Marlene Hechtner1, Martin Eichler2, Beatrice Wehler3, Roland Buhl4, Martin Sebastian5, Jan Stratmann5, Heinz Schmidberger4, Bernhard Gohrbandt6, Jessica Peuser6, Cornelius Kortsik6, Ursula Nestle7, Sebastian Wiesemann8, Hubert Wirtz9, Thomas Wehler10, Robert Bals10, Maria Blettner4, Susanne Singer11. 1. University Medical Center, Johannes Gutenberg University, Mainz, Germany; German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany. Electronic address: marlene.hechtner@uni-mainz.de. 2. University Medical Center, Johannes Gutenberg University, Mainz, Germany; German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, Germany; University Hospital Carl Gustav Carus Dresden, Germany. 3. University Medical Center, Johannes Gutenberg University, Mainz, Germany; Saarland University Medical Center, Homburg, Germany. 4. University Medical Center, Johannes Gutenberg University, Mainz, Germany. 5. University Hospital Frankfurt, Goethe University, Frankfurt, Germany. 6. Katholisches Klinikum Mainz, Mainz, Germany. 7. University Medical Center Freiburg, Albert-Ludwig-University, Freiburg Germany; Maria Hilf Hospital Moenchengladbach, Moenchengladbach, Germany. 8. University Medical Center Freiburg, Albert-Ludwig-University, Freiburg Germany. 9. Leipzig University Hospital, Leipzig University, Leipzig, Germany. 10. Saarland University Medical Center, Homburg, Germany. 11. University Medical Center, Johannes Gutenberg University, Mainz, Germany; University Cancer Center Mainz, Mainz, Germany.
Abstract
INTRODUCTION: The objective was to assess quality of life (QoL) in lung cancer survivors, compare it to the general population, and identify factors associated with global QoL, physical functioning, emotional functioning, fatigue, pain, and dyspnea. METHODS: Data from NSCLC patients who had survived 1 year or longer after diagnosis were collected cross-sectionally in a multicenter study. QoL was assessed with the European Organisation for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and the lung cancer module QLQ-LC13 across different clinical subgroups and compared to age- and sex-standardized general population reference values. Multivariable linear regression analyses were performed to test the associations of patient-, tumor-, and treatment-related factors with the six primary QoL scales. RESULTS: Six hundred fifty-seven NSCLC patients participated in the study with a median time since diagnosis of 3.7 years (range, 1.0-21.2 years). Compared to the age- and sex-standardized general population, clinically meaningful differences in the QoL detriment were found on almost all domains: lung cancer survivors had clinically relevant poorer global QoL (10 points, p < 0.001). Whereas in 12 months or longer treatment-free patients this detriment was small (8.3), it was higher in patients currently in treatment (16.0). Regarding functioning and symptom scales, respective detriments were largest for dyspnea (41 points), role function (33 points), fatigue (27 points), social function (27 points), physical function (24 points), and insomnia (21 points) observed across all subgroups. The main factor associated with poorer QoL in all primary QoL scales was mental distress (β |19-31|, all p < 0.001). Detriments in QoL across multiple primary QoL scales were also observed with current treatment (β |8-12|, p < 0.01), respiratory comorbidity (β |4-5|, p < 0.01), and living on a disability pension (β |10-11|, p < 0.01). The main factor associated with better QoL in almost all primary QoL scales was higher physical activity (β |10-20|, p < 0.001). Better QoL was also observed in patients with high income (β |10-14|, p < 0.01). CONCLUSIONS: Lung cancer survivors experience both functional restrictions and symptoms that persist long term after active treatment ends. This substantiates the importance of providing long-term supportive care.
INTRODUCTION: The objective was to assess quality of life (QoL) in lung cancer survivors, compare it to the general population, and identify factors associated with global QoL, physical functioning, emotional functioning, fatigue, pain, and dyspnea. METHODS: Data from NSCLCpatients who had survived 1 year or longer after diagnosis were collected cross-sectionally in a multicenter study. QoL was assessed with the European Organisation for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and the lung cancer module QLQ-LC13 across different clinical subgroups and compared to age- and sex-standardized general population reference values. Multivariable linear regression analyses were performed to test the associations of patient-, tumor-, and treatment-related factors with the six primary QoL scales. RESULTS: Six hundred fifty-seven NSCLCpatients participated in the study with a median time since diagnosis of 3.7 years (range, 1.0-21.2 years). Compared to the age- and sex-standardized general population, clinically meaningful differences in the QoL detriment were found on almost all domains: lung cancer survivors had clinically relevant poorer global QoL (10 points, p < 0.001). Whereas in 12 months or longer treatment-free patients this detriment was small (8.3), it was higher in patients currently in treatment (16.0). Regarding functioning and symptom scales, respective detriments were largest for dyspnea (41 points), role function (33 points), fatigue (27 points), social function (27 points), physical function (24 points), and insomnia (21 points) observed across all subgroups. The main factor associated with poorer QoL in all primary QoL scales was mental distress (β |19-31|, all p < 0.001). Detriments in QoL across multiple primary QoL scales were also observed with current treatment (β |8-12|, p < 0.01), respiratory comorbidity (β |4-5|, p < 0.01), and living on a disability pension (β |10-11|, p < 0.01). The main factor associated with better QoL in almost all primary QoL scales was higher physical activity (β |10-20|, p < 0.001). Better QoL was also observed in patients with high income (β |10-14|, p < 0.01). CONCLUSIONS:Lung cancer survivors experience both functional restrictions and symptoms that persist long term after active treatment ends. This substantiates the importance of providing long-term supportive care.
Authors: Martin Eichler; Marlene Hechtner; Beatrice Wehler; Roland Buhl; Jan Stratmann; Martin Sebastian; Heinz Schmidberger; Cornelius Kortsik; Ursula Nestle; Hubert Wirtz; Thomas Wehler; Maria Blettner; Susanne Singer Journal: Strahlenther Onkol Date: 2019-07-10 Impact factor: 3.621
Authors: Duc M Ha; Allan V Prochazka; David B Bekelman; Jennifer E Stevens-Lapsley; Edward D Chan; Robert L Keith Journal: JNCI Cancer Spectr Date: 2021-01-23
Authors: Nicola Riccetti; Maria Blettner; Katherine Taylor; Beatrice Wehler; Bernhard Gohrbandt; Ursula Nestle; Robert Bals; Marcus Stockinger; Thomas Wehler; Susanne Singer; Martin Eichler Journal: J Cancer Res Clin Oncol Date: 2022-05-24 Impact factor: 4.322