Quality of Life
Increasingly, researchers are faced with situations where patients may not gain benefits in terms of traditional end points, such as survival or disease-free survival. However, it is possible to see significant changes in health-related quality of life (HRQOL).
HRQOL, a multidimensional construct and an important concept, has, for many years, proven difficult to define. A number of definitions proposed by various authors as to the exact nature of HRQOL and the formulation of a defining consensus are shown in the bottom of the website’s home page.
Generally, HRQOL covers the subjective perceptions of the positive and negative aspects of cancer patients’ symptoms, including physical, emotional, social, and cognitive functions and, importantly, disease symptoms and side effects of treatment. Only 20 years ago, scant literature reported quality-of-life benefits. However, in recent years, there has been a large increase in studies reporting the assessment of HRQOL. At present, some 10% of all randomized cancer clinical trials include HRQOL as the main end point.
However, while the U.S. Food and Drug Administration now recognizes the benefits of HRQOL as a basis for approval of new anticancer drugs, and many international research groups include HRQOL in their studies, introducing HRQOL into oncology has been difficult. There are several reasons for this. One problem involves understanding the subjective nature of the results that HRQOL studies generate and the barriers to acceptance by clinicians. Furthermore, as Moinpour points out, bringing these metrics into a busy practice is difficult. The purpose of this review is to help clinicians understand the value of HRQOL.