Patient-reported outcomes regarding radiation therapy in patients with multiple myeloma

Figures & data

Table 1. Patient characteristics of patients receiving and not receiving palliative radiation.

	RT received (n = 12)	No RT (n = 18)
Age (y)
Mean	55.5	54.4
Median	54.5	55
Race (n)
White Non-Hispanic	7	15
Black	0	2
White Hispanic	3	1
Other	2	0
Gender (n)
Male	5	9
Female	7	9
Latency (y)
Mean	2.5	N/A
Median	0.8	N/A
Transplant received (n)	4	10
# Prior treatments
Mean	2.5	3.3
Median	3	3
RT intent
Pain	11
Fracture	2
Cord compression/emergency	2

Characteristics of patients receiving vs. those not receiving palliative radiation are detailed in Table 1. Latency indicates time in years from time of diagnosis to receipt of radiation.

Table 2. Odds ratio of total and component survey scores for patients with multiple myeloma receiving palliative radiation therapy.

	OR of lower score^a (treated/nontreated) (95% confidence interval)	p-value^a
Total	4.86 (1.54, 15.35)	.007
Pain	1.60 (1.11, 8.52)	.031
Tiredness	2.20 (0.62, 7.76)	.219
Drowsiness	2.61 (0.98, 6.94)	.056
Nausea	1.56 (0.40, 5.99)	.521
Appetite	1.66 (0.53, 5.20)	.387
Breath	4.47 (1.24, 16.16)	.022
Depression	17.40 (3.28, 92.30)	.0008
Anxiety	19.04 (4.48, 80.78)	<.0001
Overall Wellbeing	3.55 (1.18, 10.64)	.024
Spiritual Wellbeing	10.37 (1.85, 58.24)	.008
Sleeping	2.34 (0.57, 9.64)	.237
Constipation	4.14 (1.21, 14.16)	.024

Treatment associated with lower scores.

^aOR and p-value (significant values <0.05 in bold) from model including time from diagnosis effect.

Table 3. Odds ratios (95% confidence intervals) for covariates.

Model w/Covariate	Total	Pain	Breath	Depression	Anxiety	Overall Wellbeing	Spiritual Wellbeing	Constipation
Age	0.94(0.89,0.99)	0.93(0.88,0.98)	1.01(0.96,1.06)	0.94(0.88,0.99)	0.92(0.88,0.97)	0.95(0.9,1.01)	0.95(0.89,1.01)	0.94(0.89,0.99)
	p=.0255	p=.004	p=.607	p=.051	p=.0009	p=.088	p=.123	p=.018
Gender
F	1.52(0.41,5.62)	1.41(0.48,4.17)	2.28(0.82,6.34)	0.52(0.13,2.03)	0.45(0.14,1.48)	1.22(0.44,3.35)	0.62(0.18,2.11)	0.91(0.27,3.01)
M	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
	p=.527	p=.536	p=.115	p=.348	p=.190	p=.706	p=.444	p=.875
Race
Black	7.89(1.30,47.86)	5.38(0.75,38.74)	1.06(0.24,4.72)	3.06(0.24,39.44)	2.25(0.24,21.0)	3.62(1.87,7.00)	9.43(4.53,19.61)	7.34(0.74,72.36)
	p=.025	p=.095	p=.936	p=.392	p=.476	p=.0001	p < 0.0001	p=.088
Other	1.49(0.43,5.20)	1.27(0.52,3.1)	2.63(1.19,5.85)	3.14(0.16,62.74)	1.69(0.11,25.9)	0.66(0.17,2.59)	2.68(0.22,32.93)	4.88(2.01,11.84)
	p=.528	p=.601	p=.017	p=.454	p=.707	p=.554	p=.441	p=.0005
White	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Disease Status
CR	2.28(0.47,10.98)	3.91(1.12,13.64)	1.14(0.23,5.7)	1.93(0.39,9.43)	1.54(0.5,4.71)	1.11(0.22,5.61)	1.44(0.27,7.79)	3.21(1.37,7.54)
	p=.306	p=.032	p=.870	p=.418	p=.453	p=.895	p=.669	p=.007
PD	0.98(0.33,2.87)	0.96(0.36,2.58)	1.24(0.41,3.77)	1.25(0.32,4.99)	0.64(0.19,2.17)	0.82(0.31,2.17)	0.62(0.19,1.98)	2.92(1.14,7.5)
	p=.969	p=.940	p=.698	p=.748	p=.478	p=.695	p=.418	p=.026
PR	3.06(0.48,19.57)	3.36(0.59,18.97)	0.81(0.25,2.66)	0.84(0.22,3.3)	0.75(0.19,2.96)	1.66(0.49,5.63)	2.16(0.48,9.63)	9.21(1.55,54.82)
	p=.237	0 = 0.170	p=.727	p=.806	p=.685	p=.418	p=.312	p=.015
SD	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Active Therapy
AT	1.01(0.18,5.81)	0.45(0.14,1.44)	3.85(0.66,22.59)	0.91(0.2,4.08)	1.02(0.29,3.51)	1.67(0.35,8.07)	1.63(0.22,12.12)	0.87(0.38,1.97)
	p=.989	p=.178	p=.135	p=.901	p=.979	p=.524	p=.635	p=.732
New Dx	0.44(0.04,4.83)	0.66(0.09,4.71)	12.29(1.22,124.33)	0.14(0,4.09)	0.13(0,3.52)	0.56(0.08,4.24)	0.45(0.01,15.22)	0.33(0.06,1.73)
	p=.500	p=.682	p=.034	p=.252	p=.222	p=.579	p=.658	p=.192
Obs	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Time from Diagnosis	1.02(1.00,1.04)	1.01(1.00,1.03)	1(0.99,1.02)	1.02(1.00,1.04)	1.02(1.00,1.03)	1.01(1.00,1.03)	1.02(0.99,1.03)	1.01(0.99,1.03)
	p=.038	p=.014	p=.669	p=.032	p=.045	p=.018	p=.071	p=.144
Steroids
Y	2.21(0.48,10.14)	0.99(0.29,3.36)	1.67(0.59,4.75)	2.94(0.97,8.86)	2.2(0.6,8.07)	1.75(0.6,5.06)	2.89(0.93,9.02)	0.95(0.21,4.29)
N	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
	p=.308	p=.991	p=.334	p=.056	p=.235	p=.302	p=.068	p=.952
HGB	0.97(0.95,0.98)	0.98(0.97,0.99)	0.89(0.66,1.21)	0.97(0.94,1.01)	0.97(0.94,1.01)	0.99(0.97,1.00)	1.01(0.99,1.02)	0.96(0.9,1.02)
	p < 0.0001	p=.009	p=.476	p=.092	p=.122	p=.010	p=.288	p=.159
# of prior lines of therapy
	1.35(1.04,1.75)	1.38(1.13,1.68)	1.09(0.86,1.38)	1.29(0.95,1.75)	1.22(0.92,1.61)	1.36(1.1,1.68)	1.25(0.96,1.62)	1.34(1.01,1.77)
	p=.022	p=.002	p=.475	p=.098	p=.168	p=.004	p=.094	p=.039
Recent Hospitalization
Y
N	0.16(0.04,0.63)	0.28(0.09,0.85)	0.25(0.06,1.09)	0.14(0.03,0.69)	0.13(0.03,0.53)	0.34(0.11,1.07)	0.13(0.03,0.65)	0.17(0.05,0.54)
	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
	p=.009	p=.024	p=.065	p=.016	p=.004	p=.064	p=.013	p=.003
Narcotics
Y	6.88(0.35,136.8)	3.8(0.83,17.41)	0.14(0.01,2.57)	n/a	n/a	0.89(0.05,15.81) Ref	n/a	n/a
N	Ref	Ref	Ref	n/a	n/a	p=.939	n/a	n/a
	p=.206	p=.086	p=.188

*Bold values indicate p < .05.

Only ESAS domains that were significant on univariate analysis were included on multivariable analysis. These domains were found to correlate significantly with certain demographic and clinical factors. For example, Black race was associated with a nearly 8-times higher risk of higher total scores compared with White race; on the other hand, recent hospitalization was associated with a significantly lower risk of high total scores.