Symptom burden and quality of life in advanced non-small cell lung cancer patients in France and Germany

Abstract

BackgroundTo assess patient reported symptom burden and impact on disease specific health related quality of life (HRQOL) in advanced non-small cell lung cancer (NSCLC) patients. MethodsPatients with advanced (stage IIIB/IV) NSCLC in France (n=613) and Germany (n=600) were recruited into a multicenter, patient record-based cross-sectional study. Patient reported symptoms using the Lung Cancer Symptom Scale, which assesses fatigue, loss of appetite, shortness of breath, cough, pain and blood in sputum on a 0–100 visual analog scale. Disease specific and generic HRQOL were assessed using the Functional Assessment of Cancer Therapy-Lung (FACT-L) and the EuroQol five-dimensional questionnaire (EQ-5D) respectively. A multivariate regression analysis was performed with total FACT-L score as the dependent variable and symptom scores as predictors. Age, gender, stage and performance status were used as control variables. ResultsMajority of the patients were male (67%), Caucasian (93%) with an average age of 63 years. Fatigue, loss of appetite, shortness of breath, cough and pain were reported by ≥90% of patients. The mean health utility index score was found to be 0.58 and the mean general health status score was 58.0. Fatigue (β=−0.122; p<0.001), loss of appetite (β=−0.170; p<0.001), pain (β=−0.145; p<0.001), shortness of breath (β=−0.118; p<0.001) were found to be significant predictors of lung cancer specific quality of life as measured by the FACT-L total score. ConclusionFatigue, loss of appetite, shortness of breath and pain have a significant negative impact on patient reported disease specific HRQOL in advanced NSCLC patients.