Comparison of health-related quality of life with different antitumor agents for advanced soft tissue sarcoma

Abstract Background During cancer treatment, maintenance and improvement of quality of life (QOL) are important, as is prolongation of overall survival. As the disease progresses, patients may experience a decline in QOL due to physical or mental changes. However, few studies have evaluated QOL longitudinally in advanced soft tissue sarcoma (STS) patients according to the antitumor agent. The purpose of this study was to compare health-related QOL (HRQOL) in patients with advanced STS receiving the combination regimen of doxorubicin and ifosfamide (AI) or three novel antitumor agents (pazopanib, trabectedin, eribulin). Methods Twelve patients diagnosed with advanced STS who started chemotherapy between 2010 and 2017 at our hospital were enrolled. HRQOL was assessed using the European Organization on Research and Treatment of Cancer Quality-of-Life Core Questionnaire-30 (EORTC QLQ-C30) after three cycles of chemotherapy before assessing the effect of treatment. Global health status, a functional scale, and a symptomatic scale were compared for the AI regimen and the three novel antitumor agents. Results The mean global health status score of the patients treated with the AI regimen was significantly different from that of those treated with one of the three novel antitumor agents (37.9 and 56.8, respectively). No significant differences were found in the five functional scores. The nausea and vomiting score was significantly different between the AI regimen and eribulin. The constipation score was significantly higher with the AI regimen, and the diarrhea score was significantly higher with pazopanib. Conclusions Compared to the AI regimen, patients can continue treatment with one of the three innovative antitumor agents while maintaining QOL, even with progressive disease. In particular, of the three innovative antitumor agents compared to the AI regimen, patients treated with pazopanib were able to maintain social activities during treatment. In the second-line and subsequent treatments, we could not clearly show a different effect on maintenance of a better QOL among the three innovative drugs, so additional work in the future is needed. If we clarify which of the three drugs most affects QOL, recommendations can be made regarding treatment selection for the second-line and subsequent treatments.