1. 1 Assessment of Quality Of Life in patients treated with Chemo and Radiotherapy for Gastric Cancer: A Systematic Review Authors: Turma 14 Supervisors: Mário Dinis Ribeiro Cláudia Camila Dias Professor Doutor Altamiro da Costa Pereira FMUP/SBIM

2. 2 Gastric Cancer in the World FMUP/SBIM 850 000 deaths worlwide each year cause due to gastric cancer World, age-standardized rates (per 100.000 persons.year) Eucan - Database

3. 3 Gastric Cancer in Europe Male Female FMUP/SBIM Cumulative risk, 0-64 years Eucan - Database

4. 4 Introduction 1  Stomach adenocarcinoma is the most common form of gastric cancer (95% of the cases). 1 2-3  Stomach cancer is a multifactorial disease: diet, hereditary factors, Helicobacter pylori infection are possible causes. 2-3 1- http://www. vidasaudavel.pt 2- http://cancer.healthcentersonline.com/gastrointestinalsystemcancer/stomachcancer.cfm 3- http://hcd2.bupa.co.uk/fact_sheets/html/stomach_cancer.html FMUP/SBIM QoL after Chemo/Radiotherapy in Gastric Cancer

5. 5 Introduction 2  Treatment for gastric cancer often involves surgery, usually a partial or a total gastrectomy (removal of stomach tissue). 2 2  Chemotherapy and radiotherapy are standard for some stages of stomach cancer. 2 2- http://cancer.healthcentersonline.com/gastrointestinalsystemcancer/stomachcancer.cfm FMUP/SBIM QoL after Chemo/Radiotherapy in Gastric Cancer

6. 6 Introduction  Chemotherapy is the use of chemical agents to stop cancer cells from growing. 2  Chemotherapy is considered a systemic treatment. 2 2  More than half of all people diagnosed with cancer receive chemotherapy. 2 2- http://cancer.healthcentersonline.com/gastrointestinalsystemcancer/stomachcancer.cfm FMUP/SBIM QoL after Chemo/Radiotherapy in Gastric Cancer

7. 7 4  Radiotherapy uses high energy x-rays to destroy cancer cells. 4 4  A small dose of radiotherapy may be very helpful to relieve pain. 4 4- http://info.cancerresearchuk.org/cancerstats/types/stomach/?a=5441 FMUP/SBIM QoL after Chemo/Radiotherapy in Gastric Cancer

8. 8  QoL cannot be yet universally defined 5, however there are many attempts to do so.  These multiple treatments have different consequences in de Quality of Life (QoL) in patients.  Schipper et al. proposed: “the functional effect of illness and its consequent therapy upon a patient, as perceived by the patient”. 6 FMUP/SBIM QoL after Chemo/Radiotherapy in Gastric Cancer 5- Spilker B, ed. Quality of Life and pharmacoeconomics in clinical trials. Philadelphia:Lippincott-Raven, 1996 6- Schipper H, Clinch J, Olweny LM. Definitions and conceptual issues. In: Spilker B, ed. Quality of Life and pharmacoeconomics in clinical trials, Philadephia : Lippincott- Raven, 1996: 11-24

9. 9 Aim FMUP/SBIM QoL after Chemo/Radiotherapy in Gastric Cancer ____________________________________________ To review which instruments were used to measure the QoL in patients with gastric cancer submitted to chemo and radiotherapy. To summarize QoL measures across studies. ____________________________________________

10. 10 Methods:  The MesH terms that we use were: ◊ ″Quality of Life And stomach Neoplasms Not surgery. “ FMUP/SBIM QoL after Chemo/Radiotherapy in Gastric Cancer  Literature searches were conducted in Medline.

11. 11 Limits:  Publication Date till September 2005.  Only items with an abstract.  Humans.

12. 12 Methods  Inclusion Criteria oArticles in which QoL was evaluated in patients with gastric cancer and were treated by chemo and radiotherapy. FMUP/SBIM

13. 13 Methods After searching in Medline 45 articles were found. Due to the applying of the inclusion and exclusion criteria the number of articles was reduced to 13. Exclusion critérium Number of articles Patients with more than one type of cancer 7 Patients with another type of cancer (not gastric cancer) 4 Patients weren’t treated with chemo and radiotheraphy 5 QoL was not measured 6 Other reasons 10 Total of articles excluded: 32 FMUP/SBIM QoL after Chemo/Radiotherapy in Gastric Cancer

14. 14 Fluxogram QoL after Chemo/Radiotherapy in Gastric Cancer