Normative data and trends in quality of life from the Lung Cancer Symptom Scale (LCSS)

Abstract

Normative data and trends for a disease- and site-specific quality of life (QL) instrument for individuals with lung cancer, the Lung Cancer Symptom Scale (LCSS), are presented to facilitate the user's interpretation of test scores. Data for patients enrolled in two large, identical, randomized trials of a new combination chemotherapy regimen for patients with stages III and IV non-small-cell lung cancer (NSCLC) were combined into one dataset (n = 673). For these patients with a Karnofsky performance status (KPS) of 60-100%, QL had been prospectively measured at baseline, day 29 and every 6 weeks thereafter. Descriptive statistics for the LCSS are presented for three time points (baseline, day 29 and day 71) and for specific demographic and disease-related characteristics (age, gender, race, performance status and stage of disease) to provide expected values and their variability during chemotherapy. Data from a small dataset of 63 NSCLC inpatients with KPS scores of 20-50% are also presented for a comparison sample of supportive care for inpatients and hospice patients. For the 673 NSCLC patients at baseline there were no significant differences in QL by age, gender, or race. Major presenting lung cancer symptoms at baseline for this combined sample were dyspnea 87%, cough 86%, pain 81%, loss of appetite 75%, and hemoptysis 41%. Of these patients, 81% had three or more presenting symptoms at baseline (2% had no symptoms; 5%, one symptom; 12%, two symptoms; 18%, three symptoms; 27%, four symptoms; and 36%, five symptoms). The mean LCSS baseline score (best = 0; worst = 100) was 26.56 (SD 16.10). The mean scores for day 29 and day 71 were 25.46 (SD 16.52) and 25.30 (SD 16.93), respectively, but follow-up assessments on progressers were not obtained. Stage III patients had a mean LCSS score of 23.7 (SD 15.1), whereas stage IV patients reported a mean LCSS score of 27.3 (SD 16.3). The mean LCSS score for the group with KPS 60-70% was 34.8 (SD 15.5), and that for the group with KPS 80-100% was 23.3 (SD 15.1). The mean LCSS score for the lower performance group, with KPS scores of 20-50% at baseline, was 46.85 (SD 17.65).

Treatment Paradigms for Patients with Metastatic Non-Small-Cell Lung Cancer: First-, Second-, and Third-Line

“…Survival is short in the setting of advanced nsclc, a median of 4-6 months, and more than 80% patients have multiple severe cancer-related symptoms [4][5][6] . Systemic therapy, the mainstay of treatment in advanced nsclc, can improve survival by up to 8-12 months in selected patients and can improve symptom control and quality of life in 60%-70% despite treatment toxicity 4,[6][7][8] .…”

Validation of a Swedish Version of the Cancer Dyspnea Scale

“…Common symptoms are dyspnea (Hollen et al 1999;Lutz et al 2001;Okuyama et al 2001), fatigue (Lutz et al 2001;Okuyama et al 2001), pain (Hollen et al 1999;Lutz et al 2001), cough (Hollen et al 1999;Lutz et al 2001), loss of appetite (Hollen et al 1999;Lutz et al 2001) and haemoptysis (Hollen et al 1999;Lutz et al 2001). In patients with cancer at the end of life with a median survival of 43 days, fatigue, appetite loss and dyspnea were the most severe symptoms (Lundh Hagelin, Seiger & Fürst 2006).…”

Comprendre les symptômes éprouvés par les sujets atteints du cancer du poumon

“…Il existe divers rapports sur l'incidence et la prévalence des symptômes du cancer du poumon tout au long de la maladie, mais leurs conclusions varient selon les chercheurs (Brown, Carrieri, JansonBjerklie et Dodd, 1986;Burt, O'Driscoll, Notley, Barber et Stout, 1990;Hollen, Gralla, Kris, Eberly et Cox, 1999). Les patients atteints d'un cancer du poumon éprouvent un certain nombre de symptômes directement liés à leur maladie, tels la dyspnée, la toux, des douleurs thoraciques, une respiration sifflante (DeMaria et Cohen, 1987;Edmonds, Karlsen, Khan et Addington-Hall, 2001) et l'hémoptysie (Coy et Kennelly, 1980;Hollen et al, 1999). La fatigue, la perte d'appétit, la perte de poids et les troubles du sommeil font également partie des symptômes dits plus généraux (Blesch et al, 1991;Lutz, Huang, Ferguson, Kavanagh, Tercilla et Lu, 1997).…”