Quality of life in patients with metastatic gastroenteropancreatic neuroendocrine tumors receiving peptide receptor radionuclide therapy: information from a monitoring program in clinical routine

Abstract

We evaluated health-related quality of life (HRQoL) in patients with metastatic gastroenteropancreatic neuroendocrine tumors (GEPNET) over the course of first peptide receptor radionuclide therapy (PRRT) to first restaging, and compared scores with general population (GP) norms. Methods: We used data from routine HRQoL monitoring with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30. Patients received 4–6 cycles of ¹⁷⁷Lu-DOTATATE or ⁹⁰Y-DOTATOC. To be eligible for analysis, patients had to have at least one HRQoL assessment before PRRT and one after treatment completion. Linear mixed models were used to consider HRQoL changes over time. Results: A total of 61 GEPNET patients (small intestine: N = 37; pancreatic: N = 24) were eligible for analysis. Clear improvements from baseline to first restaging were found for diarrhea in small intestine NET patients showing a clinically relevant decrease of 16 points. We observed a clinically relevant decrease in appetite loss (17 points), but for female small intestine patients only. Other HRQoL changes were also restricted to sociodemographic/clinical subgroups and mainly reflected improvements, except for physical and social functioning showing decreasing scores in older small intestine NET patients. Compared to HRQoL GP norms, patients had impairments in diarrhea, fatigue, appetite loss, physical, social, role functioning, and global HRQoL. Except for diarrhea and appetite loss, patient scores at first restaging did not reach GP levels. Conclusion: Our analyses support previous findings of stable HRQoL under PRRT. Yet, this must not belie patients’ significant HRQoL impairments compared to the GP.