The prognostic impact of quality of life assessed with the EORTC QLQ-C30 in inoperable non-small cell lung carcinoma treated with radiotherapy

Mamon

et al. 2010

Cancer

BACKGROUND:Although it is known that standard 5-fluorouracil-based chemoradiation therapy for rectal cancer causes significant acute gastrointestinal (GI) toxicity, research on patient-reported outcomes (PROs) is limited. The authors undertook the current study to assess the feasibility of incorporating PRO measurement into routine clinical practice and to describe the trajectory of symptom development during treatment. METHODS: Seventy-seven consecutive patients who were treated between 2006 and 2008 were eligible. Patients completed the 7-item Bowel Problems Scale immediately before weekly physician visits. RESULTS: The questionnaire completion rate was 95%. Individual GI symptoms had different trajectories of development. By Week 5, approximately 40% of all patients developed clinically meaningful pain, bowel urgency, or tenesmus that was not present during Week 1; 30% developed diarrhea, abdominal cramping, and passing mucus. However, overall symptom burden was moderate. Seventyfive percent of patients who presented with rectal bleeding at Week 1 improved by Week 3 of treatment. Within each physician-assessed grade of diarrhea, patient experience varied widely. For example, of the 50 patients who developed grade 2 diarrhea on the Radiation Therapy Oncology Group Acute Morbidity Scale, the numbers of patients reporting only occasional symptoms versus those reporting frequent or very frequent symptoms were similar. CONCLUSIONS: PROs provided information on patient symptoms during chemoradiation treatment for rectal cancer that was not captured otherwise, and it was feasible to incorporate PROs into routine clinical practice. The current results may be used by physicians to counsel their patients before treatment initiation and to provide a benchmark against which trials that use new therapies may be compared.

mentioning

confidence: 99%

Patient‐reported acute gastrointestinal symptoms during concurrent chemoradiation treatment for rectal cancer

Mamon

et al. 2010

Cancer

“…Health-related quality-of-life prognostic factor analyses have been carried out on several different cancer populations, including, among others, lung (Herndon et al, 1999;Langendijk et al, 2000;Montazeri et al, 2001;Efficace et al, 2006), oesophageal (Blazeby et al, 2001;Fang et al, 2004), advanced breast (Luoma et al, 2003;Efficace et al, 2004a), and head and neck (de Graeff et al, 2001) cancers, highlighting the importance HRQOL scores may have in predicting survival. Only three studies have examined HRQOL and/or cognitive functioning as a prognostic factor in brain cancer (Meyers et al, 2000;Klein et al, 2003;Sehlen et al, 2003).…”

mentioning

confidence: 99%

The prognostic value of health-related quality-of-life data in predicting survival in glioblastoma cancer patients: results from an international randomised phase III EORTC Brain Tumour and Radiation Oncology Groups, and NCIC Clinical Trials Group study

et al. 2007

This is one of the few studies that have explored the value of baseline symptoms and health-related quality of life (HRQOL) in predicting survival in brain cancer patients. Baseline HRQOL scores (from the EORTC QLQ-C30 and the Brain Cancer Module (BN 20)) were examined in 490 newly diagnosed glioblastoma cancer patients for the relationship with overall survival by using Cox proportional hazards regression models. Refined techniques as the bootstrap re-sampling procedure and the computation of C-indexes and R 2 -coefficients were used to try and validate the model. Classical analysis controlled for major clinical prognostic factors selected cognitive functioning (P ¼ 0.0001), global health status (P ¼ 0.0055) and social functioning (Po0.0001) as statistically significant prognostic factors of survival. However, several issues question the validity of these findings. C-indexes and R 2 -coefficients, which are measures of the predictive ability of the models, did not exhibit major improvements when adding selected or all HRQOL scores to clinical factors. While classical techniques lead to positive results, more refined analyses suggest that baseline HRQOL scores add relatively little to clinical factors to predict survival. These results may have implications for future use of HRQOL as a prognostic factor in cancer patients.

“…[40] Langendijk et al evaluated baseline QOL using EORTC QLQ C30 in 198 patients planned for radiotherapy and estimated the prognostic value of several parameters for survival. [41] Performance status, weight loss, and Nclassification were found to be independent prognostic factors. Global QOL was the strongest predictor of survival after multivariate analysis.…”

Section: Quality Of Life As a Prognostic Marker In Lung Cancermentioning

confidence: 89%

Quality of life measures in lung cancer

et al. 2005

Lung cancer is one of the leading causes of cancer death worldwide. Survival has not improved significantly in spite of newer therapies. In view of the high-symptom burden and severe morbidity, evaluation of quality of life (QOL) becomes important in these patients. Several instruments are now available for this purpose, and have demonstrated good correlation with performance status, symptoms, and survival. Quality of life assessments also help in comparing different therapeutic regimes, thus allowing selection of the appropriate modality. Problems of inconsistent interpretability and high-patient dropout rate poses a challenging problem that needs to be tackled. In spite of these drawbacks, QOL is now considered to be an essential component of lung cancer management and should be performed routinely. Such a practice will help the physician plan appropriate treatment strategies and set practical therapeutic goals.