Improving measured health-related quality of life with outpatient high-dose methotrexate regimen among oncology patients with intracranial metastases: A systematic assessment

• Main Authors: Heun Min (Author), Elizabeth Weil (Author), Maggie Nelson (Author), John Charlson (Author), Yee Chung Cheng (Author), Lubna N Chaudhary (Author), John Burfeind (Author), Janet Retseck (Author), Deepika Sriram (Author), Sailaja Kamaraju (Author)
• Format: Book
• Published: Archives of Nursing Practice and Care - Peertechz Publications, 2023-12-30.
• Subjects: Research Article
• Online Access: Connect to this object online.

Summary

<p>Intracranial metastases including leptomeningeal disease are not uncommon in patients with metastatic solid tumor cancers, such as breast and sarcoma.  Treatment options are limited with disease progression on standard-of-care therapies, and high-dose Methotrexate (MTX) is offered for patients with well-preserved performance status. However, standard high-dose MTX treatment entails a lengthy hospitalization and close monitoring which can limit Quality of Life (QoL) for patients who already have multiple provider visits. The impact of high-dose MTX on patients' daily lives has not yet been qualitatively examined. As a quality improvement project, our team designed an outpatient high-dose protocol for patients who tolerated at least one cycle of inpatient high-dose MTX, and herein we describe the protocol and a quality survey with patients' feedback.  The purpose of this study is to explore and compare the influence of high-dose MTX treatments in two different settings - inpatient and ambulatory - on patients' QoL. Second, we aim to identify recurrent themes defining patients' perceived QoL and healthcare experiences. This study identified key QoL impacts that high-dose MTX treatments have on metastatic breast and sarcoma patients. Patients experienced decreased health-related burdens and improved social and psychosocial well-being associated with high-dose MTX treatment compared to standard inpatient treatment. This study provides an opportunity to identify recurrent thematic domains defining QoL in women with metastatic breast cancer.</p>

DOI

10.17352/2581-4265.000065