LETTER TO THE EDITOR
REVISTA DE LA FACULTAD DE MEDICINA HUMANA 2024 - Universidad Ricardo Palma
1,a
1 Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú.
a Medical student
Dear Editor:
The World Health Organization (WHO) defines palliative care as an approach to improving the quality of life of the patient and their family as they face the complications associated with a potentially fatal disease in advanced stages. This includes prophylaxis and mitigation of suffering through the identification, estimation, and treatment of physical, psychosocial, and emotional spheres(1).
Similarly, the WHO biopsychosocial model considers that pathologies affect not only an organ or system
but also the set of dimensions that make up an individual(2). From this, the
term “quality of life” has gained relevance when inquiring into the relationship of an individual, the
pathology, and the treatment.
Preserving a sense of well-being in cancer patients in palliative care is a predominant objective in
cancer control, therefore various instruments are available for measuring quality of life. However, it
remains a challenge to quantify it and compare it between individuals, so it is essential to be diligent
when selecting an instrument.
Certainly, “The Short Form-36 Health Survey” or SF-36 questionnaire is a tool translated into several
languages, including Spanish, and validated in Peru since 2012, thus contributing to countless
influential national studies. However, in order to expand the availability of tools that quantify and
compare quality of life among cancer patients in the Pain Therapy Unit, other options could be chosen to
implement.
One of the quality of life measurement instruments also validated in Spanish is the EORTC
QLQ-C30(3, 4). It is a questionnaire with a length of 30
items immersed in 3 dimensions (functional, symptomatic, and global quality of life status) that
demonstrate the multidimensionality of quality of life in cancer patients. The functional dimension
includes 15 items that develop physical, role, cognitive, emotional, and social functioning; Here the
daily activities that could be affected as a result of the pathology are reflected. The symptomatic
dimension includes 13 items describing symptoms such as fatigue, pain, nausea/vomiting, dyspnea,
insomnia, loss of appetite, constipation, diarrhea, and financial difficulties. Finally, the global
quality of life dimension is made up of 2 items that subjectively assess how the cancer patient discerns
his or her quality of life from an affective perspective(5).
Kyranou et al. (2021) used the EORTC QLQ-C30 and the EORTC QLQ-SWB32 (spiritual well-being) in patients
receiving oncological palliative care in Cyprus. The participating patients found the items
understandable and consistent with the clinical utility proposed by the tool(6).
Furthermore, Sommer et al. (2020) investigated the measurement invariance assumption of the EORTC
QLQ-C30 in patients with hematological malignancies from multicenter studies conducted in Italy. This
study provides support for measurement invariance across age, comorbidity, and time; also, support for
partial scalar invariance for the dimension of cognitive, emotional, and physical functioning with
respect to sex and illness. This shows that the QLQ-C30 is a specific and valid tool(7).
Likewise, Cocks et al. (2023) provided the QLQ-C30 to evaluate the concepts of functional health,
symptoms, side effects, and quality of life in oncology patients of various types of cancer in the US
and Europe. The proposed items were widely understood in all language versions and provided relevant
information for the study, showing good evidence of validity(8).
In Latin America, Sánchez-Pedraza et al. (2020) evaluated the clinimetric properties of the EORTC QLQ
C-30 when applied to patients from the Colombian population diagnosed with cancer, thus testing
cross-cultural adaptation. They found that the instrument's reliability is adequate when measured with
estimates of internal consistency and by comparison of repeated measures(9).
In Peru, Vidaurre T et al. (2019) assessed the quality of life and the socio-economic implications after
the implementation of the National Plan against Cancer of Peru (Plan Esperanza) and the implementation
of the telechemotherapy module (TELECHEMO) in a Lamas category II-E hospital (second level of care) in
the department of San Martin. The proposed tool made it possible to prospectively evaluate the quality
of life of the patients included in the research, highlighting the results corresponding to the family
and social environment(10).
| Aspects | SF-36 | EORTC QLQ-C30 |
|---|---|---|
| Translation and validation | It has been translated into Spanish since 1995 (1) and validated in Peru since 2012 (2) | It has been translated into Spanish since 1995 (1) and validated in Peru since 1997 (2) |
| Purpose and use | Generic evaluation of quality of life (3) | Specific evaluation for cancer patients (3) |
| Dimensions and scale | 8 scales: (4),(5)
|
15 scales: (4)
|
| Specificity and relevance | Less specific for particular diseases, suitable for comparisons between different health conditions (6) | Specific for cancer, captures aspects and symptoms relevant to oncologic patients (5) |
| Interpretation and sensitivity | Less sensitive to specific changes in particular diseases (7) | More sensitive and specific to detect changes in quality of life in cancer patients (6) |
| Number of items | 36 items (8) | 30 items (7) |
Source: Own elaboration
It is essential to have a range of judiciously translated and validated tools that quantify quality of life in cancer patients, given that it is a national priority in terms of health research. In this context, the EORTC QLQ-30 tool is a valid alternative to the SF-36, so its application could contribute to the existing knowledge base, in addition to serving as a relevant background for future studies in oncology.
Conflict of Interest Statement: The author declares no conflict of interest in the
publication of this article.
Author Contributions: The author participated in the generation, data collection,
drafting, and final version of the original article.
Funding: Self-funded.
Received: June 8, 2024
Approved: June 30, 2024
Correspondence: Jimena Alexandra Villacorta Ramos
Address: Av. Alfredo Benavides 5440, Santiago de Surco 15039
Phone: 938184853
Email: jimena.villacorta.ramos@gmail.com
Article published by the Journal of the faculty of Human Medicine of the Ricardo Palma University. It is an open access article, distributed under the terms of the Creatvie Commons license: Creative Commons Attribution 4.0 International, CC BY 4.0(https://creativecommons.org/licenses/by/4.0/), that allows non-commercial use, distribution and reproduction in any medium, provided that the original work is duly cited. For commercial use, please contact revista.medicina@urp.edu.pe.
