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Submitted on June 24, 2004
Accepted on December 1, 2004
Dept of Endocrinology, Christie Hospital, Manchester, UK
* To whom correspondence should be addressed. E-mail: stephen.m.shalet{at}man.ac.uk.
We studied fifty (27 female) GHD cancer survivors and 47 (24 females) GHD patients with pituitary pathologies. All GHD patients were considered for GH replacement on the basis of subjectively poor QOL. Primary outcome measures were scores of QOL instruments PGWB and AGHDA at baseline, early (EFU) (6-13 months) and long-term (24-77 months) treatment follow-up (LTFU). Of secondary interest were six PGWB domains.
Linear mixed-effect regression was used to model each QOL outcome. The groups differed with respect to three covariates; age, gender and BMI. These variables were included in all fitted models. Baseline scores for PGWB and AGHDA were not different between groups. Ranking of PGWB domains were similar between groups at baseline (lowest domain; vitality). Pattern of change in mean scores for all outcome measures from baseline did not differ between groups (P = 0.86). All QOL variables improved significantly with treatment; estimated mean change ± se; PGWB 16.2 ± 1.7, AGHDA -6.2 ± 0.6, PGWB domains (transformed percentage scales: anxiety 12.4 ± 1.7, depression 14.1 ± 2.1, health 12.4 ± 1.7, self-control 11.3 ± 2.0, well-being 15.2 ± 1.7, vitality 22.5 ± 2.0 (vitality; greatest change). There was no evidence of group difference in EFU or LTFU means for any outcome variables.
QOL in adult GHD cancer survivors, is comparable to that in GHD adults with pituitary pathologies and improves with GH replacement in a similar manner. We conclude that QOL impairment in adult GHD cancer survivors, appears mainly related to GHD rather than cancer diagnosis and treatment.
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