Prospective Study on Quality of Life Before and After Radical Radiotherapy in Non–Small-Cell Lung Cancer

Langendijk, J.A.; Aaronson, Neil K.; Jong, J.M.A. de; Velde, G. P. M. Ten; Müller, Martin; Lamers, R. J. S.; Slotman, Ben J.; Wouters, Emiel F.M.

doi:10.1200/jco.2001.19.8.2123

Cited by 90 publications

(62 citation statements)

References 26 publications

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“…The dependent variable in these regression analyses was overall QoL (EORTC QLQ-30, item 30); age, gender and histology (SCLC/NSCLC), were included as potential confounders. Since fatigue is the most frequently reported cancer-related side-effect, being of significant influence on QoL, we also adjusted for this variable [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

“…More apparent predictors for QoL found in this study appeared to be gender, tumor stage, and fatigue. The latter finding is not surprising, as fatigue is identified as the most predominant factor that influences overall QoL [18,19,21]. In addition, the more persistent worsening of some symptoms and functioning scores may be caused by the occurrence of relapse.…”

Section: Discussionmentioning

confidence: 99%

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High-dose radiotherapy or concurrent chemo-radiation in lung cancer patients only induces a temporary, reversible decline in QoL

Pijls‐Johannesma

Houben

Boersma

et al. 2009

Radiotherapy and Oncology

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a b s t r a c tBackground and purpose: Aggressive radiotherapy or concurrent chemo-radiation therapy for lung cancer leads to a high incidence of severe, mostly esophageal, toxicity. The purpose of this study was to investigate the evolution of quality of life (QoL) in patients with lung cancer, selected for curative radiotherapy (RT) or chemo-RT. Methods: Seventy-five lung cancer patients completed a longitudinal the EORTC QLQ-C30 and LC13. Linear mixed regression models were fitted to investigate the impact of different factors on overall QoL. Results: Overall QoL decreased shortly after the end of RT (4 points, p = 0.19), but increased back to baseline within 3 months. Mean scores of role functioning (p = 0.018), cognitive functioning (p = 0.002), dyspnoea (EORTC QLQ-LC13; p = 0.043), dysphagia (p = 0.005) and hoarseness (p = 0.029), showed a significant worsening over time. Emotional functioning (p = 0.033) improved significantly over time. Severe esophagitis (Pgrade 2) was reported in only 12% of the patients. Next to maximal esophageal toxicity Pgrade 2 (p = .0.010), also tumor stage IIIA (p < 0.001), tumor stage IIIB (p = 0.003), gender (p = 0.042) and fatigue (p < 0.001) appeared to be significant predictors of QoL. Conclusion: High-dose radiotherapy or concurrent chemo-radiation in the treatment of lung cancer seems to be a well-tolerated treatment option with preservation of QoL. Lung cancer remains a major public health problem worldwide because of its high incidence, rapid progression, and poor outcome [1]. The majority of patients who develop lung cancer die of this disease within a year [2]. Aggressive radiotherapy or concurrent chemo-radiation therapy for lung cancer is standard care for patients with locally advanced disease, i.e. stage III non-small cell lung cancer (NSCLC) or limited stage small cell lung carcinoma (LD-SCLC) [3,4].Combined concurrent modality treatment increases long-term survival, but at the expense of a higher incidence of severe esophagitis [5][6][7][8]. In order to allow proper balancing between expected benefits and drawbacks of aggressive therapy, knowledge of the effects of a given treatment on the quality of life (QoL) is needed.An optimal therapy could be defined as one that increases survival or provides benefit through reduction in cancer-related symptoms and improved QoL.To the best of our knowledge, in only one study, QoL assessment was performed in patients receiving high-dose radiotherapy for NSCLC [9]. No data are at present known on the influence of concurrent chemo-radiation on the QoL.Moreover, a broad Medline search using the terms ''QoL and SCLC" (December 2008) revealed only 15 studies of which none examined QoL after radiotherapy treatment.The purpose of this study was to investigate the evolution of QoL on NSCLC stages I-III and LD-SCLC patients, referred for hyperfractionated accelerated high-dose radiotherapy (RT) with or without concurrent chemotherapy, with curative intent. Since we hypothesized that QoL would be considerably influenced by esophageal...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

High-dose radiotherapy or concurrent chemo-radiation in lung cancer patients only induces a temporary, reversible decline in QoL

Pijls‐Johannesma

Houben

Boersma

et al. 2009

Radiotherapy and Oncology

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“…The effect on quality of life was measured with the EORTC quality of life questionnaire QLQ-C30 (Wymenga et al 1999, Langendijk et al 2001. Questions were added to evaluate the specific carcinoid symptoms, such as flushes and abdominal cramps, and the specific sideeffects of IFN such as chills and muscle pain.…”

Section: Methodsmentioning

confidence: 99%

Interferon and meta-iodobenzylguanidin combinations in the treatment of metastatic carcinoid tumours

Zuetenhorst

Olmos

Muller

et al. 2004

Endocr Relat Cancer

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Interferon (IFN) and meta-iodobenzylguanidin (MIBG) are active in metastatic carcinoids. In a phase II study, we evaluated the effect upon diagnostic 131 I-MIBG uptake and the clinical response of the combination. 131I-MIBG scintigraphy was performed prior to treatment, after 8 weeks of IFN and after unlabelled MIBG. The tumour over non-tumour (T/NT) ratios were quantitatively determined by comparing counts in the centre of the tumour (liver metastases) with those in an adjacent area of normal liver uptake (T/NT1) and with abdominal background area (T/NT2).The T/NT1 ratio showed an increase of > 10% in only four out of 21 patients (19%) after IFN ðP ¼ 0:178Þ and significantly more often in nine out of 18 patients (50%) after unlabelled MIBG ðP ¼ 0:016Þ. The absolute uptake in tumour deposits was also increased if compared with the abdominal background (T/NT2: 23% increase after IFN and 83% increase after unlabelled MIBG). The combination produced 91% of patients with stable disease (using World Health Organisation criteria) at computed tomography scan and a biochemical response (a reduction of at least 50% in urinary 5-hydroxyindolacetic acid excretion) in 39%.IFN-a did not significantly improve tumour retention of 131 I-MIBG. In contrast, unlabelled MIBG significantly improved biodistribution and tumour uptake in 83%. A synergistic effect was not seen.

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“…[1][2][3] However, progress has been incremental over several decades, and nevertheless the great majority of people with metastatic or recurrent cancer will die from their disease. 4,5 Although a significant number of advanced cancer patients respond to first-line regimens, survival rates continue to remain fairly low, with the main outcome being largely palliative. 2,6,7 Nevertheless, it is becoming apparent that treatment may improve quality of life even if it does not lengthen it.…”

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confidence: 99%

“…12 In contrast to these studies, no significant group differences were found in patientreported outcome scores between tumor responders and nonresponders (with the exception of chest pain) in a study involving patients with nonsmall cell lung carcinoma (n ϭ 130) after radical radiotherapy. 4 Moreover, the authors reported that a substantial number of nonresponding patients attained symptom palliation and improved health-related quality of life. Finally, in a study examining the relation between patient well-being and disease response among 155 breast carcinoma patients, 61% of responders and 17% of those with PD reported improved well being, whereas 24% of partial responders reported diminished well being.…”

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confidence: 99%

Metaanalysis of the correlation between radiographic tumor response and patient‐reported outcomes

Victorson

Soni

Cella

2005

Cancer

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BACKGROUND The primary aim of the current study was to determine whether radiographic tumor response is associated with patient‐reported outcomes such as symptom response or health‐related quality of life. METHODS A metaanalysis was conducted of 21 available studies from 1995–2003 that provided data sufficient for examining the association between tumor response and patient‐reported outcomes, including symptom response and health‐related quality of life. A second aim was to examine the influence of possible moderating study variables on effect size variation. RESULTS As hypothesized, patient‐reported outcome improvement rates were most frequently associated with patients classified as a complete or partial response (CR/PR), followed by those with stable disease (SD) and progressive disease (PD). Moderate effect sizes were observed between the CR/PR and SD (effect size of 0.35) and CR/PR and PD categories (effect size of 0.43). A weak effect size was found between SD and PD (effect size of 0.16), raising concern over the meaningfulness of the SD category. No significant correlations were found between effect size and patient or study characteristics. Significant associations existed between treatment duration and age, study duration, survival, and symptom response rates, especially among PD patients. CONCLUSION Despite significant study‐to‐study heterogeneity, an important association exists in the correlation between tumor response and formal measures of change in patient‐reported outcomes. A better understanding of this relation would be enhanced if future reports included estimates of effect size in patient‐reported outcome change by tumor response category. Practical implications, limitations, and directions for future research are provided. Cancer 2006. © 2005 American Cancer Society.

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Prospective Study on Quality of Life Before and After Radical Radiotherapy in Non–Small-Cell Lung Cancer

Cited by 90 publications

References 26 publications

High-dose radiotherapy or concurrent chemo-radiation in lung cancer patients only induces a temporary, reversible decline in QoL

High-dose radiotherapy or concurrent chemo-radiation in lung cancer patients only induces a temporary, reversible decline in QoL

Interferon and meta-iodobenzylguanidin combinations in the treatment of metastatic carcinoid tumours

Metaanalysis of the correlation between radiographic tumor response and patient‐reported outcomes

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