Association between tumor response and change in EQ5D-3L quality of life among cancer patients

Stephen Joseph Garcia, Charles Vincent Uy, Corazon Ngelangel, Francisco delos Reyes


Purpose: The primary aim in cancer treatment is to provide excellent tumor response while maintaining the most acceptable quality of life. The relationship of QoL to tumor response has not yet been well discussed. This study determines the association between the change in the QoL from baseline to one (1) year follow-up and tumor response among patients enrolled in the ASEAN Cost in Oncology (ACTION) study.

Methods: Pooled data from the ACTION study was reviewed. Associations between demographics, cancer type, and tumor response were analyzed.

Results: Of the qualified profiles (412 / 742), breast cancer (42.2%), colorectal (21.8%), and head neck (10%) are still most common. Of these cases, 126 (30.6%) were metastatic on presentation. Demographic data showed female sex having better tumor response. More importantly, tumor response was significantly associated with improvement in QoL: complete or partial response was associated with improvement in QoL (p = .000) while progressive disease related to worse situations. The general pattern seen above was reflected in female breast cancer cases, colon and rectal cancer, and other malignant neoplasms.

Conclusion: Improvement in QoL was significantly associated with better tumor response. This trend was similar for breast cancer, colorectal cancer and other malignancies. The use of universal measures of health like the EQ5D 3L may be used to quantify improvements in QoL with several limitations: 1) cultural differences should be established and 2) limitations in quantifying precise changes in QoL. The utilization of more culturally adept QoL measures may address this problem. Similarly, the use of secondary data may limit the results in this study. Prospective studies specifically addressing the objectives may improve results.


Quality of Life, QOL, Tumor response, Cancer, EQ 5D 3L


Osoba D. Health Related Quality of Life and Cancer Clinical Trials. Ther Adv Med Oncol. 2011;3(2):57–71.

Eisenhauer EA, Therasse P, Bogaerts J , et al. New response evaluation criteria in solid tumours: revised RECIST guideline. Eur J Cancer. 2009;45(2):228-47.

Anderson JR, Cain KC, Gelber RD. Analysis of survival by tumor response and other comparisons of time-to-event by outcome variables. J Clin Oncol. 2008;26(24):3913-5.

National Comprehensive Cancer Network- Editorial Board. NCCN Guidelines for Treatment of Cancer by Site. [Internet]. Retrieved August 1, 2016, from

Modi S, Panageas KS, Duck ET, et al. Prospective exploratory analysis of the association between tumor response, quality of life, and expenditures among patients receiving paclitaxel monotherapy for refractory metastatic breast cancer. J Clin Oncol. 2002;20(17):3665-73.

Shin DB, Bang SM, Park SH, et al. Correlation of quality of life with tumor response in patients receiving palliative chemotherapy for advanced gastrointestinal tumors. Med Oncol. 2008;25(1):81-7.

Wu YL, Fukuoka M, Mok TS, et al. Tumor response and health-related quality of life in clinically selected patients from Asia with advanced non-small-cell lung cancer treated with first-line gefitinib: post hoc analyses from the IPASS study. Lung Cancer. 2013;81(2):280-7.

Kenne Sarenmalm E, Odén A, Ohlén J, et al. Changes in health-related quality of life may predict recurrent breast cancer. Eur J Oncol Nurs. 2009;13(5):323-9.

Siddiqui F, Pajak TF, Watkins-Bruner D, et al. Pretreatment quality of life predicts for locoregional control in head and neck cancer patients: a radiation therapy oncology group analysis. Int J Radiat Oncol Biol Phys. 2008;70(2):353-60.

Demegillo KJ, Ngelangel CA. Association between Baseline EQ5D Quality of Life with 1-Year Survival among Cancer Patients from Two Philippine Government Medical Oncology Clinics. Section of Medical Oncology, UP- Philippine General Hospital. 2016.

Kimman M, Jan S, Kingston D, et al. Socioeconomic impact of cancer in member countries of the Association of Southeast Asian Nations (ASEAN): the ACTION study protocol. Asian Pac J Cancer Prev. 2012;13(2):421-5.

The EuroQol Group. EuroQol-a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199-208.

De Vita VT, Lawrence TS, Rosenberg SA. Cancer: Principle and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health; 2015.

Ngelangel CA, Wang EH. Cancer and the Philippine Cancer Control Program. Jpn J Clin Oncol. 2002;32(1): S52-S61.

Ngelangel CA. Quality of Life of Filipino Cancer Patients. Asia-Pacific Ocology Haematology. 2008;1(1):18-19.

Tchen N1, Bedard P, Yi QL, et al. Quality of life and understanding of disease status among cancer patients of different ethnic origin. Br J Cancer. 2003;89(4):641-7.

Ramiro LS, Ngelangel CA, Amarillo ML, Streiner D, The UP-DOH QOL scale measures of quality of life of Filipino cancer patients, Phil J Int Med. 1997;35:179–88.


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International Journal of Cancer Therapy and Oncology (ISSN 2330-4049)

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