The impact of anticancer therapy on quality of life has been receiving increasing attention, particularly with diseases such as low-grade non-Hodgkin’s lymphoma (NHL), where palliation rather than cure is the primary objective of therapy. The
The impact of anticancer therapy on quality of life has beenreceiving increasing attention, particularly with diseases such as low-gradenon-Hodgkin’s lymphoma (NHL), where palliation rather than cure is the primaryobjective of therapy. The Functional Assessment of Cancer Therapy-General(FACT-G) is a validated questionnaire that captures the major areas of patients’subjective evaluation of the impact of their cancer on the following domains:physical, social, emotional, functional, and relationship with doctor (J ClinOncol 11:570-579, 1993). There are two to seven questions per domain,yielding a total score from 0 to 112.
We used the FACT-G survey to assess quality of life in a phaseIII randomized trial of ibritumomab tiuxetan (Zevalin) radioimmunotherapy vsrituximab (Rituxan) immunotherapy in patients with relapsed or refractorylow-grade, follicular, or transformed NHL. The phase III trial enrolled 73patients on the ibritumomab tiuxetan arm and 70 patientson the rituximab arm, with the following baseline characteristics: median age,59 years (range: 29 to 80 years); 51% female; largest tumor > 5 cm, 45%; bonemarrow involvement, 39%; and International Prognostic Index intermediate/high or high-riskgroup, 12%.
FACT-G total scores and subscale scores were compared betweenbaseline and 3 months posttherapy within each of the treatment arms. Threemonths was chosen because patients were most likely to be in a maximal responsefrom either therapy at this point. Not all patients completed thequestionnaires; 62% and 51% of patients on the ibritumomab tiuxetan andrituximab arms, respectively, completed both a baseline and a 3-month FACT-Gsurvey.
Of note, the mean baseline FACT-G score, prior to treatment, washigh in both treatment arms: 86.9 for ibritumomab tiuxetan and 90.7 forrituximab. At 3 months posttherapy, the ibritumomab tiuxetan group experienced astatistically significant increase in the FACT-G total score (86.9 to 93.3; P =.001); the increase for the rituximab arm was not statistically significant(90.7 to 93.4; P = .185). Patients on the ibritumomab tiuxetan arm alsoexperienced statistically significant improvement in the following FACT-Gsubscales: emotional, physical, and functional well-being; the rituximab groupexperienced a statistically significant improvement in the emotional subscale.
CONCLUSION: Ibritumomab tiuxetan therapy results in astatistically significant improvement in patient self-assessed quality of life.Such information may help patients and physicians with their treatmentdecisions.