Benefits of chemotherapy for quality of life in patients with advanced nonsmall-cell lung cancer.

It has now become clear that chemotherapy for advanced nonsmall-cell lung cancer, compared with best supportive care only, improves survival, even if the amplitude of the benefit remains disappointing. However, some clinicians are still reluctant to prescribe chemotherapy in this patient population, arguing that the survival gain is too small to counterbalance the side effects. Therefore, randomized trials using quality of life as an endpoint and comparing best supportive care with or without chemotherapy were reviewed. Although there are difficulties in the methodology of quality of life assessments and in the analysis of quality of life data, most of the selected trials showed an improvement for quality of life in various components in the chemotherapy arm. Therefore, even if some of the reported results might be biased and should be interpreted with caution, the data analyses constitute a further argument to stop denying chemotherapy for patients with advanced nonsmall-cell lung cancer, at least for those who might be eligible for inclusion in a clinical trial.