Quality of life during chemotherapy in lung cancer patients: results across different treatment lines

Abstract

Background:Most lung cancer patients are diagnosed at an advanced disease stage and predominantly receive palliative treatment, which increasingly consists of several chemotherapy lines. We report on patients' quality of life (QOL) to gain knowledge on QOL during and across multiple lines of chemotherapy. This includes patients with (neo)adjuvant therapy up to 3rd or above line palliative chemotherapy.Methods:Lung cancer patients receiving outpatient chemotherapy at the Kufstein County Hospital completed an electronic version of the EORTC QLQ-C30. Linear mixed models were used for statistical analysis.Results:One hundred and eighty seven patients were included in the study. Surprisingly, irrespective of the chemotherapy line patients reported stable QOL scores during treatment. None of the calculated monthly change rates attained clinical significance, referring to established guidelines that classify a small clinical meaningful change as 5 to 10 points. According to treatment line, 3rd or above line palliative chemotherapy was associated with the worst QOL scores, whereas patients undergoing (neo)adjuvant or 1st line palliative chemotherapy reported fairly comparable QOL.Conclusion:The essential finding of our study is that all QOL aspects of the EORTC QLQ-C30 questionnaire remained unchanged during each chemotherapy line in an unselected population of lung cancer patients. Between treatment lines pronounced differences were found, indicating that later palliative chemotherapy lines are associated with higher QOL impairments. These changes in QOL may not primarily be related to the treatment, but rather refer to impairments due to disease progression and may be partly due to a consequence of the prior therapies.

Quality of life across chemotherapy lines in patients with advanced colorectal cancer: a prospective single-center observational study

“…The latter patients reported a substantially higher symptom burden. Similar results have been shown in a few other studies of patients with lung, pancreas, and biliary tract cancers [18][19][20]. Traditionally, objective end points such as response and survival rates have been used to evaluate the efficacy of chemotherapy in patients with advanced CRC.…”

The oligometastatic state—separating truth from wishful thinking

“…44 Prolonged systemic chemo therapy, or the use of successive lines of chemo therapy, can be associated with cumulative toxic effects or negatively impact quality of life. [48][49][50] At present, the role of adjuvant chemo therapy after ablation of oligo metastases is unclear. Peri-operative chemotherapy improves progression-free survival in metastasis from CRC, 51 but data for most other disease sites are lacking.…”

Quality of life among lung cancer patients undergoing treatment at a tertiary cancer institute in North India

“…Studies also suggest that most QOL aspects remain unchanged during treatment, suggesting that palliative treatment did not negatively impact QOL. 27 So the health related QOL assessment should be done in routine clinical practice in lung cancer patients. 28 Since we measured quality of life after diagnosis, and only of those patients who had unresectable disease, the validity of our measurements can sometimes be biased by any temporary effects due to patients being informed of their diagnosis of lung cancer and possible prognosis.…”