Caren van Roekel

98 Chapter 3 From the figures it can be depicted that changes in almost all categories were most notable at one week after treatment. Role functioning was the most affected functioning scale. Fatigue and pain were the most affected symptom scales. Although there were very few patients that filled in the questionnaires beyond three months follow-up, all categories seemed to stabilize over time. At every time point, there was a lot of variation between patients in all categories except FI, LMCSM, LMCJ and LMCFeelings. The development of QoL was best explained by a linear mixed-effects regression model using a random intercept per patient, to allow for different starting points at baseline. For GHS, as a general measure of quality of life, an increase of on average 0.55 points per time point was found. However, this was not significant (p=0.48) and there was quite some variation between patients, as can be seen in Figure 1. Still, there was a steep decline in functioning scores and rise of symptoms from baseline to 1 week. Patients with a higher WHO performance score had on average 20 points lower GHS (p=0.0002, 95% CI [-32.3;-8.8]). No other variables were of significant influence on the development of GHS. Figure 3 shows the development of GHS per patient for patients with WHO performance scores of 0 versus scores 1 or 2. Although there is a lot of variation between patients, patients with a lower WHO performance score have on average a higher QoL. In functioning scales, PF, RF and SF were significantly influenced by WHO performance status, where a higher WHO performance status at baseline decreased functioning (p<0.001 in all categories). In symptom scales, a higher WHO performance status increased mean symptom scores of FA, DY, DI, and LMCFati (p<0.001 in all categories). There were no other variables that had a significant influence on the various symptom scores. Both within and between patients, there was a lot of variation in scores.