2765 - Longitudinal Changes in Health-Related Quality of Life and Hope in Radiation Oncology Patients

Purpose/Objective(s): Radiation can significantly affect health-related quality of life (HRQoL), yet longitudinal data through treatment are limited. Hope has been established as a predictor of HRQoL. We examined longitudinal HRQoL changes following radiotherapy and whether baseline hope is associated with post-treatment HRQoL trajectories.

Materials/Methods: Patients seen in radiation oncology clinic between October 2022 and February 2025 completed the EuroQol five-dimension five-level (EQ-5D-5L) and Adult Hope Scale (AHS). The EQ-5D-5L assesses HRQoL across five domains of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression (scored 1-5, lower is better), and includes a self-rated visual analog scale (VAS) ranging from 0 (worst) to 100 (best imaginable health). A composite time trade-off (cTTO) utility index was calculated using US population preference weights (Pickard et al., Value Health 2019), where 1.0 indicates perfect health and =0 a state equivalent to death. The AHS is a 12-item scale with pathway and agency subscales (eight-point Likert, higher is greater hope). Timepoints were categorized as baseline (pre-radiation), acute (0–3 months post-radiation), early (3–6 months), and late (6+ months). Linear mixed-effects models evaluated longitudinal changes in cTTO, VAS, domain scores, and hope. A linear model assessed the effect of pre-XRT agency and pathway scores on CTTO at 0-3 months, adjusting for baseline cTTO. Correlations between scores at various times points were also calculated.

Results: A total of 45 patients with =3 survey timepoints were included. 35.6% were female-identifying, median age was 63.1 years (IQR 53.5, 73.5). At 0-3 months post-radiation, anxiety-depression EQ-5D-5L subscores decreased significantly compared to baseline (estimated difference = -0.36, p = 0.007), and VAS scores improved significantly at 0-3 months post-radiation (estimated difference = 11.2, p = 0.004). cTTO and hope remained stable with no statistically significant changes from baseline observed across post-radiation timepoints. Baseline hope was strongly correlated with cTTO scores 0-3 months post-radiation (r = 0.59), with this association attenuating over time (3-6 months: r = 0.32; 6+ months: r = 0.12). After adjusting for baseline cTTO, there was no effect of pre-XRT pathway or agency score on 0-3 month cTTO.

Conclusion: While there were no significant changes in HRQoL or hope within and after six months of radiation treatment, anxiety and depression improved significantly in the acute post-radiation window. Baseline hope was strongly correlated with pre-treatment and acute post-treatment HRQoL, indicating that patients with higher baseline hope had greater HRQoL acutely after radiation. These findings highlight pre-treatment hope as a potential predictor of near-term post-radiation HRQoL and a possible target for supportive care interventions.