Prognostic Value of Functional Assessment of Cancer Therapy-General (FACT-G) in Advanced Non-Small-Cell Lung Cancer Treated with Korean Medicine.

Hyeonjin Jeon,Sehyun Kim,Bumsang Shim,Wankyu Eo,Sookyung Lee

doi:10.1155/2020/2845401

Abstract

Objectives The impact of health-related quality of life (HRQoL) on survival has been investigated in patients with various cancers. Here, we evaluated the prognostic value of HRQoL using the Functional Assessment of Cancer Therapy-General (FACT-G) in advanced non-small-cell lung cancer (NSCLC) patients treated with Korean medicine. Methods A retrospective review of medical records and FACT-G scores of patients with advanced NSCLC who received treatment with Korean medicine was conducted. The reliability of the FACT-G was determined using Cronbach's alpha and calculating floor-and-ceiling effects. Correlations between FACT-G scores were estimated using Pearson's correlation analysis. Overall survival was calculated using the Kaplan–Meier method, and the prognostic impact of FACT-G scores and patients' characteristics was evaluated with Cox proportional hazards regression. Results Of the 165 enrolled patients, 115 (70%) had extrathoracic metastasis and 139 (84%) had undergone prior anticancer treatment. The median overall survival was 10.1 months. The mean FACT-G score was 65.0, and Cronbach's alpha for the FACT-G was 0.917. Age ≥65 years, male sex, smoking history, squamous-cell carcinoma, Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≥2, and presence of extrathoracic metastasis were associated with an increased risk of mortality. High FACT-G total scores, physical well-being (PWB), emotional well-being, and functional well-being were associated with prolonged survival. After adjusting for age, sex, smoking history, ECOG-PS, histological type, and presence of extrathoracic metastasis, a high FACT-G total score (hazard ratio (HR): 0.99, p=0.032) and high PWB score (HR: 0.94, p < 0.001) were associated with prolonged survival as independent prognostic factors in patients with advanced NSCLC. Conclusion The FACT-G total score and PWB score as HRQoL measurements were significant prognostic factors for survival in advanced NSCLC patients treated with Korean medicine. This finding implies that the FACT-G can be used in clinical practice as a predictor of survival in patients with advanced NSCLC.

Highlights

Lung cancer is the leading cause of cancer deaths worldwide, with an estimate of 1.76 million deaths in 2018 [1]
Erefore, this study aimed to investigate the prognostic value of the Functional Assessment of Cancer erapy-General (FACT-G) in the survival of advanced non-small-cell lung cancer (NSCLC) patients treated with Korean medicine (KM)
Based on the results of this study, the FACT-G total score and the physical well-being (PWB) score were independent prognostic factors for survival in patients with advanced NSCLC, which implies that high FACT-G total scores and high PWB scores were associated with prolonged survival and lower risk of mortality

Summary

Introduction

Lung cancer is the leading cause of cancer deaths worldwide, with an estimate of 1.76 million deaths in 2018 [1]. Due to the limited treatment options and relatively short survival, patients with advanced NSCLC should be treated effectively at every decision point. Health-related quality of life (HRQoL) in clinical practice is an important factor used to decide the optimal care for patients, considering benefits and risks of treatment modalities and anticancer therapies. HRQoL reflecting various aspects of the patient’s condition has gained importance as an endpoint to determine the effectiveness of anticancer therapy in clinical trials [5]. In the clinical practice of advanced NSCLC, an important issue is HRQoL management, which deteriorates as disease progresses. Erefore, HRQoL is commonly used as one of the main endpoints in clinical trials to evaluate the effectiveness of anticancer therapies for advanced NSCLC [14, 15] Physical discomfort may cause psychological stress that leads to limitations in social activities among these patients [10,11,12,13]. erefore, HRQoL is commonly used as one of the main endpoints in clinical trials to evaluate the effectiveness of anticancer therapies for advanced NSCLC [14, 15]

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