MOST and HRQL indices in recurrent ovarian cancer
Patients with recurrent ovarian cancer can assess the effectiveness and safety of palliative chemotherapy using the Concerns of Measurement of Ovarian Symptoms and Treatment (MOST); a validated patient-reported symptom assessment instrument for recurrent ovarian cancer (ROC). This research aims to determine if there is a correlation between MOST symptom indices and essential markers of health-related quality of life and if symptoms within MOST symptom indices tend to cluster with the quality of health-related life (HRQL). At baseline and before each cycle of chemotherapy, a prospective group of women with ROC completed the MOST-T35, EORTC QLQ-C30, and EORTC QLQ-OV28 questionnaires. Data collected at the start and end of treatment were analyzed. Clusters of co-occurring symptoms were found using exploratory factor analysis and hierarchical cluster analysis. Correlations between MOST symptom indices and HRQOL were analyzed using trajectory models. Sample size was calculated by comparing the number of women who completed all 22 symptom-specific MOST items and at least 1 HRQoL measure at baseline (762) and at end of treatment (681). At the start and end of treatment, 4 clusters of symptoms appeared: gastrointestinal symptoms, symptoms of peripheral neuropathy, nausea and vomiting, and psychological symptoms. Lower scores in the QLQ-C30 and OV28 functioning domains and lower general health were associated with higher levels of psychological (MOST-Psych) and disease/treatment-related (MOST-DorT) symptoms. Statistical approaches and periods agreed on 4 groups of MOST symptoms. These results indicate that MOST is a promising intervention for improving HRQoL, especially when combined with appropriate referral pathways for symptom management for use in clinical practice.