EORTC QLQ-C15-PAL: Quality of Life in Palliative Cancer Care
European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire—Cancer Palliative (15 items) · Also known as: QLQ-C15-PAL
The EORTC QLQ-C15-PAL is a 15-item quality-of-life instrument specifically designed for advanced cancer patients receiving palliative care. Developed by Groenvold et al. in 2006, it is a shortened version of the QLQ-C30, retaining core QoL domains while reducing respondent burden—critical in palliative settings where fatigue and functional impairment limit questionnaire completion. It measures physical, emotional, and functional well-being alongside key palliative symptoms.
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When to use it
EORTC QLQ-C15-PAL is indicated for patients with advanced, metastatic, or terminal cancer receiving active palliative care (hospice, palliative medicine, best supportive care settings). Primary use is palliative care clinical trials, symptom management research, and quality-of-life evaluation in end-of-life contexts; secondary use in palliative care clinics for routine QoL monitoring and symptom burden assessment. NOT for curative-intent or early-stage cancer (use full QLQ-C30 instead). Specifically suited for patients who are very ill, fatigued, or cognitively impaired and cannot tolerate lengthy questionnaires.
Strengths & limitations
- Concise 15-item format reduces respondent burden, crucial for frail, symptomatic palliative patients; completion time 5–10 minutes vs. 15–20 for QLQ-C30.
- Retains core QLQ-C30 scales (physical, emotional, cognitive, social functioning, symptoms), enabling comparison with curative-intent cohorts.
- Validated in large palliative care cohorts across cancer types and settings (hospice, inpatient palliative units, community palliative teams).
- Enables meaningful QoL assessment even in very ill patients near end of life, where comprehensive scales may be infeasible.
- Widely translated (50+ languages) and adopted in international palliative care research.
- Reduced number of items per scale may limit granularity compared to QLQ-C30; fewer items per scale = less detailed assessment.
- Limited symptom coverage compared to full QLQ-C30 (6 symptom items vs. 18 in C30); may not capture all relevant palliative symptoms.
- Global Health/QoL is single-item only; lacks detail for comprehensive existential or meaning-focused assessment.
- Symptom item selection reflects QLQ-C30 condensation, not palliative-specific symptom prioritization; some items may be less relevant in end-of-life contexts (e.g., work/daily activity limitations).
Frequently asked
When should I use QLQ-C15-PAL vs. the full QLQ-C30?
Use QLQ-C15-PAL for advanced, metastatic, or terminal cancer patients in palliative care where respondent burden is a concern (frailty, cognitive impairment, limited life expectancy). Use full QLQ-C30 for curative-intent or early-stage patients with adequate functional status. Some trials use both: QLQ-C30 at earlier disease stages, transition to QLQ-C15-PAL as disease progresses.
Can QLQ-C15-PAL be used to assess QoL before/after a palliative intervention (e.g., pain management)?
Yes. QLQ-C15-PAL change scores (baseline to post-intervention) are clinically meaningful, especially for symptom scales. A ≥10–15 point improvement in symptom burden scores suggests meaningful relief. In palliative contexts, even modest improvements in specific symptoms (pain, dyspnea) can substantially improve perceived QoL.
What is the MCID for QLQ-C15-PAL scales?
MCID estimates for QLQ-C15-PAL are approximately 10–15 points on 0–100 scales (similar to QLQ-C30). However, MCID may differ in palliative populations; any improvement in symptom burden often feels clinically meaningful to patients. Consider both statistical MCID and clinical context when interpreting change.
Is QLQ-C15-PAL appropriate for patients very close to death?
Yes. QLQ-C15-PAL is designed for advanced patients, including those in final days/weeks of life. However, cognitive impairment, severe fatigue, or unconsciousness may prevent completion. Family/caregiver-reported QoL (if validated) may supplement direct patient assessment near end of life. Some studies use proxy-reported QLQ-C15-PAL; acknowledge this distinction in analysis.
How are missing data handled in QLQ-C15-PAL scoring?
EORTC scoring guidelines: if ≥50% of items in a scale are missing, do not score that scale. If <50% are missing, impute the mean of completed items. In palliative settings with high missing data rates (due to illness/attrition), report data completeness and avoid scales with substantial missing data.
Is QLQ-C15-PAL freely available?
QLQ instruments are copyrighted by EORTC but available for non-commercial research use (registration required via qlg.eortc.be). Validated translations in 50+ languages are available through official channels. Use licensed versions to ensure psychometric integrity.
Sources
- Groenvold, M., Petersen, M. A., Aaronson, N. K., Arraras, J. I., Blazeby, J. M., Bottomley, A., et al. (2006). The development of the EORTC QLQ-C15-PAL: a shortened quality-of-life questionnaire for cancer patients in palliative care. Eur J Cancer, 42(1), 55–64. DOI: 10.1016/j.ejca.2005.06.022 ↗
- Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst, 85(5), 365–376. DOI: 10.1093/jnci/85.5.365 ↗
How to cite this page
ScholarGate. (2026, June 3). European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire—Cancer Palliative (15 items). ScholarGate. https://scholargate.app/en/oncology/eortc-qlq-c15-pal
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