modified version of the Memorial Symptom Assessment Scale (MSAS) was used to obtain data on symptom occurrence, severity, and distress. Binary logistic regression analyses were used to test for differences in symptom occurrence rates between the two treatment groups. Ordinal logistic regression analyses were used to test for differences in severity and distress ratings between the two treatment groups. Results: Patients who received CTX with TT were significantly younger (P=0.009); were diagnosed with cancer longer (P=0.004); had a higher number of prior treatments (P=0.024); had metastatic disease, specifically to the liver (P < 0.001); had a diagnosis of anal, colon, rectum, or colorectal cancer (CRC) (P < 0.001); and were positive for detection of B-Raf proto-oncogene, serine/threonine kinase (BRAF) and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations (both P < 0.001). In addition, CTX treatment regimens were significantly different between the two groups (P < 0.001). After controlling for significant covariates, patients who received TT reported lower occurrence rates for lack of energy, cough, feeling drowsy, and difficulty sleeping (all, P < 0.05). Patients who received TT reported lower severity scores for dry mouth (P=0.034) and change in the way food tastes (P=0.035). However, they reported higher severity scores for "I don't look like myself" (P=0.026). No differences in symptom distress scores were found between the two treatment groups. Conclusions: This study is the first to evaluate for differences in the symptom experience of GI cancer patients who received CTX alone or CTX with TT using a multidimensional symptom assessment scale. While between group differences in patients' symptom experiences were identified, both treatment groups warrant ongoing assessments to optimally manage their symptoms.

AB - Background: Approximately 28% of patients with gastrointestinal (GI) cancers will receive targeted therapy (TT) because of the associated increases in survival. Only four studies have examined the symptom experience of these patients. To date, no studies have evaluated for differences in symptom occurrence, severity, and distress between patients who received chemotherapy (CTX) alone (n=304) or CTX with TT (n=93). Methods: Patients completed self-report questionnaires, approximately one week after they received CTX. A modified version of the Memorial Symptom Assessment Scale (MSAS) was used to obtain data on symptom occurrence, severity, and distress. Binary logistic regression analyses were used to test for differences in symptom occurrence rates between the two treatment groups. Ordinal logistic regression analyses were used to test for differences in severity and distress ratings between the two treatment groups. Results: Patients who received CTX with TT were significantly younger (P=0.009); were diagnosed with cancer longer (P=0.004); had a higher number of prior treatments (P=0.024); had metastatic disease, specifically to the liver (P < 0.001); had a diagnosis of anal, colon, rectum, or colorectal cancer (CRC) (P < 0.001); and were positive for detection of B-Raf proto-oncogene, serine/threonine kinase (BRAF) and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations (both P < 0.001). In addition, CTX treatment regimens were significantly different between the two groups (P < 0.001). After controlling for significant covariates, patients who received TT reported lower occurrence rates for lack of energy, cough, feeling drowsy, and difficulty sleeping (all, P < 0.05). Patients who received TT reported lower severity scores for dry mouth (P=0.034) and change in the way food tastes (P=0.035). However, they reported higher severity scores for "I don't look like myself" (P=0.026). No differences in symptom distress scores were found between the two treatment groups. Conclusions: This study is the first to evaluate for differences in the symptom experience of GI cancer patients who received CTX alone or CTX with TT using a multidimensional symptom assessment scale. While between group differences in patients' symptom experiences were identified, both treatment groups warrant ongoing assessments to optimally manage their symptoms.

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