Impact of dermatologic adverse events on quality of life in 283 cancer patients: a questionnaire study in a dermatology referral clinic.

ABSTRACT

BACKGROUND: Anticancer therapies cause a wide range of dermatologic adverse events (AE). Although the frequency and severity of these events have been described, their effects on health-related quality of life (QoL) remain poorly understood, and the ones having a greater impact have not been ascertained. OBJECTIVE: To assess QoL in patients on conventional versus targeted anti-cancer therapies using a dermatology-specific questionnaire. METHODS: Patients (n = 283) completed the Skindex-16, a QoL questionnaire measuring the effects on three domains symptoms, emotions, and function. Patients were grouped into two categories according to the types of oncology treatments received (1) targeted therapies and (2) non-targeted therapies. Correlations of Skindex-16 scores with type of anti-cancer therapy, number of AEs, and specific dermatologic AEs were investigated. RESULTS: Significant differences between patients treated with targeted versus non-targeted therapy with regards to total Skindex-16 (p = 0.02) and emotion subdomain (p = 0.02) scores were observed. Additionally, patients on targeted therapies experienced a significantly greater number of AEs (p < 0.001) compared with patients on non-targeted therapies. Patients who exhibited epidermal growth factor receptor (EGFR) inhibitor-induced rash had higher Skindex-16 scores (p = 0.009) and higher scores in the symptom (p < 0.001), emotion (p = 0.01), and function (p = 0.001) subdomains than patients without this AE. Similar results were observed for pruritus. All p values were two sided. CONCLUSIONS: Dermatologic AEs are associated with a diminished QoL. Targeted therapies are associated with a significantly increased number of AEs and worse total and emotion Skindex-16 scores in comparison with non-targeted therapies. EGFR inhibitor rash and pruritus produced the greatest negative impact.