Quality of life predicts survival in patients with non-small cell lung cancer
1 Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan
2 Department of Healthcare Administration, College of Health Science, Asia University, Taichung, Taiwan
3 Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
4 School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
5 Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
6 Graduate Institute of Health Care Administration, College of Public Health, China Medical University, Taichung, Taiwan
7 Cancer Center, China Medical University Hospital, Taichung, Taiwan
8 Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
9 Bristol-Myers Squibb (Taiwan) Ltd, Global Development & Medical Affair, Taipei, Taiwan
10 Department of Psychiatry, Medical College, National Cheng-Kung University, Tainan, Taiwan
11 Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
BMC Public Health 2012, 12:790 doi:10.1186/1471-2458-12-790Published: 15 September 2012
Patients with non-small cell lung cancer (NSCLC) have a poor prognosis. The objective of this study was to examine the relationship of EORTC QLQ-C30 and QLQ-LC13 and survival in patients with NSCLC undergoing different treatments.
Investigators conducted a health-related quality of life (HRQOL) survey of 488 patients with NSCLC: 162 patients undergoing surgery, 312 patients without surgery, and their survival status was prospectively followed up. EORTC QLQ-C30 and QLQ-LC13 scores and clinical variables at baseline were analyzed using Cox’s proportional hazard regression to identify factors that influenced survival.
Median survival of these 474 patients was 9.82 months. After adjustment, emotional functioning scale, and symptom scales of pain and nausea/vomiting are associated with survival in NSCLC patients with surgery whereas social functioning scale, and symptom scales for fatigue, appetite loss, and financial problems had a significant impact on survival in NSCLC patients without surgery. The results of multivariate analysis showed that none of QLQ-LC13 scales are significant predictors of survival. After simultaneously considering these scales, we found significant independent predictors of survival were nausea/vomiting (HR = 0.11, 95% CI = 0.02-0.63 for score >0 compared with =0) in NSCLC patients with surgery and appetite loss (HR = 1.77, 95% CI = 1.26-2.49 for score >0 compared with =0) in NSCLC patients without surgery.
HRQOL provides additional predictive information that supplements traditional clinical factors, and is a new prognostic indicator for survival of NSCLC patients under different treatments.