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Quality of life in patients with malignant spinal cord compression: a systematic review

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Abstract

Introduction

Malignant spinal cord compression (MSCC) is an oncological emergency that may result in a devastating combination of malignancy and disability. Existing quality of life (QoL) questionnaires commonly used in MSCC literature (EORTC QLQ-C30, BM-22, Brief Pain Inventory, and Spine Oncology Study Group Outcomes) may not capture all the commonly reported symptoms and lack specificity to MSCC. The primary objective of this systematic review is to determine unmet patient needs and underreported QoL issues and compile a comprehensive list of QoL issues. The secondary objective of this review is to compile all existing QoL tools and questionnaires and determine whether any QoL issues are not addressed in the existing tools currently used in the literature.

Methods

A literature search was conducted on Ovid MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases between 1946 and February 6, 2023, to compile all QoL issues and existing questionnaires used to assess QoL in patients with MSCC. All study designs were included given that they discussed QoL issues specific to patients with MSCC.

Results

The results of this systematic review identified the most frequently discussed QoL issues in the literature studying MSCC. This included direct symptoms of MSCC such as back pain, paralysis, limb weakness/numbness, and urinary/bowel incontinence. Indirect symptoms coming from radiotherapy treatment such as dysphagia, painful swallowing, mouth pain, dry mouth, diarrhea, fatigue, and nausea/vomiting were also noted. Other symptoms resulting from corticosteroid treatment included difficulty sleeping, blurring of vision, weight gain, and mood disturbance. Patients also experienced psychosocial issues such as anxiety, depression, emotional distress, low self-esteem, concerns about dependence on others, concerns about getting home, and fear about their prognosis and future.

Conclusion

This review highlights the QoL issues specific to patients with MSCC and QoL tools capturing these issues. Relevance of QoL issues identified in this systematic review must be prospectively validated by patients and healthcare professionals with experience in treating MSCC.

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Data availability

All data used in this review can be found in the studies listed in References.

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Funding

This research was funded by the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group (QLG), grant number 006/2023. The EORTC QLG business model involves license fees for commercial use of their instruments. Academic use of EORTC instruments is free of charge.

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Authors and Affiliations

  1. Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada

    Milena Gojsevic, Saba Shariati, Elwyn Zhang, Samantha K. F. Kennedy, Thenugaa Rajeswaran, Hany Soliman, Shereen Akkila & Edward Chow

  2. Department of Clinical Oncology, Tuen Mun Hospital, Hospital Authority, Hong Kong, Hong Kong

    Adrian Wai Chan & Shing-Fung Lee

  3. Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    Pierluigi Bonomo

  4. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany

    Dirk Rades

  5. Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus

    Vassilios Vassiliou

  6. Department of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore, Singapore

    Shing-Fung Lee

  7. Department of Oncology, Princess Margaret Hospital, Hong Kong, Hong Kong

    Henry C. Y. Wong

  8. The University of Manchester, Manchester, UK

    Agata Rembielak

  9. Department of Clinical Oncology, The Christie NHS Foundation Trust and the University of Manchester, Manchester, UK

    Agata Rembielak

  10. Department of Radiation Oncology, University Hospitals Leuven, Louvain, Belgium

    Eva Oldenburger

  11. St. George’s University, Northumbria, England

    Lucas Azevedo

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  1. Milena Gojsevic
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On behalf of EORTC Quality of Life Group

Contributions

MG, AWC, SS sconducted the literature search. Records were independently screened by MG and AWC by title and abstract according to the eligibility criteria. Potential articles were further assessed through full-text screening. Conflicts were resolved by discussion between authors or consultation with EZ. MG, AWC, EZ, TR, SS, and SKFK conducted data extraction. MG wrote the body of the manuscript with help from SS. MG, AWC, EZ, and SKFK incorporated the comments from other authors. EC was the senior author overseeing the project. All others listed provided significant edits to the manuscript and gave a final approval. SKFK is the research manager for this project.

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Correspondence to Edward Chow.

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This research was funded by the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group (QLG), grant number 006/2023. The EORTC QLG business model involves license fees for commercial use of their instruments. Academic use of EORTC instruments is free of charge.

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Gojsevic, M., Shariati, S., Chan, A.W. et al. Quality of life in patients with malignant spinal cord compression: a systematic review. Support Care Cancer 31, 736 (2023). https://doi.org/10.1007/s00520-023-08186-4

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  • DOI: https://doi.org/10.1007/s00520-023-08186-4

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