Szu-Chun Yang1,2, Wu-Wei Lai3, Tzuen-Ren Hsiue1, Wu-Chou Su1, Cheng-Kuan Lin4, Jing-Shiang Hwang5, Jung-Der Wang6,7,8. 1. Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 704, Taiwan. 2. Department of Public Health, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 704, Taiwan. 3. Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 704, Taiwan. 4. Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA. 5. Institute of Statistical Science, Academia Sinica, 128 Academia Road Section 2, Taipei, 115, Taiwan. 6. Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 704, Taiwan. jdwang121@gmail.com. 7. Department of Public Health, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 704, Taiwan. jdwang121@gmail.com. 8. Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 704, Taiwan. jdwang121@gmail.com.
Abstract
PURPOSE: This study attempted to compare changes in the Quality-of-Life (QoL) scores after three different first-line anti-cancer treatments for advanced non-small cell lung cancer (NSCLC) in a real-world clinical setting. PATIENTS AND METHODS: From May 2011 to December 2013, we prospectively measured the QoL scores of patients with locally advanced or metastatic NSCLC using the World Health Organization Quality-of-Life-Brief (WHOQOL-BREF) questionnaire. Each QoL measurement was matched by age and sex with one healthy referent from the National Health Interview Survey. Dynamic changes in patients' QoL scores and major determinants were repeatedly assessed by construction of a mixed-effects model to adjust for possible confounders. RESULTS: A total of 336 patients with 577 QoL measurements related to first-line anti-cancer treatments were enrolled. Performance status was the most important predictor of QoL scores in all domains after controlling for potential confounders. With age- and sex-matched healthy subjects as the reference, patients treated with gemcitabine + platinum showed significantly lower scores in multiple physical and psychological domain items in the WHOQOL-BREF. However, pemetrexed + platinum and gefitinib/erlotinib affected patients' QoL scores in 'energy/fatigue' and 'daily activities' with smaller magnitudes, and the scores appeared to improve after 3-4 months of treatment. CONCLUSIONS: Patients receiving gemcitabine + platinum as first-line anti-cancer treatment for advanced NSCLC experienced relatively poor QoL scores throughout treatment course. Studies to develop a real-time computerized system automatically updating the mixed-effects model for QoL to facilitate participatory clinical decision making by physicians, patients, and their families merit further research.
PURPOSE: This study attempted to compare changes in the Quality-of-Life (QoL) scores after three different first-line anti-cancer treatments for advanced non-small cell lung cancer (NSCLC) in a real-world clinical setting. PATIENTS AND METHODS: From May 2011 to December 2013, we prospectively measured the QoL scores of patients with locally advanced or metastatic NSCLC using the World Health Organization Quality-of-Life-Brief (WHOQOL-BREF) questionnaire. Each QoL measurement was matched by age and sex with one healthy referent from the National Health Interview Survey. Dynamic changes in patients' QoL scores and major determinants were repeatedly assessed by construction of a mixed-effects model to adjust for possible confounders. RESULTS: A total of 336 patients with 577 QoL measurements related to first-line anti-cancer treatments were enrolled. Performance status was the most important predictor of QoL scores in all domains after controlling for potential confounders. With age- and sex-matched healthy subjects as the reference, patients treated with gemcitabine + platinum showed significantly lower scores in multiple physical and psychological domain items in the WHOQOL-BREF. However, pemetrexed + platinum and gefitinib/erlotinib affected patients' QoL scores in 'energy/fatigue' and 'daily activities' with smaller magnitudes, and the scores appeared to improve after 3-4 months of treatment. CONCLUSIONS:Patients receiving gemcitabine + platinum as first-line anti-cancer treatment for advanced NSCLC experienced relatively poor QoL scores throughout treatment course. Studies to develop a real-time computerized system automatically updating the mixed-effects model for QoL to facilitate participatory clinical decision making by physicians, patients, and their families merit further research.
Entities:
Keywords:
Dynamic changes; Healthy reference; Lung cancer treatment; Quality of life; Repeated measurements
Authors: Rafael Rosell; Enric Carcereny; Radj Gervais; Alain Vergnenegre; Bartomeu Massuti; Enriqueta Felip; Ramon Palmero; Ramon Garcia-Gomez; Cinta Pallares; Jose Miguel Sanchez; Rut Porta; Manuel Cobo; Pilar Garrido; Flavia Longo; Teresa Moran; Amelia Insa; Filippo De Marinis; Romain Corre; Isabel Bover; Alfonso Illiano; Eric Dansin; Javier de Castro; Michele Milella; Noemi Reguart; Giuseppe Altavilla; Ulpiano Jimenez; Mariano Provencio; Miguel Angel Moreno; Josefa Terrasa; Jose Muñoz-Langa; Javier Valdivia; Dolores Isla; Manuel Domine; Olivier Molinier; Julien Mazieres; Nathalie Baize; Rosario Garcia-Campelo; Gilles Robinet; Delvys Rodriguez-Abreu; Guillermo Lopez-Vivanco; Vittorio Gebbia; Lioba Ferrera-Delgado; Pierre Bombaron; Reyes Bernabe; Alessandra Bearz; Angel Artal; Enrico Cortesi; Christian Rolfo; Maria Sanchez-Ronco; Ana Drozdowskyj; Cristina Queralt; Itziar de Aguirre; Jose Luis Ramirez; Jose Javier Sanchez; Miguel Angel Molina; Miquel Taron; Luis Paz-Ares Journal: Lancet Oncol Date: 2012-01-26 Impact factor: 41.316
Authors: Camilla Zimmermann; Debika Burman; Nadia Swami; Monika K Krzyzanowska; Natasha Leighl; Malcolm Moore; Gary Rodin; Ian Tannock Journal: Support Care Cancer Date: 2010-03-30 Impact factor: 3.603
Authors: Ji-Youn Han; Keunchil Park; Sang-We Kim; Dae Ho Lee; Hyae Young Kim; Heung Tae Kim; Myung Ju Ahn; Tak Yun; Jin Seok Ahn; Cheolwon Suh; Jung-Shin Lee; Sung Jin Yoon; Jong Hee Han; Jae Won Lee; Sook Jung Jo; Jin Soo Lee Journal: J Clin Oncol Date: 2012-02-27 Impact factor: 44.544
Authors: Jeff A Sloan; Xinghua Zhao; Paul J Novotny; Jason Wampfler; Yolanda Garces; Matthew M Clark; Ping Yang Journal: J Clin Oncol Date: 2012-03-26 Impact factor: 44.544
Authors: M Tazaki; Y Nakane; T Endo; F Kakikawa; K Kano; H Kawano; K Kuriyama; K Kuroko; E Miyaoka; H Ohta; N Okamoto; S Shiratori; S Takamiya; K Tanemura; R Tsuchiya Journal: Jpn J Clin Oncol Date: 1998-02 Impact factor: 3.019
Authors: G Chen; J Feng; C Zhou; Y-L Wu; X-Q Liu; C Wang; S Zhang; J Wang; S Zhou; S Ren; S Lu; L Zhang; C-P Hu; C Hu; Y Luo; L Chen; M Ye; J Huang; X Zhi; Y Zhang; Q Xiu; J Ma; L Zhang; C You Journal: Ann Oncol Date: 2013-03-01 Impact factor: 32.976
Authors: Giorgio Vittorio Scagliotti; Purvish Parikh; Joachim von Pawel; Bonne Biesma; Johan Vansteenkiste; Christian Manegold; Piotr Serwatowski; Ulrich Gatzemeier; Raghunadharao Digumarti; Mauro Zukin; Jin S Lee; Anders Mellemgaard; Keunchil Park; Shehkar Patil; Janusz Rolski; Tuncay Goksel; Filippo de Marinis; Lorinda Simms; Katherine P Sugarman; David Gandara Journal: J Clin Oncol Date: 2008-05-27 Impact factor: 44.544
Authors: Giorgio V Scagliotti; Keunchil Park; Shekar Patil; Janusz Rolski; Tuncay Goksel; Renato Martins; Steven J M Gans; Carla Visseren-Grul; Patrick Peterson Journal: Eur J Cancer Date: 2009-05-25 Impact factor: 9.162