Quality of life in patients with non-small cell lung cancer
Abstract
Background/Aim. As lung cancer is considered the greatest contributor to death among all cancer types any help might be valuable in the assessment of treatment effects. The aim of this study was for assess the quality of life (QoL) in patients with non-small cell lung cancer (NSCLC) treated with gemcitabine-cisplatin regimen as the first line of chemotherapy. Methods. The QoL was assessed using certified Serbian translations of the European Organization for Research and Treatment of Cancer Quality Life Questionnaire Core 30 (EORTC QLQ-C30) and Lung Cancer Module (QLQ-LC13) – version 3. The questionnaire was used before starting treatment and after the completion of the 2nd and the 4th cycle of chemotherapy. The questionnaire scales and single items were compared in order to assess the impact of treatment on the QoL. Results. A total of 60 patients started and 51 completed all questionnaires. There were no changes in the global health status score between the baseline, the 2nd and the 4th cycle of chemotherapy (42.78 ± 15.76, 45.56 ± 17.59, 48.20 ± 19.24, respectively; p = 0.1). Social function score, symptom scores: nausea and vomiting, pain, appetite loss, constipation, diarrhea and financial difficulties score differed significantly among chemotherapy cycles, indicating improved or worsened the QoL. In the lung cancer symptom score a significant difference between measurements was observed in cough, alopecia, chest pain and in using analgesics. Conclusion. Monitoring of changes in the QoL among patients with locally advanced and metastatic NSCLC showed that chemotherapy did not decrease the global health status but led to significant changes in the social and financial functioning of patients. Some symptoms associated with the disease reduced in the intensity but some new occurred as a result of chemotherapy. Using questionnaires to assess the QoL helped in easier identification of adverse effects and specific problems for adequate treatment.
References
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed on day/month/year.
Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin 2015; 65(2): 87−108.
Bray F, Ren J, Masuyer E, Ferlay J. Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer 2013; 132(5): 1133−45.
Siegel RL, Miller KD, Jemal A. Cancer Statistics. CA Cancer J Clin 2015; 65(1): 5−29.
Petrosyan F, Daw H, Haddad A, Spiro T. Targeted therapy for lung cancer. Anticancer Drugs 2012; 23(10): 1016−21.
Pearman T. Psychosocial factors in lung cancer: Quality of life, economic impact, and survivorship implications. J Psychosoc Oncol 2008; 26(1): 69−80.
Sarna L, Padilla G, Holmes C, Tashkin D, Brecht ML, Evangelista L. Quality of life of long-term survivors of non-small-cell lung cancer. J Clin Oncol 2002; 20(13): 2920−9.
Aaronson NK, Bullinger M, Ahmedzai S. A Modular approach to quality-of-life assessment in cancer clinical trials. Recent Results Cancer Res 1988; 111: 231−49.
Hollen PJ, Gralla RJ. Comparison of instruments for measuring quality of life in patients with lung cancer. Semin Oncol 1996; 23(5): 31−40.
Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R, et al. The IASCL Lung Cancer Staging Project: Pro-posals for the revision of the TNM groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumors. J Thorac Oncol 2007; 2(8): 706−14.
Engelen V, Detmar S, Koopman H, Maurice-Stam H, Caron H, Hoo-gerbrugge P, et al. Reporting health-related quality of life scores to physicians during routine follow-up visits of pediatric on-cology patients: Is it effective. Pediatr Blood Cancer 2012; 58(5): 766−74.
Gridelli C, Perrone F, Nelli F, Ramponi S, de Marinis F. Quality of life in lung cancer patients. Ann Oncol 2001; 12(3): S21−5.
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organisation 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 1993; 85(5): 365−76.
Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Coop-erative Oncology Group. Am J Clin Oncol 1983; 5(6): 649−55.
Gazdar A. Activating and resistance mutations of EGFR in non-small-cell lung cancer: role in clinical response to EGFR tyrosine kinase inhibitors. Oncogene 2009; 28(1): S24−31.
Bergman B, Aaronson NK, Ahmedzai S, Kaasa S, Sullivan M. The EORTC QLQ-LC13: a modular supplement to the EORTC Core Quality of Life Questionnaire (QLQ-C30) for use in lung cancer clinical trials. EORTC Study Group on Quality of Life. Eur J Cancer 1994; 30A(5): 635−42.
Eisenhauer E, Verweij J, Therasse P. Response assessment in solid tumours (RECIST): Version 1.1 and Supporting Papers. Eur J Cancer 2009; 45(2): 225−310.
Travis WD, Brambilla E, Nicholson AG, Yatabe Y, Austin J, Beasley MB, et al. The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification. J Thorac Oncol 2015; 10(9): 1243−60.
Department for Prevention and Control of Noncommunicable Diseases. The incidence and mortality in central Serbia 2012. Belgrade: Institute of Public Health of Serbia “Dr Milan Jovanovic-Batut”; 2014. (Serbian)
le Chevalier T, Scagliotti G, Natale R, Danson S, Rosell R, Stahel R, et al. Efficacy of gemcitabine plus platinum chemotherapy compared with other platinum containing regimens in ad-vanced non-small-cell lung cancer: A meta-analysis of survival outcomes. Lung Cancer 2005; 47(1): 69−80.
Li L, Schaid DJ, Fridley BL, Kalari KR, Jenkins GD, Abo RP, et al. Gemcitabine metabolic pathway genetic polymorphisms and response in patients with non-small cell lung cancer. Pharma-cogenet Genomics 2012; 22(2): 105−16.
Rajappa S, Gundeti S, Talluri MR, Digumarti R. Chemotherapy for advanced lung cancer: A 5-year experience. Indian J Cancer 2008; 45(1): 20−6.
D'Addario G, Früh M, Reck M, Baumann P, Klepetko W, Felip E, et al. Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010; 21 Suppl 5: v116−9.
Hickish TF, Smith IE, O'Brien ME, Ashley S, Middleton G. Clinical benefit from palliative chemotherapy in non-small-cell lung cancer extends to the elderly and those with poor prognostic factors. Br J Cancer 1998; 78(1): 28−33.
Higginson IJ, Carr AJ. Measuring quality of life: Using quality of life measures in the clinical setting. BMJ 2001; 322(7297): 1297−300.
Wintner LM, Giesinger JM, Zabernigg A, Sztankay M, Meraner V, Pall G, et al. Quality of life during chemotherapy in lung cancer patients: Results across different treatment lines. Br J Cancer 2013; 109(9): 2301−8.
Braun DP, Gupta D, Staren ED. Quality of life assessment as a predictor of survival in non-small cell lung cancer. BMC Can-cer 2011; 11: 353.
Hollen PJ, Gralla RJ, Kris MG, Cox C, Belani CP, Grunberg SM, et al. A dilemma in analysis: Issues in the serial measurement of quality of life in patients with advanced lung cancer. Lung Cancer 1997; 18(2): 119−36.
Zabora J, Brintzenhofeszoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psy-chooncology 2001; 10(1): 19−28.
Kennard BD, Stewart SM, Olvera R, Bawdon RE, Hailin AO, Lewis CP, et al. Nonadherence in adolescent oncology patients: Pre-liminary data on psychological risk factors and relationships to outcome. J Clin Psychol Med Settings 2004; 11(1): 31−9.
Gibson RJ, Keefe DM. Cancer chemotherapy-induced diarrhoea and constipation: mechanisms of damage and prevention strategies. Support Care Cancer 2006; 14(9): 890−900.
Portenoy RK. Constipation in the cancer patient: causes and management. Med Clin North Am 1987; 71(2): 303−11.
Hotta K, Matsuo K, Ueoka H, Kiura K, Tabata M, Tanimoto M. Meta-analysis of randomized clinical trials comparing Cisplatin to Carboplatin in patients with advanced non-small-cell lung cancer. J Clin Oncol 2004; 22(19): 3852−9.
Jiang J, Liang X, Zhou X, Huang R, Chu Z. A meta-analysis of randomized controlled trials comparing carboplatin-based to cisplatin-based chemotherapy in advanced non-small cell lung cancer. Lung Cancer 2007; 57(3): 348−58.
Roscoe JA, Morrow GR, Aapro MS, Molassiotis A, Olver I. Antic-ipatory Nausea and Vomiting. Support Care Cancer 2011; 19(10): 1533−8.
Scott HR, McMillan DC, Forrest LM, Brown DJ, McArdle CS, Mi-lroy R. The systemic inflammatory response, weight loss, per-formance status and survival in patients with inoperable non-small cell lung cancer. Br J Cancer 2002; 87(3): 264−7.
Xara S, Amaral TF, Parente B. Undernutrition and quality of life in non-small cell lung cancer patients. Rev Port Pneumol 2011; 17(4): 153−8. (Portuguese)
Buzaglo J, Gayer C, Mallick R, Charap E, Ferris A, Golant M, et al. Understanding the experience of living with non-small-cell lung cancer (NSCLC): A qualitative study. J Community Sup-port Oncol 2014; 12(1): 6−12.
Harle AS, Blackhall FH, Smith JA, Molassiotis A. Understanding cough and its management in lung cancer. Curr Opin Support Palliat Care 2012; 6(2): 153−62.
Park S, Kim IR, Baek KK, Lee SJ, Chang WJ, Maeng CH, et al. Prospective analysis of quality of life in elderly patients treated with adjuvant chemotherapy for non-small-cell lung cancer. Ann Oncol 2013; 24(6): 1630−9.
Can G, Demir M, Erol O, Aydiner A. A comparison of men and women's experiences of chemotherapy-induced alopecia. Eur J Oncol Nurs 2013; 17(3): 255−60.
Shin H, Jo SJ, Kim do H, Kwon O, Myung SK. Efficacy of inter-ventions for prevention of chemotherapy-induced alopecia: A systematic review and meta-analysis. Int J Cancer 2015; 136(5): 442−54.
Green CR, Hart-Johnson T, Loeffler DR. Cancer-related chronic pain: Examining quality of life in diverse cancer survivors. Cancer 2011; 117(9): 1994−2003.
Herndon JE 2nd, Fleishman S, Kornblith AB, Kosty M, Green MR, Holland J. Is quality of life predictive of the survival of patients with advanced nonsmall cell lung carcinoma? Cancer 1999; 85(2): 333−40.
Afsharimani B, Kindl K, Good P, Hardy J. Pharmacological op-tions for the management of refractory cancer pain-what is the evidence? Support Care Cancer 2015; 23(5): 1473−81.
Riley J, Branford R, Droney J, Gretton S, Sato H, Kennett A, et al. Morphine or oxycodone for cancer-related pain? A rando-mized, open-label, controlled trial. J Pain Symptom Manage 2015; 49(2): 161−72.
Ohe Y, Ohashi Y, Kubota K, Tamura T, Nakagawa K, Negoro S. Randomized phase III study of cisplatin plus irinotecan versus carboplatin plus paclitaxel, cisplatin plus gemcitabine, and cis-platin plus vinorelbine for advanced non-small cell lung can-cer: Four-Arm Cooperative Study in Japan. Ann Oncol 2007; 18(2): 317−23.
Wang XS, Shi Q, Lu C, Basch EM, Johnson VE, Mendoza TR, et al. Prognostic value of symptom burden for overall survival in patients receiving chemotherapy for advanced nonsmall cell lung cancer. Cancer 2010; 116(1): 137−45.
Lemonnier I, Guillemin F, Arveux P, Clément-Duchêne C, Velten M, Woronoff-Lemsi MC, et al. Quality of life after the initial treat-ments of non-small cell lung cancer: a persistent predictor for patients' survival. Health Qual Life Outcomes 2014; 12: 73.