Endocrine Abstracts (2003) 6 OC2

The nature of the quality of life (QOL) impairment in adult GHD survivors of cancer and their response to GH replacement therapy

S Tolhurst-Cleaver, A Mukherjee, L Smethurst & SM Shalet


Christie Hospital, Manchester, UK.


OBJECTIVE: To determine the characteristics of the QOL impairment observed in GHD survivors of cancer (group 1), and response to GH replacement in comparison with GHD patients with primary pituitary pathology (non-secreting pituitary adenoma or prolactinoma; group 2).

METHODS: Patients were considered for GH replacement on the basis of biochemically established severe GHD and subjectively poor QOL noted at interview. QOL was studied at baseline, and at early (6-13 months) and long-term treatment follow-up (24-77 months) in 50 patients (27 female), (group 1) and 47 (24 females), (group 2). Data from 2 self-rating questionnaires, the PGWB (generic, 6 domains; anxiety, depression, health, self-control, well being, vitality; lower score-worse QOL) and AGHDA (disease generated; higher score-worse QOL) were studied.

RESULTS: Baseline total scores for PGWB and AGHDA were not different between groups 1 and 2. The lowest domain score of the PGWB was represented by vitality in both groups, and was significantly lower than all other domains (p<0.0001).

AGHDA score improved significantly at early follow-up in group 1 (medians 16 vs. 9, p<0.0001) and group 2 (median 17 vs. 9.5, p<0.0001).

PGWB total score increased significantly at early follow-up in group 1 (medians 64 vs. 82, p<0.0001) and in group 2 (medians 61 vs. 77, p=0.0001). In both groups at early follow-up, the vitality domain achieved a greater percentage increment than all other domains (p<0.05). The degree of improvement in scores for both questionnaires remained unchanged at long-term follow-up.

CONCLUSION: The weighting of QOL domain scores, in adult GHD survivors of cancer, is comparable to that observed in GHD adults with primary pituitary pathology. QOL domain scores also improve with GH replacement in a comparable manner in these two groups. The QOL impairment observed in GHD survivors of cancer appears mainly related to GHD rather than cancer diagnosis and treatment.

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