Garrison, LP

Goulart, BHL

Martins, R

Patrick, D

Ramsey, S

Sullivan, SD

Elsevier - Publisher Connector 

PCN35 SYSTEMATIC REVIEW OF THE IMPACT OF CHEMOTHERAPY ON PATIENT REPORTED OUTCOMES IN ADVANCED NON-SMALL-CELL LUNG CANCER 

Rio Abstracts A499
PCN33
QUALITY OF LIFE OF PATIENTS WITH NON-HODGKIN LYMPHOMA AT 
THE SOCIAL SECURITY MEXICAN INSTITUTE
Contreras-Hernandez I1, Balderas-Peña LMA2, Mould-Quevedo J3, Sat-Muñoz D4,  
Garduño-Espinosa J1, Morgan-Villela G4
1Social Security Mexican Institute, Mexico City, Mexico, 2Social Security Mexican Institute, 
pecialties’ Hospital, Western National Medical Center, Guadalajara, Mexico, 3Pﬁzer Mexico, 
Mexico City, Mexico, 4Social Security Mexican Institute, Guadalajara, Mexico
OBJECTIVES: The aim of this study was to estimate the quality of life (QOL) of 
non-hodgkin’s lymphoma patients in their different stages attended at a tertiary refer-
ral center at the Social Security Mexican Institute (IMSS). METHODS: Quality of life 
surveys for patients with non-hodgkin lymphoma were administered at the “Hospital 
de Especialidades” CMNO at IMSS, during July 2008 to February 2009 using the 
following inclusion criteria: patients older than 16 years with non-hodgkin’s lym-
phoma histological diagnosis who accepted to be included in the protocol through 
informed consent. Patients excluded were those who showed a second malignant 
neoplasm or incomplete information. To evaluate QOL, the validated Spanish version 
of the EORTC QLQ-C30 was administered to patients. This questionnaire evaluates 
global health status, ﬁve functional domains (physical, role, emotional, cognitive and 
social), three symptom scales (fatigue, nausea and vomiting, pain), and six single items 
(dyspnea, insomnia, appetite loss, constipation, diarrhea, ﬁnancial difﬁculties) on a 
scale from 0 to 100 (0  death, 100  perfect health). The assessment calculates means 
and range for EORTC QLQ-C30 score items and statistical differences between 
disease stage were estimated through ANOVA tests, p value 0.05 was considered 
signiﬁcant to show differences. RESULTS: We analyzed data of 50 non-hodgkin’s 
lymphoma patients, mean age 53.88 o 16.8 years old, 48% were women, 74% were 
married, and 22% had an educational level of preparatory school. Patients were allo-
cated according clinical stages as follow: I-18%, II-22%, III-28%, IV-32%. Global 
health status scores in each stage resulted in: I:85.18, II:62.12, III:63.09, IV:70.83; 
p  0.13. The main differences among functional domains in the clinical stages were 
related to emotional function (I-76, II-64, III-60, IV-80; p  0.024) and cognitive 
function (I-76, II-75, III-69, IV-88; p  0.025). CONCLUSIONS: Signiﬁcant differ-
ences were observed in Mexican non-hodgkin’s lymphoma patient’s functional 
domains in their clinical stages.
PCN34
QUALITY OF LIFE IN DIFFERENT STAGES OF COLORECTAL PATIENTS 
ATTENDED AT THE SOCIAL SECURITY MEXICAN INSTITUTE
Contreras-Hernandez I1, Balderas-Peña LMA2, Mould-Quevedo J3, Sat-Muñoz D4,  
Garduño-Espinosa J1, Morgan-Villela G4
1Social Security Mexican Institute, Mexico City, Mexico, 2Social Security Mexican Institute, 
pecialties’ Hospital, Western National Medical Center, Guadalajara, Mexico, 3Pﬁzer Mexico, 
Mexico City, Mexico, 4Social Security Mexican Institute, Guadalajara, Mexico
OBJECTIVES: The aim of this study was to evaluate the quality of life (QOL) of 
colorectal cancer patients seeking care at a tertiary referral center within the Social 
Security Mexican Institute (IMSS). METHODS: Quality of life questionnaires were 
administered to colorectal cancer patients seeking care at the Hospital de Especiali-
dades del Centro Medico Nacional de Occidente (CMNO) from July 2008 to February 
2009. Evaluated patients under went informed consent, were 16 years of age or older, 
and had a colorectal cancer histological diagnosis (stage I, II, III and IV)). Patients 
were excluded if they had a second malignant neoplasm or incomplete information. 
To evaluate QOL, the validated Spanish version of the EORTC QLQ-C30 was 
administered to patients. This questionnaire evaluates global health status, ﬁve func-
tional domains (physical, role, emotional, cognitive and social), three symptom scales 
(fatigue, nausea and vomiting, pain), and six single items (dyspnea, insomnia, appetite 
loss, constipation, diarrhea, ﬁnancial difﬁculties) on a scale from 0 to 100 (0  death, 
100  perfect health). The assessment calculates means and ranges for EORTC QLQ-
C30 score items and statistical differences were estimated through ANOVA tests. 
RESULTS: A total of 29 colorectal cancer patients were included in the analysis. The 
mean age of evaluated patients was 54 years o SD13, 55% were female, 72% were 
married, and 15% had completed elementary school. Patients presented various clini-
cal stages of colorectal cancer, speciﬁcally I-1 (3%), II-9 (31%), III-9 (31%) IV-10 
(34%). Global Health Status showed the following results: I:83.33, II:67.59, III:74.07, 
IV:67.50; p  0.87. On the other hand, patients with later stages of CRC reported 
greater fatigue (I-100, II-67, III-80, IV-47; p  0.08) and pain (I-83, II-50, III-67, 
IV-48; p  0.005). CONCLUSIONS: Signiﬁcant differences were observed in Mexican 
colorectal cancer patients symptoms in their clinical stages.
PCN35
SYSTEMATIC REVIEW OF THE IMPACT OF CHEMOTHERAPY ON 
PATIENT REPORTED OUTCOMES IN ADVANCED NON-SMALL-CELL 
LUNG CANCER
Goulart BHL1, Sullivan SD1, Garrison LP1, Ramsey S2, Martins R3, Patrick D1
1University of Washington, Seattle, WA, USA, 2Fred Hutchinson Cancer Research Center, 
Seattle, WA, USA, 3Seattle Cancer Care Alliance, Seattle, WA, USA
OBJECTIVES: The impact of chemotherapy on patient reported outcomes (PRO) of 
patients with advanced non-small-cell lung cancer remains poorly understood. We 
performed a systematic review of the literature to address how ﬁrst-line chemotherapy 
affects PRO. Our aims were: To evaluate patterns of reporting of PRO in randomized 
controlled trials of advanced non-small-cell lung cancer; To estimate the effects of 
ﬁrst-line chemotherapy on PRO and the correlation between PRO and overall survival. 
METHODS: We performed a Medline systematic review of published clinical trials 
from 1980 to 2008. Randomized, phase III trials of ﬁrst-line chemotherapy against 
Best Supportive Care, placebo, or another chemotherapy regimen were eligible. We 
collected data on the type of PRO instrument, reported measures, effect-size, and 
whether there was a statistically signiﬁcant result on any PRO favoring the experi-
mental chemotherapy arm. We also computed overall survival differences between 
experimental and control arms and measured the correlation of OS difference with 
effect size for global QoL as assessed by the EORTC QLQ-C30 instrument. RESULTS: 
Twenty-two trials from 1998 to 2008 reported PRO. U.S. contributed with only one 
trial (4.5%). In 6 trials, Best Supportive Care was the control arm (27%). The EORTC 
QLQ-C30/LC13 instrument was used in 14 (64%) trials. Effect-size was directly 
measured in only 2 trials, and calculated in 3 other trials. Mean effect size was 0.013 
for chemotherapy vs. BSC (n  2) and 0.041 for chemotherapy vs. chemotherapy 
(n  2). Mean OS difference of chemotherapy vs. BSC was 1.9 months (P  0.04). 
Pearson correlation of OS difference and effect-size was –0.43. CONCLUSIONS: 
Reporting of PRO in randomized controlled trials of advanced non-small-cell lung 
cancer remains highly variable. There remains a substantial uncertainty about the 
impact of chemotherapy on global QoL, but the net effect is likely small. A possible 
association of overall survival differences with global QoL awarrants further 
investigation.
PCN36
A QUALIDADE DE VIDA DOS DOENTES ONCOLÓGICOS
Almeida A1, Pontinha C2
1Universidade da Beira Interior, Covilhã, Portugal, 2Hospital Sousa Martins, Guarda, Portugal
OBJETIVOS: O cancro é uma doença crónica que representa grande morbilidade e 
mortalidade, sendo considerada uma das principais causas de morte em todo o mundo. 
O objectivo deste trabalho foi investigar quais os factores que inﬂuenciam a QV do 
doente oncológico. MÉTODOS: Estudo transversal, descritivo e exploratório, na 
vertente quantitativa, com uma amostragem não probabilística, por conveniência. Na 
recolha de dados, foram utilizados os questionários QLQ-30 e o IN-PATSAT32 da 
EORTC. RESULTADOS: Analisados os dados sócio demográﬁcos veriﬁcamos que é 
composta por 54% de indivíduos do sexo masculino, 80% dos indivíduos são casados, 
64% são provenientes do meio rural, 42% da população tem apenas o 1°ciclo de 
escolaridade. Relativamente à situação proﬁssional veriﬁcamos que 30% pertencem 
ao quadro de instituições e 24% estão desempregados. Algumas variáveis sócio 
demográﬁcas apresentam relação com a variável de avaliação da QV e estão também 
relacionadas com percepção de cuidados prestados. Quanto à caracterização clínica 
da amostra, existem 30% de indivíduos que possuem neoplasias a nível gastrointesti-
nal e 26% neoplasias ginecológicas, 18% dos inquiridos pensam sofrer de um quisto, 
infecção ou inﬂamação. Um total de 50% já efectuaram cirurgia e 54% estão a fazer 
quimioterapia. CONCLUSÕES: Os resultados demonstram que, no âmbito da QV 
dos doentes oncológicos, o funcionamento social representa a variável com pior índice 
de QV (score-35.66). Relativamente à escala dos sintomas veriﬁcamos que as variáveis: 
fadiga, dor; insónia e perda de apetite e situação ﬁnanceira são as que apresentam 
maior peso na redução da QV. Os doentes têm uma melhor percepção de cuidados 
prestados relativamente aos cuidados de enfermagem, comparativamente com os cui-
dados médicos. As variáveis que apresentam piores níveis de avaliação são: acessibili-
dade/acesso, conforto e limpeza e o tempo de espera. De uma forma global, os doentes 
classiﬁcaram a saúde, e a QV na última semana, como mediana e apresentaram uma 
boa satisfação sobre os cuidados prestados.
CANCER – Health Care Use & Policy Studies
PCN37
ABRANGÊNCIA DO RASTREAMENTO DE CÂNCER DE MAMA POR 
MAMOGRAFIA EM BENEFICIÁRIAS DE UMA OPERADORA DE  
PLANO DE SAÚDE
Reis Neto JP, Tovar C
CAPESESP/CAPESAUDE, Rio de Janeiro, RJ, Brazil
OBJETIVOS: Avaliar a mamograﬁa no rastreamento de câncer de mama em bene-
ﬁciárias de um plano de saúde, deﬁnindo, a partir dos resultados, estratégias baseadas 
nas melhores evidências para uso racional do recurso. MÉTODOS: Análise retrospec-
tiva do perﬁl das mulheres beneﬁciárias de um plano de saúde submetidas à mamogra-
ﬁa nos últimos quattro anos. As variáveis consideradas foram faixa etária (inferior a 
35 anos, 35 a 39 anos, 40 a 49 anos e 50 anos ou mais), freqüência e regularidade da 
realização do exame. RESULTADOS: No período, foram realizadas 57,104 mamogra-
ﬁas, despesa total de R$ 5,065,885.58. A média de idade das 32,645 mulheres sub-
metidas ao exame foi de 52 anos. A taxa de rastreamento variou conforme faixa etária: 
62.0% para mulheres com 50 anos ou mais, 83.3% no intervalo de 40 a 49 anos, 
58.7% entre 35 a 39 anos e 2.4% (n  429) em idade inferior a 35 anos. A freqüência 
e regularidade da realização do exame também variaram em função da idade. CON-
CLUSÕES: As diretrizes para realização de mamograﬁa da operadora estabelecem 
como padrão o uso do método de rotina para mulheres a partir dos 40 anos. Mulheres 
na faixa etária dos 35 aos 40 anos pertencentes ao grupo de risco e aquelas de qualquer 
idade sintomáticas ou com anormalidade ao exame clínico da mama, também devem 
realizar o exame. Observamos neste estudo que 38.0% de mulheres com idade igual ou 
superior a 50 anos, cuja indicação de mamograﬁa é consenso, não realizou a prevenção 
primária de forma adequada. No grupo dos 40 aos 49 anos de idade, este percentual 
foi menor (16.7%). Não foi observado desperdício de recurso. A partir desses resulta-
dos, será traçada uma nova estratégia de ampliação do número de beneﬁciárias que 
deverão ser incentivadas a realizar o exame de forma regular.


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PCN35 SYSTEMATIC REVIEW OF THE IMPACT OF CHEMOTHERAPY ON PATIENT REPORTED OUTCOMES IN ADVANCED NON-SMALL-CELL LUNG CANCER

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