Health Outcomes for Definite Concurrent Chemoradiation in Locally Advanced Non-Small Cell Lung Cancer: A Prospective Study

• Published in: Respiration Vol. 97; no. 4; pp. 310 - 318
• Main Authors: Nguyen, Pham Anh Hong, Vercauter, Piet, Verbeke, Luc, Beelen, Roel, Dooms, Christophe, Tournoy, Kurt G.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.04.2019
• Subjects: Care and treatment; Chemotherapy; Clinical Investigations; Methods; Non-small cell lung cancer; Patient outcomes; Radiotherapy; Belgium; Health-related quality of life; Value-based healthcare; Patient-reported outcomes; Concurrent chemoradiation; Lung cancer
• ISSN: 0025-7931; 1423-0356
• DOI: 10.1159/000493984

Background: In patients with locally advanced lung cancer treated with concurrent chemoradiation, outcome measurements have been mostly limited to survival. Objectives: We aimed to measure outcomes that matter to these patients beyond survival in a general clinical practice. Methods: In a prospective single-centre study, consecutive patients with locally advanced non-small cell lung cancer reported their own outcomes using the EORTC Quality of Life Questionnaire Core 30 at baseline, during therapy, at therapy stop and till 1 year after therapy end every 3 months. Survival, complications, quality of death and case-mix variables were measured. Results: There were 32 consecutive patients included prospectively from June 2013 until September 2016. Median overall survival was 24.3 months (95% CI 12.7–35.9). Severe toxicity (grade III–IV) was frequent (haematologic toxicity III–IV in 59%). Patient-reported outcomes (PROs) documented the burden on global health status and on functional domains (physical, role, social, emotional and cognitive functioning). Deterioration was pronounced during and after treatment with drops over 20 up to 40% points from baseline for physical, role and social functioning. Clinically meaningful negative effects did persist up to 6 and 9 months for physical and role functioning. Fifty-six percent of the deceased patients died in hospital. Conclusions: The assault on health-related quality of life during concurrent chemoradiation for locally advanced lung cancer is considerable. Loss of physical and role functioning persists up to 6 and 9 months after therapy end, respectively. Measuring PROs can help to identify issues for improvement of the value of care delivered.