ORIGINAL RESEARCH article
Front. Glob. Women’s Health
Sec. Quality of Life
Volume 6 - 2025 | doi: 10.3389/fgwh.2025.1537824
Quality of life and pain severity changes over time in breast cancer patients referring to palliative oncology treatment in Indonesia: a hospital-based cohort study
Provisionally accepted
- 1University of Indonesia, Depok, Indonesia
- 2Martin Luther University of Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
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Introduction Understanding quality of life (QOL) and change of pain severity over time is important to quantify cancer patients' treatment outcomes. However, this information is limited, especially in lower-middle-income countries. This study aimed to prospectively assess QOL, QOL domains, and pain severity over time in patients with advanced breast cancer in Indonesia. Methods Women with advanced breast cancer (n=160) referred to the palliative oncology unit were enrolled in the study. They completed the European Organization for Research and Treatment of Cancer QOL questionnaire for advanced cancer patients (EORTC QLQ-C15-PAL) and pain severity (Visual Analogue Scale/VAS) at three assessment points (baseline (T0), three- (T1) and six-months (T2) follow-up). The repeated measures analysis of variance model was used to assess changes over time adjusted for age, place of residence, marital status, and the Karnofsky Performance Status score. Change over time was classified into three groups (deterioration, improvement, or small difference). Results The descriptive analysis showed that EORTC QLQ-C15-PAL mean scores for overall QOL and functional scales (physical and emotional functioning) were fair to good at all assessment points (range: 60-70 points) and substantially better at T0 compared to T1 and T2. In addition, most symptom scales of the EORTC QLQ-C15-PAL indicated lessening symptom burden (<10 points), except for pain and fatigue (20 to 30 points). At the same time, overall QOL, emotional functioning, fatigue, dyspnea, appetite loss, constipation, and VAS remained stable over time. Exceptions were seen for physical functioning (a medium to large deterioration with score of -16.5 and -19.8 points, respectively) and insomnia (a medium improvement: score of -13.4 points) with a clinically relevant change. Conclusions Our findings from a six-month longitudinal study show that palliative oncology treatment benefits advanced breast cancer patients in this health facility across several symptom scales.
Keywords: quality of life1, advanced breast cancer2, pain severity3, EORTC QLQ-C15-PAL4, Indonesia5
Received: 01 Dec 2024; Accepted: 22 Sep 2025.
Copyright: © 2025 Gayatri, Efremov, Wienke, Mikolajczyk and Kantelhardt. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dwi Gayatri, dwi.gayatri@ui.ac.id
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