Symptoms in gastrointestinal stromal tumors.

9637 Background: A major barrier to effective symptom management in gastrointestinal stromal tumors (GIST) is lack of recognition of the symptom burden of the disease and treatment. Symptom burden is the combined impact of disease- and treatment-related symptoms on daily functioning. Our aim was to describe the symptom burden of patients with GIST. Methods: After giving IRB-approved informed consent, 150 patients with GIST completed the 20 symptom severity and 6 interference items of the MD Anderson Symptom Inventory for GIST (MDASI-GIST) at least every 2 weeks for 1 year. Symptoms and interference were rated on 0-10 scales (0 = none or no interference, 10 = worst imaginable or complete interference). Patients also answered a single overall quality-of-life (QOL) question every 3 months. Demographic and disease information was collected on all patients. Trajectory analysis determined higher and lower symptom groups. Mixed modeling identified factors predictive of symptom burden. Results: Mean subject age was 59.2 years (standard deviation [sd] = 11.7). 51% (77) of the subjects were female, 83% (124) were white, 47% (70) were employed. Subjects had been diagnosed for an average of 48.3 months (sd = 63.2) and 52% (78) were receiving imatinib. Mean overall QOL rating was 7.7 (best = 10, sd = 2.4). Symptoms reported as most severe over the course of the year were fatigue (mean [M] = 2.95, sd = 2.60), drowsiness (M = 2.30, sd = 2.38), general weakness (M = 2.18, sd = 2.40), disturbed sleep (M = 2.16, sd = 2.46), and muscle soreness/cramping (M = 2.06, sd = 2.41). The mean severity of the 5 most severe symptoms, the interference items, and QOL were all significantly correlated (all P < 0.001). 36.5% of patients were in the higher symptom trajectory group. Younger age, having a primary diagnosis of gastric GIST, and not currently receiving imatinib were predictive of higher symptom burden. Conclusions: Approximately 1/3 of patients with GIST experience higher symptom burden primarily related to fatigue, sleep difficulty, weakness, and muscle discomfort. Higher symptom burden significantly impacts QOL. Additional research is needed to identify effective methods of symptom management. Clinical trial information: NCT01178307.