Impact of adjuvant therapy toxicity on quality of life and emotional symptoms in patients with colon cancer: a latent class analysis

Clin Transl Oncol. 2021 Mar;23(3):657-662. doi: 10.1007/s12094-020-02454-z. Epub 2020 Jul 16.

Abstract

Objective: To identify distinct trajectories of toxicity in colorectal cancer (CRC) patients after adjuvant chemotherapy and its impact on quality of life (QoL) and psychological symptoms.

Methods: A prospective, multicenter study was conducted in 157 patients. A latent class analysis defined the unobserved latent constructs that can be predicted as symptom clusters, considering the intensity of four types of adverse events (AEs). Patients completed EORTC-QLQ-C30, BSI-18, PDRQ-9, and DRS scales.

Results: Ninety-six percent had some degree of toxicity, with grades 3-4 being the most common: neurotoxicity (7.2%), hematological (13.1%), digestive (5.2%), and skin toxicity (1.4%). Three distinct latent classes were identified (high [72.5%], mild [16.9%], and low [10.6%] toxicity). Patients with high toxicity had the worst QoL scores and moderately high somatization and psychological distress scores.

Conclusions: Adjuvant chemotherapy for CRC was associated with frequent toxicity that negatively impacted QoL and psychological wellbeing.

Keywords: Adjuvant treatment; Cancer; Latent class analysis; Oxaliplatin; Toxicity; Trajectory analysis.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Antimetabolites, Antineoplastic / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Capecitabine / adverse effects
  • Chemotherapy, Adjuvant / adverse effects
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / mortality
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / psychology*
  • Decision Making
  • Emotions
  • Female
  • Fluorouracil / adverse effects
  • Humans
  • Latent Class Analysis*
  • Leucovorin / adverse effects
  • Male
  • Middle Aged
  • Organoplatinum Compounds / adverse effects
  • Physician-Patient Relations
  • Prospective Studies
  • Pyridines / adverse effects
  • Quality of Life*
  • Spain

Substances

  • Antimetabolites, Antineoplastic
  • Organoplatinum Compounds
  • Pyridines
  • oxiplatin
  • Capecitabine
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol