PURPOSE: To determine the added value of quality of life (QOL) as a prognostic factor for overall survival (OS) in patients with locally advanced non-small-cell lung cancer (NSCLC) treated on Radiation Therapy Oncology Group RTOG-9801. PATIENTS AND METHODS: Two hundred forty-three patients with stage II/IIIAB NSCLC receivedinduction paclitaxel and carboplatin (PC) and then concurrent weekly PC and hyperfractionated radiation (to 69.6 Gy). Patients were randomly assigned to amifostine (AM) or no AM during chemoradiotherapy. The following pretreatment factors were analyzed as prognostic factors for OS: Karnofsky performance status, stage, sex, age, race, marital status, histology, tumor location, hemoglobin, tobacco use, treatment arm (AM v no AM) and QOL scores (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 [QLQ-C30] and Lung Cancer 13 [LC-13]). A multivariate (MVA) Cox proportional hazards model was performed using a backwards selection process. RESULTS: Of the 239 analyzable patients, 91% had a baseline global QOL score. Median follow-up time was 59 months for patients still alive and 17 months for all patients. Median baseline QLQ-C30 global QOL score was 66.7 on both treatment arms. Whether the global QOL score was treated as a dichotomized variable (based on the median score) or a continuous variable, all other variables fell out of the MVA for OS. Patients with a global QOL score less than 66.7 had an approximately 70% higher rate of death than patients with scores > or = 66.7 (P = .004). A 10-point higher baseline global QOL score corresponded to a decrease in the hazard of death by approximately 10% (P = .004). The other independent QOL predictors for OS were the QLQ-C30 physical functioning (P = .011) and LC-13 dyspnea scores (P = .012). CONCLUSION: In this analysis, baseline global QOL score replaced known prognostic factors as the sole predictor of long-term OS for patients with locally advanced NSCLC.
RCT Entities:
PURPOSE: To determine the added value of quality of life (QOL) as a prognostic factor for overall survival (OS) in patients with locally advanced non-small-cell lung cancer (NSCLC) treated on Radiation Therapy Oncology Group RTOG-9801. PATIENTS AND METHODS: Two hundred forty-three patients with stage II/IIIAB NSCLC received induction paclitaxel and carboplatin (PC) and then concurrent weekly PC and hyperfractionated radiation (to 69.6 Gy). Patients were randomly assigned to amifostine (AM) or no AM during chemoradiotherapy. The following pretreatment factors were analyzed as prognostic factors for OS: Karnofsky performance status, stage, sex, age, race, marital status, histology, tumor location, hemoglobin, tobacco use, treatment arm (AM v no AM) and QOL scores (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 [QLQ-C30] and Lung Cancer 13 [LC-13]). A multivariate (MVA) Cox proportional hazards model was performed using a backwards selection process. RESULTS: Of the 239 analyzable patients, 91% had a baseline global QOL score. Median follow-up time was 59 months for patients still alive and 17 months for all patients. Median baseline QLQ-C30 global QOL score was 66.7 on both treatment arms. Whether the global QOL score was treated as a dichotomized variable (based on the median score) or a continuous variable, all other variables fell out of the MVA for OS. Patients with a global QOL score less than 66.7 had an approximately 70% higher rate of death than patients with scores > or = 66.7 (P = .004). A 10-point higher baseline global QOL score corresponded to a decrease in the hazard of death by approximately 10% (P = .004). The other independent QOL predictors for OS were the QLQ-C30 physical functioning (P = .011) and LC-13 dyspnea scores (P = .012). CONCLUSION: In this analysis, baseline global QOL score replaced known prognostic factors as the sole predictor of long-term OS for patients with locally advanced NSCLC.
Authors: Elizabeth A Hahn; David Cella; Olivier Chassany; Diane L Fairclough; Gilbert Y Wong; Ron D Hays Journal: Mayo Clin Proc Date: 2007-10 Impact factor: 7.616
Authors: Farzan Siddiqui; Thomas F Pajak; Deborah Watkins-Bruner; Andre A Konski; James C Coyne; Clement K Gwede; Adam S Garden; Sharon A Spencer; Christopher Jones; Benjamin Movsas Journal: Int J Radiat Oncol Biol Phys Date: 2007-09-24 Impact factor: 7.038
Authors: K Furuse; M Fukuoka; M Kawahara; H Nishikawa; Y Takada; S Kudoh; N Katagami; Y Ariyoshi Journal: J Clin Oncol Date: 1999-09 Impact factor: 44.544
Authors: Mirjam A G Sprangers; Jeff A Sloan; Ruut Veenhoven; Charles S Cleeland; Michele Y Halyard; Amy P Abertnethy; Frank Baas; Andrea M Barsevick; Meike Bartels; Dorret I Boomsma; Cynthia Chauhan; Amylou C Dueck; Marlene H Frost; Per Hall; Pål Klepstad; Nicholas G Martin; Christine Miaskowski; Miriam Mosing; Benjamin Movsas; Cornelis J F Van Noorden; Donald L Patrick; Nancy L Pedersen; Mary E Ropka; Quiling Shi; Gen Shinozaki; Jasvinder A Singh; Ping Yang; Ailko H Zwinderman Journal: Twin Res Hum Genet Date: 2009-06 Impact factor: 1.587
Authors: Gordon H Guyatt; Carol Estwing Ferrans; Michele Y Halyard; Dennis A Revicki; Tara L Symonds; Claudette G Varricchio; Anna Kotzeva; Jose M Valderas; Jordi Alonso; Jordi L Alonso Journal: Mayo Clin Proc Date: 2007-10 Impact factor: 7.616
Authors: Kathryn Elizabeth Hudson; Steven Paul Wolf; Gregory P Samsa; Arif H Kamal; Amy Pickar Abernethy; Thomas William LeBlanc Journal: J Palliat Med Date: 2018-02-08 Impact factor: 2.947
Authors: Yaacov Richard Lawrence; Rebecca Paulus; Corey Langer; Maria Werner-Wasik; Mark K Buyyounouski; Ritsuko Komaki; Mitchell Machtay; Colum Smith; Rita S Axelrod; Todd Wasserman; Jeffrey D Bradley; Benjamin Movsas Journal: Lung Cancer Date: 2013-03-07 Impact factor: 5.705
Authors: David H Gustafson; Lori L DuBenske; Kang Namkoong; Robert Hawkins; Ming-Yuan Chih; Amy K Atwood; Roberta Johnson; Abhik Bhattacharya; Cindy L Carmack; Anne M Traynor; Toby C Campbell; Mary K Buss; Ramaswamy Govindan; Joan H Schiller; James F Cleary Journal: Cancer Date: 2013-01-25 Impact factor: 6.860