Somatostatin analogues (SSAs) are regularly used in the treatment of neuroendocrine tumours (NETs) to control the symptoms of hormonal hypersecretion. Evidence shows that SSAs can reduce tumour progression, and are therefore also being used in patients with non-functioning tumours. As many NETs present with advanced disease curative therapy is often not possible; therefore, assessing the impact of therapy on quality of life (QoL) is vital to patient management. This is particularly true in patients with non-functioning tumours where symptom control is not the primary aim of commencing SSAs.
Aim: To assess whether QoL was being evaluated in patients with NETs being treated with SSAs, and the impact on QoL following treatment with SSAs, comparing symptomatic with asymptomatic patients.
Method: Twenty patients with NETs treated at Queen Elizabeth Hospital Birmingham (QEHB) were included: the last 10 symptomatic patients and 10 asymptomatic patients that had been started on SSA therapy and had completed at least 3 months of treatment (as of October 2016). Data was collected about whether validated QoL questionnaires (EORTC QLQ GI.NET21) had been recorded and what the average QoL score was. This was then compared over the course of treatment.
Results: 75% of patients completed a QoL questionnaire before starting SSA therapy, and 65% of patients completed a further questionnaire after 1 month. Nine symptomatic patients had completed both pre-SSA and post-1-month questionnaires, with six showing an improvement in average QoL score after 1 month. In the equivalent five asymptomatic patients, four showed an improvement in average QoL score.
Conclusion: Three quarters of patients completed a baseline QoL questionnaire, however fewer patients completed a questionnaire after 1 month, and this rate dropped again with subsequent treatments. At QEHB it is now standard practice for patients to complete a QoL questionnaire when attending for SSA treatment; which ensures higher completion levels for the first three months of treatment. The majority of symptomatic and asymptomatic patients showed an improvement in average QoL score after 1 month of treatment, indicating that SSAs can improve QoL in patients with NETs, and the benefits of commencing SSAs outweigh side-effects in asymptomatic patients.
04 Dec 2017
UK and Ireland Neuroendocrine Tumour Society