Dyspnea as a Prognostic Factor in Patients with Non-Small Cell Lung Cancer

Ban, Woo Ho; Lee, Jong Min; Ha, Jeonghoon; Yeo, Chang Dong; Kang, Hyeon Hui; Rhee, Chin Kook; Moon, Hwa Sik; Lee, Sang Haak

doi:10.3349/ymj.2016.57.5.1063

Cited by 34 publications

(20 citation statements)

References 21 publications

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“…Respiratory symptoms such as cough, sputum, and dyspnea were more frequent in patients with NSCLC and COPD than in those without, which supports the hypothesis and is consistent with the results of previous studies [ 25 ]. Declines in lung function and the severity of symptoms in patients with lung cancer are known to have significant effects on quality of life [ 26 ], and in particular, patients who suffer from dyspnea are known to be at higher risk of death and poor prognosis than those without dyspnea [ 6 , 8 ]. Therefore, in this study, the quality of life in patients with advanced NSCLC was analyzed using the EORTC QLQ-C30 scale.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, various symptoms, including dyspnea and quality of life, affect the prognosis of patients with lung cancer. In particular, respiratory symptoms and changes in pulmonary function, which serve as diagnostic criteria for COPD, have a very negative impact on the prognosis of patients with lung cancer [ 6 – 8 ]. Many studies have reported the prevalence of COPD and its effects and prognosis in patients with lung cancer, but few have considered quality of life and survival of patients with lung cancer according to severity of airway obstruction.…”

Section: Introductionmentioning

confidence: 99%

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Effect of COPD on symptoms, quality of life and prognosis in patients with advanced non-small cell lung cancer

Ban

Sohng

2018

BMC Cancer

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BackgroundMany studies have reported the prevalence of chronic obstructive pulmonary disease (COPD) and its effects and prognosis in patients with lung cancer, but few have considered quality of life and survival of patients with lung cancer according to severity of airway obstruction. This study investigated the presence of COPD and the severity of airway obstruction in patients with non-small cell lung cancer (NSCLC), and analyzed how these factors affected symptoms, quality of life, and prognosis.MethodsWe retrospectively reviewed the prospective lung cancer database of the Catholic Medical Centers at the Catholic University of Korea from 2014 to 2017. We enrolled patients with advanced NSCLC and evaluated quality of life using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30. We also estimated pulmonary function and analyzed survival data.ResultsOf the 337 patients with advanced NSCLC, 170 (50.5%) had COPD and 167 (49.5%) did not. Significant differences were observed in symptoms between the two groups. The COPD group complained of more symptoms, such as cough, sputum, and dyspnea, than those in the non-COPD group. The distribution according to the severity of obstruction in the COPD group was as follows: Grade 1 (FEV1 ≥ 80%) 35 patients (20.6%), Grade 2 (50% ≤ FEV1 < 80%) 103 patients (60.6%), Grade 3 (30% ≤ FEV1 < 50%) 24 patients (14.1%), and Grade 4 (FEV1 < 30%) 8 patients (4.7%). The presence of COPD did not affect overall quality of life in patients with NSCLC, but as the airway obstruction increased, physical function decreased, and fatigue and dyspnea were more frequent. The overall median survival of the COPD group was shorter than that of the non-COPD group (median survival, 224 vs. 339 days, p = 0.035).ConclusionsIn this study, a high prevalence of COPD was found among patients with advanced NSCLC, and COPD patients complained about various symptoms and had diminished quality of life in several sectors. Therefore, it is necessary to actively evaluate quality of life, lung function, and symptoms in patients with lung cancer and reflect them in the treatment and management plans of these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of COPD on symptoms, quality of life and prognosis in patients with advanced non-small cell lung cancer

Ban

Sohng

2018

BMC Cancer

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“…Breathlessness is a common symptom in patients with cancer ( 1 , 2 ) and is the commonest amongst patients with lung cancer ( 3 ) and among patients in need of palliative care or advanced cancer ( 4 ). As classified by the American Thoracic Society in 1999 (5, p. 322), breathlessness is a subjective experience of difficulty in breathing that consists of qualitative distinctive sensations that differ in intensity.…”

Section: Introductionmentioning

confidence: 99%

Developing and Assessing the Effectiveness of a Nurse-Led Home-Based Educational Programme for Managing Breathlessness in Lung Cancer Patients. A Feasibility Study

et al. 2020

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Introduction: Breathlessness is the most common and refractory symptom in lung cancer patients. Even though various educational programmes have been developed, only a few were intended for implementation in the home setting for its management. Aim: Feasibility of a study for implementing a nurse-led educational programme for breathlessness management of lung cancer patients at home. Method: A randomized feasibility study was undertaken between February 2017 and October 2018. Patients were recruited through referral from oncologists from two oncology centers in Cyprus under certain inclusion and exclusion criteria. Patients were randomized in the intervention or control group via a computer programme, and their named family caregivers (f.c.) were allocated in the same group. Participants were not blinded to group assignment. The intervention consisted of a PowerPoint presentation and implementation of three non-pharmacological interventions. The control group received usual care. Patients were assessed for breathlessness, anxiety, and depression levels, whereas f.c. were assessed for anxiety, depression, and burden levels. F.c. also assessed patients' dyspnea level. The duration of the study process for both the intervention and control group was over a period of 4 weeks. Results: Twenty-four patients and their f.c. ( n = 24) were allocated equally in the intervention and control group. Five patients withdrew, and the final sample entered analysis was 19 patients and 19 family caregivers. In the intervention group n = 11 + 11, and in the control group n = 8 + 8. In the intervention group patients' breathlessness and anxiety levels showed improvement and their f.c.s in the anxiety and burden levels. Major consideration was the sample size and the recruitment of the patients by the referring oncologists. Attrition was minor during the study process. No harm was recorded by the participants of the study. Conclusions: The study provided evidence of the feasibility of the implementation of the educational programme. For the future definitive study major consideration should be patients' recruitment method in order to achieve adequate sample size. Moreover, qualitative data should be collected in relation to the intervention and the involvement of f.c. The feasibility study was registered to the Cyprus Bioethics Committee with the registration number 2016/16. There was no funding of the study.

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“…Ex-smoker was defined as the patient who quitted smoking at least one month before the diagnosis of lung cancer. The patient who had smoked fewer than 100 cigarettes in their lifetime or had never smoked as never smoker [7]. Lung function test was performed according to the American Thoracic Society/European Respiratory Society standardization guidelines.…”

Section: Data Sourcementioning

confidence: 99%

Smoking is associated with pneumonia development in lung cancer patients

Heo

Yeo

Park

et al. 2020

Preprint

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Background: Various host factors can promote pneumonia susceptibility of lung cancer patients. However, data about risk factors for pneumonia in lung cancer patients receiving active treatments such as chemotherapy, radiotherapy, and surgical intervention are limited. Thus, the purpose of this study was to identify risk factors for pneumonia development in lung cancer patients. Methods: The present study used a lung cancer cohort of the Catholic Medical Center at the Catholic University of Korea from January 2015 to December 2018. Pneumonia was defined by the presence of a new or progressive infiltration on chest imaging together with any of the following: new onset purulent sputum, change in character of chronic sputum, and fever. We ruled out noninfectious infiltration such as drug or radiation toxicity and hydrostatic pulmonary edema. We especially excluded those if computed tomography revealed sharp demarcation consolidation or ground glass opacity limited radiation field. Results: A total of 413 patients were enrolled in this study. Pneumonia occurred in 118 (28.6%) patients. The pneumonia group had significantly worse overall survival (OS) than the non -pneumonia group (456.7 ± 35.0 days vs. 813.4 ± 36.1 days, log rank p < 0.001). In patients with pneumonia, OS was shorter in ex-smokers and current smokers than in never smokers (592.0 ± 101.0 days vs. 737.0 ± 102.8 days vs. 1357.0 days, log rank p < 0.001). Age (hazard ratio [HR]: 1.046; 95% confidence interval [CI]: 1.019–1.074; p = 0.001), clinical stage IV (HR: 1.759; 95% CI: 1.004–3.083; p = 0.048), neutropenia (HR: 2.620; 95% CI: 1.562–4.396; p < 0.001], and smoking (HR: 2.040; 95% CI: 1.100–3.784; p = 0.024) were independent risk factors of pneumonia development in lung cancer patients in multivariate analysis. In subgroup analysis for patients treated with chemotherapy, age (HR: 1.043; 95% CI: 1.012–1.074; p = 0.006), neutropenia (HR: 3.199; 95% CI: 1.826–5.605; p < 0.001), and smoking (HR: 2.125; 95% CI: 1.071–4.216; p = 0.031) were independent risk factors of pneumonia development. Conclusions: Smoking and neutropenia were risk factors affecting pneumonia development in the total group and subgroup of patients with lung cancer.

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Dyspnea as a Prognostic Factor in Patients with Non-Small Cell Lung Cancer

Cited by 34 publications

References 21 publications

Effect of COPD on symptoms, quality of life and prognosis in patients with advanced non-small cell lung cancer

Effect of COPD on symptoms, quality of life and prognosis in patients with advanced non-small cell lung cancer

Developing and Assessing the Effectiveness of a Nurse-Led Home-Based Educational Programme for Managing Breathlessness in Lung Cancer Patients. A Feasibility Study

Smoking is associated with pneumonia development in lung cancer patients

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