Prognostic value of Quality of life (QoL) assessment among Tunisian lung cancer patients

##plugins.themes.academic_pro.article.main##

Baraa Ben Bdira
Imen Gargouri
Wafa Benzarti
Samia Belajouza
Asma Knaz
Ahmed Abdelghani
Abdelhamid Garrouche
Mohamed Benzarti
Abdelaziz Hayouni
Sana Aissa

Abstract

Aim: To investigate the prognostic value of quality of life (QoL) assessment among Tunisian lung cancer patients for survival.

Methods: A prospective cohort study was performed from January 2018 to June 2019. Performance status (PS), QoL questionnaire-core30 (QLQ-C30),
QoL questionnaire-Lung Cancer 13 (QLQ-LC13) and European QoL-5 dimensions-3level version questionnaire (EQ-5D-3L) were used to QoL
assessment. Patients were divided into 2 groups according to global QLQ-C30 score, a Clinically Significant Deficit (CSD) was considered if the score
was ≤50. Cox regression analysis and Stepwise regression analysis were performed to evaluate the prognostic significance of QoL. Overall survival (OS)
was calculated using the Kaplan-Meier method. Log-rank test was used to compare survival curves. p value cutoff for statistical significance was 0.05.

Results: One hundred patients were included. Median OS for patients with CSD in QoL was 365 days, compared with 467 days for those without
significant difference in QoL (Log-rank test, p=0.036). Similarly, Median progression free survival for patients with CSD in QoL was 122 days compared
with 326 days for those who did not report a significant difference in QoL (Log-rank test, p=0.05). Upon multivariable stepwise regression analysis, Global
QoL score (QLQ-C30) was a significant predictor of OS (coefficient estimate (CE)=0.336, p=0.005), along with stage IV (CE=-0.193, p=0.033) and tumor
progression (CE =-0.238, p=0.047).

Conclusion: QoL was a predictor of survival in our cohort of patients with lung cancer. This should recommend an active intervention for patients with a
significant deficit in QoL in Early Palliative Care.

##plugins.themes.academic_pro.article.details##

References

  1. Chabowski M, Polanski J, Jankowska-Polańska B, Rosińczuk J, Szymanska-Chabowska A. Quality of life of patients with lung cancer. OncoTargetsTher. 2016 Feb;1023.
  2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov;68(6):394–424.
  3. Torre LA, Siegel RL, Jemal A. Lung Cancer Statistics. In: Ahmad A, Gadgeel S, editors. Lung Cancer and Personalized Medicine Internet . Cham: Springer International Publishing; 2016 cited 2020 Mar 15 . p. 1–19. Available from: http://link.springer. com/10.1007/978-3-319-24223-1_1
  4. Bhattacharya P, Dessain SK, Evans TL. Palliative Care in Lung Cancer: When to Start. CurrOncol Rep. 2018 Nov;20(11):90.
  5. Stinchcombe TE, Socinski MA. Current Treatments for Advanced Stage Non-Small Cell Lung Cancer. Proc Am Thorac Soc. 2009 Apr 15;6(2):233–41.
  6. Tanvetyanon T. Quality-of-Care Indicators for Non-Small Cell Lung Cancer. Cancer Control. 2009 Oct;16(4):335–41.
  7. Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WEE, et al. The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer. J ThoracOncol. 2016 Jan;11(1):39–51.
  8. Damm K, Roeske N, Jacob C. Health-related quality of life questionnaires in lung cancer trials: a systematic literature review. Health Econ Rev. 2013 Dec;3(1):15.
  9. Osoba D. Health-related quality of life and cancer clinical trials. TherAdv Med Oncol. 2011 Mar;3(2):57–71.
  10. Montazeri A. Quality of life data as prognostic indicators of survival in cancer patients: an overview of the literature from 1982 to 2008. Health Qual Life Outcomes. 2009 Dec;7(1):102.
  11. Lemonnier I, Baumann C, Jolly D, Arveux P, Woronoff-Lemsi M-C, Velten M, et al. Solitary pulmonary nodules: consequences for patient quality of life. Qual Life Res. 2011 Feb;20(1):101–9.
  12. Khalladi R, Gargouri I, Zedini C, Saad HB. Qualité de vie des patients Tunisiens atteints de cancer du poumon: étude descriptive Quality of life of Tunisian patients withlung cancer: descriptive study. Tunis Med. 2019;97:13.
  13. Jacot W, Colinet B, Bertrand D, Lacombe S, Bozonnat M-C, Daurès J-P, et al. Quality of life and comorbidity score as prognostic determinants in non-small-cell lung cancer patients. Ann Oncol. 2008 Aug;19(8):1458–64.
  14. Pater JL, Loeb M. Nonanatomic prognostic factors in carcinoma of the lung: a multivariate analysis. Cancer. 1982 Jul 15;50(2):326-31.
  15. Efficace F, Bottomley A, Smit EF, Lianes P, Legrand C, Debruyne C, et al. Is a patient’s self-reported health-related quality of life a prognostic factor for survival in non-small-cell lung cancer patients? A multivariate analysis of prognostic factors of EORTC study 08975. Ann Oncol. 2006 Nov;17(11):1698–704.
  16. Sloan JA, Zhao X, Novotny PJ, Wampfler J, Garces Y, Clark MM, et al. Relationship Between Deficits in Overall Quality of Life and Non–Small-Cell Lung Cancer Survival. J ClinOncol. 2012 May 1;30(13):1498–504.
  17. Khalladi R, Gargouri I, Zedini C, Ben Saad H. Which factors influence the quality of life of Tunisian patients with lung cancer ? J Fac Med Or,2 (9) : 597-608.
  18. Fiteni F, Vernerey D, Bonnetain F, Vaylet F, Sennélart H, Trédaniel J, et al. Prognostic value of health-related quality of life for overall survival in elderly non-small-cell lung cancer patients. Eur J Cancer. 2016 Jan;52:120–8.
  19. Braun DP, Gupta D, Staren ED. Quality of life assessment as a predictor of survival in non-small cell lung cancer. BMC Cancer. 2011 Dec;11(1):353.
  20. Wood R, Taylor-Stokes G, Smith F, Chaib C. The humanistic burden of advanced non-small cell lung cancer (NSCLC) in Europe: a real-world survey linking patient clinical factors to patient and caregiver burden. Qual Life Res. 2019 Jul;28(7):1849–61.
  21. Khan I, Morris S, Pashayan N, Matata B, Bashir Z, Maguirre J. Comparing the mapping between EQ-5D-5L, EQ-5D-3L and the EORTC-QLQ-C30 in non-small cell lung cancer patients. Health Qual Life Outcomes. 2016 Dec;14(1):60.
  22. Carnio S, Di Stefano R, Novello S. Fatigue in lung cancer patients: symptom burden and management of challenges. Lung Cancer Targets Ther. 2016 May;73.
  23. Cramp F, Byron-Daniel J. Exercise for the management of cancerrelated fatigue in adults. Cochrane Pain, Palliative and Supportive Care Group, editor. Cochrane Database Syst Rev Internet . 2012 Nov 14 cited 2020 Mar 18 ; Available from: http://doi.wiley. com/10.1002/14651858.CD006145.pub3
  24. Jones LW. Precision Oncology Framework for Investigation of Exercise As Treatment for Cancer. J Clin Oncol. 2015 Dec10;33(35):4134–7.