Main Session
Sep
28
PQA 02 - Lung Cancer/Thoracic Malignancies, Patient Reported Outcomes/QoL/Survivorship, Pediatric Cancer
2540 - Financial Toxicity in Patients with Sarcoma Undergoing Radiation Therapy
Presenter(s)
Rachel Zhang, BA - UCI School of Medicine, Orange, CA
R. Zhang1, K. S. Hanubal2, E. C. Y. Ku2, E. Chen2, M. A. Hoyt3, and J. P. Harris2; 1University of California - Irvine School of Medicine, Irvine, CA, 2Department of Radiation Oncology, University of California - Irvine, Orange, CA, 3Department of Population Health and Disease Prevention, University of California - Irvine, Irvine, CA
Purpose/Objective(s):
Financial toxicity negatively affects health outcomes and quality of life for patients undergoing cancer treatment, and its burden on patients with sarcoma receiving radiation therapy (RT) remains largely unexplored. The goal of this study was to assess the degree of financial toxicity in this population, identify risk factors for financial toxicity, and investigate its relationship with patient-reported outcomes.Materials/Methods:
Patients who underwent radiation therapy for sarcoma at an NCI-designated Comprehensive Cancer Center and completed a financial toxicity survey prior to treatment were identified. Financial toxicity was assessed using FACIT-COST, a validated 12-item self-reported survey, and graded using the following cutoffs, with a lower COST score indicating greater financial distress: Grade 0 (COST = 26), Grade 1 (14-25), Grade 2 (1-13), and Grade 3 (0). The EORTC-QLQ-C30 was also given at the same time as FACIT-COST to assess global health status, quality of life, and functional domains.Results:
57 patients were identified from 2021 to 2024, with a median age of 68. Median COST score was 28. 25% of patients had Grade 1 financial toxicity, 9% Grade 2, and 0% Grade 3. Overall, 56% of patients reported cancer causing some degree of financial hardship (FACIT-COST Question 12). Age < 40 (p = 0.002) and Medicaid coverage (p = 0.045) were independently associated with greater financial toxicity. Greater financial toxicity was associated with more advanced T stage at the time of RT (p = 0.04). More financial toxicity was weakly associated with worse global health/QoL (rho = 0.27, p = 0.04) and moderately associated with lower role functioning (rho = 0.38, p = 0.003), physical functioning (rho = 0.42, p = 0.001), emotional functioning (rho = 0.45, p = 0.006), and social functioning (rho = 0.55, p < 0.0001). Of the 10 patients who completed both pre-RT and post-RT surveys 3 months after completion of RT, no significant difference was found between pre-RT and post-RT COST scores. 5 patients had a decrease in COST score with a mean decrease of 7.2.Conclusion:
Financial toxicity was prevalent in one-third of patients with sarcoma undergoing radiation therapy. Its significant association with worse functioning across various domains of quality of life underscores its importance in treatment decision-making. Addressing financial challenges may be crucial to improving patient outcomes and overall well-being during cancer treatment.