EP1.01-36 Quality of Life in Advanced Lung Cancer Patients in a Dutch Population

Abstract

In advanced lung cancer chemotherapy is associated with a statistically significant improvement in overall survival (OS) compared to best-supportive care (BSC) alone, by improving survival with 9% at 12 months and median survival by 1.5 months. However, discussion remains whether adverse events of chemotherapy outweigh the relatively modest increase in survival. We aimed to investigate the quality of life (QoL) of patients with uncurable lung cancer treated with systemic therapy or best-supportive care (BSC) alone. The European Organisation for Research and Treatment of Cancer (EORTC) QOL questionnaire (QLQ-C30) and the EORTC QLQ-LC13 were used to assess patients reported outcome measures (PROMs) at baseline, 3, 6 and 12 months in 235 patients with stage IIIb and IV NSCLC or SCLC diagnosed and treated between 2013 and 2017 in 4 large teaching hospitals in the Netherlands. Comparison between systemic therapy and BSC alone were assessed by using change in SS14 score from inclusion to 12 months. The analysis method used for this correlated longitudinal data was linear mixed modelling. Out of 58 of 235 patients who received no systemic therapy, the vast majority did not receive any treatment because of patients refusal of treatment (58.6%), followed by poor performance status (20.7%), comorbidities (5.2%) and rapid deterioration (15.5%). Systemically treated patients had a significantly prolonged OS compared to BSC (median OS of 691 vs 219 days (p<0.0001)) and a higher number of patients in the best supportive care arm died during the observation period (62.1% vs 44.6%, p=0.02). Over time there was no significant time-treatment interaction in global health, functional or symptom scores between systemic therapy and BSC (p>0.05). Although, systemic therapy in advanced lung cancer patients led to significantly longer OS compared to best supportive care, the quality of life decreased in both groups non-differently over time.