Cancer treatment impact on cognitive functioning and quality of life in lung cancer survivors.

Abstract

9112 Background: Relatively little research has examined the impact of cancer treatment on cognitive functioning (CF) and quality of life (QOL) in lung cancer survivors. We conducted an eight-year longitudinal study of lung cancer (LC) patients (pts) to systematically evaluate how changes in CF may affect their QOL. Methods: Between 2005-2008, we followed 1,757 primary LC pts who responded to CF questions at least once within 8 years of diagnosis. Overall QOL measured by LCSS (Lung Cancer Symptom Scale) and LASA (Linear Analogue Self Assessment) were assessed among 1,604 of 1,757 (91%) who completed the questionnaire at one or both of two time periods: short-term (T1-within 3 years of diagnosis) and long-term follow-up (T2-beyond 5 years of diagnosis). Questions rated overall CF and problems in thinking clearly. The primary endpoint, the percentage of the 1600 pts reporting they had a problem with cognitive functioning was accurate to within 2.5% with 95% confidence. Chi-square tests of 800 pts each has 80% power to detect a 7% difference in rates with a 5% Type I error. Results: 28% of pts reported a problem thinking clearly at T1 and T2. Seven percent of pts at T1 had been told by a doctor they had cognitive dysfunction. At T2, this was 8%. Males were more likely to have CF concerns (8% vs. 5%, p=0.04). Pts with SCLC were more likely to report CF problems (13% vs. 6%, p=0.04). Stage I patients had a 5% problem rate; stages II, III, and IV rates were 7%, (p=0.01). Surgical pts were less likely to report having problems thinking clearly (24% vs. 31%, p=0.03). Mean QOL scores differed >10 points between T1 and T2 of patients reporting CF, indicating clinical significance (p<0.01). Conclusions: Patient-reported assessments verify that impaired CF is a prevalent and debilitating side effect of cancer and its treatment that affects patient QOL. Self-report assessments are crucial and are needed to identify the impact that lung cancer and its treatments have on QOL. Funding Source:NIH grants: CA 115857, CA 84354>, CA 80127 and CA 77118. No significant financial relationships to disclose.