Monitoring physical and psychosocial symptom trajectories in ovarian cancer patients receiving chemotherapy

23 patients were assessed longitudinally (eight time points) with regard to symptom burden (depression, anxiety, fatigue, and QOL) by means of patient-reported outcome instruments (HADS, MFI-20, EORTC QLQ-C30/-OV28) and clinician ratings (HAMA/D) at each chemotherapy cycle and at the first two aftercare visits.Statistically significant decrease over time was found for depressive symptoms and anxiety as well as for all fatigue scales. With regard to QOL, results indicated significant increase for 11 of 15 QOL scales, best for Social (effect size = 1.95; p < 0.001), Emotional (e.s. = 1.62; p < 0.001) and Physical Functioning (e.s. = 1.47; p < 0.001). Abdominal Symptoms (e.s. = 1.01; p = 0.009) decreased, Attitudes towards Disease and Treatment (e.s. = 1.80; p < 0.001) improved significantly over time. Analysis of Sexual Functioning was not possible due to a high percentage of missing responses (61.9%).The present study underlines the importance of longitudinal assessment of QOL in order to facilitate the identification of symptom burden in OC patients. We found that patients show high levels of fatigue, anxiety and depressive symptoms and severely impaired QOL post-surgery (i.e. at start of chemotherapy) but condition improves considerably throughout chemotherapy reaching nearly general population symptoms levels until aftercare.According to GLOBOCAN estimates [1], 224.747 women worldwide were diagnosed with ovarian cancer (OC) in 2008. Fatally enough, early stage disease usually presents with minor and unspecific symptoms [2,3], considerably prolonging the time period between occurrence of first complaints and physician consultation. This circumstance is the major reason why in 75% of the concerned patients OC is diagnosed at an advanced stage (i.e. FIGO stages III and IV) [4] and prognosis is consequently poor. Therefore, OC is called the "silent killer". In the majority of cases, treatment involves cytoreductive surgery with obligatory removal of the uterus and bot