Quality of life in poor prognosis patients with locally advanced non-small cell lung cancer (LA-NSCLC) undergoing a phase II study of concurrent cetuximab and definitive thoracic radiotherapy followed by docetaxel and cetuximab.

Abstract

e17559 Background: A single institution prospective clinical trial was conducted to examine the safety and efficacy of concurrent cetuximab and definitive thoracic radiotherapy followed by docetaxel plus cetuximab. Quality of life (QOL) was assessed as a secondary endpoint. Survival and toxicity data are presented separately. Methods: Eligible pts with unresectable stage IIA or IIIB LA-NSCLC, who also had ECOG PS 2 OR weight loss ≥5% in 3 months OR age >70, completed QOL measures at baseline, after concurrent cetuximab/radiotherapy (recovery), and after docetaxol/cetuximab (consolidation). Scores were calculated for Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Fatigue Symptom Inventory (FSI) worst fatigue, FSI fatigue interference, and Functional Assessment of Cancer Therapy – Lung Trial Outcome Index (FACT-L TOI). FACT-L TOI assessed physical (e.g., nausea) and functional (e.g., difficulty sleeping) well-being as well as lung cancer specific symptoms (e.g., shortness of breath, cough). Descriptive and t-test results are presented. Results: Pts (N = 27) were primarily male (67%) and non-Hispanic Caucasian (96%) with mean age of 73 years. High attrition between recovery (N = 22) and consolidation (N = 10) occurred. Compared to baseline, pts reported higher levels of worst fatigue (p < .03) and fatigue interference (p = .01) at recovery. There was a decline in IADLs (p = .01) but no significant difference in ADLs or FACT-L TOI. Further examination of FACT subscales revealed declines in physical (p < .0001) and functional (p = .02) well-being but improvement in lung cancer specific symptoms (p < .0001). A similar pattern is found for comparisons between baseline and consolidation (ps < .05). There were no significant differences between recovery and consolidation. Conclusions: Although pts experienced declines in QOL across most domains after concurrent cetuximab and radiotherapy, there was improvement in lung cancer specific symptoms. Pts were also able to maintain their ability to perform ADLs. High attrition after recovery is a notable limitation.