HRQoL changes predict survival in NSCLC

May 19 2014

By Lucy Piper, Senior medwireNews Reporter

Changes in health-related quality of life (HRQoL) during treatment may help predict survival in patients with advanced non-small-cell lung cancer (NSCLC), suggest findings from the EORTC 08975 study.

The findings indicate that these changes in HRQoL, as measured on subscales of the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and LC13, provide additional prognostic value to baseline HRQoL scores for predicting survival.

Lead researcher Divine Ediebah (EORTC, Brussels, Belgium) and colleagues analysed HRQoL data from 391 patients undergoing chemotherapy for stage IIIb or IV NSCLC.

All baseline HRQoL variables were predictive of survival, except emotional functioning on the QLQ-C30. In multivariate analyses, adjusting for sociodemographic and clinical variables, three baseline HRQoL variables remained significantly associated with survival, namely physical function, pain and dysphagia.

With every 10-point increase in baseline physical functioning score, the risk of death decreased by 7%, while it increased by 11% with every 10-point increase in baseline pain and by 12% with every 10-point increase in dysphagia.

Changes from baseline in these HRQoL variables also predicted survival, but only changes in pain score and social functioning remained significant in multivariate analysis. Every 10-point increase in pain score from baseline to cycle 1 of treatment was associated with an 8% increased risk of death, while every 10-point increase in social functioning score from baseline to cycle 2 was associated with a 9% lower risk of death.

“Our results have important implications for both clinical and research practices”, the researchers remark in the British Journal of Cancer.

They say that “baseline HRQoL, in addition to clinical variables, should be taken into consideration when planning treatment. Also, inclusion of baseline HRQoL as a stratification factor could increase trial efficiency, create more homogenous treatment groups and improve understanding of trial results.”

Ediebah and team recommend regular monitoring of HRQoL during treatment to identify patients who deteriorate, and suggest there is potential for interventions for pain, physical functioning, dysphagia and social functioning to improve survival outcomes.

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