Impact of dermatologic adverse events on quality of life in 283 cancer patients: a questionnaire study in a dermatology referral clinic

Am J Clin Dermatol. 2013 Aug;14(4):327-33. doi: 10.1007/s40257-013-0021-0.

Abstract

Background: Anticancer therapies cause a wide range of dermatologic adverse events (AE). Although the frequency and severity of these events have been described, their effects on health-related quality of life (QoL) remain poorly understood, and the ones having a greater impact have not been ascertained.

Objective: To assess QoL in patients on conventional versus targeted anti-cancer therapies using a dermatology-specific questionnaire.

Methods: Patients (n = 283) completed the Skindex-16, a QoL questionnaire measuring the effects on three domains: symptoms, emotions, and function. Patients were grouped into two categories according to the types of oncology treatments received: (1) targeted therapies and (2) non-targeted therapies. Correlations of Skindex-16 scores with type of anti-cancer therapy, number of AEs, and specific dermatologic AEs were investigated.

Results: Significant differences between patients treated with targeted versus non-targeted therapy with regards to total Skindex-16 (p = 0.02) and emotion subdomain (p = 0.02) scores were observed. Additionally, patients on targeted therapies experienced a significantly greater number of AEs (p < 0.001) compared with patients on non-targeted therapies. Patients who exhibited epidermal growth factor receptor (EGFR) inhibitor-induced rash had higher Skindex-16 scores (p = 0.009) and higher scores in the symptom (p < 0.001), emotion (p = 0.01), and function (p = 0.001) subdomains than patients without this AE. Similar results were observed for pruritus. All p values were two sided.

Conclusions: Dermatologic AEs are associated with a diminished QoL. Targeted therapies are associated with a significantly increased number of AEs and worse total and emotion Skindex-16 scores in comparison with non-targeted therapies. EGFR inhibitor rash and pruritus produced the greatest negative impact.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Ambulatory Care Facilities
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Biological Therapy / adverse effects*
  • Biological Therapy / methods
  • Cross-Sectional Studies
  • Dermatology / methods
  • Drug Eruptions / epidemiology
  • Drug Eruptions / etiology*
  • Drug Eruptions / physiopathology
  • Exanthema / chemically induced
  • Exanthema / epidemiology
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Molecular Targeted Therapy / adverse effects*
  • Molecular Targeted Therapy / methods
  • Neoplasms / drug therapy
  • Neoplasms / pathology
  • Pruritus / chemically induced
  • Pruritus / epidemiology
  • Quality of Life*
  • Referral and Consultation
  • Severity of Illness Index
  • Sex Distribution
  • Surveys and Questionnaires

Substances

  • Antineoplastic Agents