ABSTRACT
In 2018, we introduced a paper-based questionnaire for the assessment of patient-reported symptoms and toxicities in the management of patients receiving active anti-cancer treatment, showing a significant quality of life (QoL) improvement compared to the previous routine practice. In this secondary analysis, we show the results obtained in patients older than 70 years. Patients treated in 2017 underwent “usual” visits (group A) while patients treated in 2018, before each visit, received a questionnaire by a nurse, in order to provide information to be discussed during the visit (group B). Primary objective was the comparison of QoL changes, measured by EORTC QLQ-C30. Out of 211 patients, 88 were older than 70 years.  Tumors and setting were similar between group A and B. After 1 month, global QoL was improved in group B (mean change from baseline + 4.47 vs – 0.89 in group A, p = 0.006, effect size 0.23). There were statistically significant differences, in favor of group B, also for role functioning and emotional functioning. Mean changes from baseline for pain were significantly better for group B (- 3.25 vs + 6.03, p = 0.01, effect size 0.43). The proportion of older patients obtaining a clinically significant improvement in global QoL was 36.6% in group B vs 19.1% in group A (p = 0.09), without significant heterogeneity in the proportion of patients with improved QoL between younger and older patients (p = 0.60).
The use of patient-reported outcomes in clinical practice for patients receiving active anti-cancer treatment is associated with a significant QoL improvement also in older patients.

IMPACT STATEMENT
The adoption of paper-based patient-reported outcome measures in clinical practice is associated with a significant QoL improvement in older patients receiving active anti-cancer treatment.