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High baseline QOL scores predict better overall survival for patients with non–small cell lung cancer

Patients with non–small cell lung cancer with high baseline quality of life scores had a greater likelihood of survival at 12 months, according to recent research published in JAMA Oncology.

“The [quality of life (QOL)] analysis of RTOG 0617 demonstrates that baseline QOL was significantly associated with survival on multivariate analysis. This analysis suggests that improved [radiation therapy] treatment techniques may enhance the therapeutic window for patients with lung cancer,” Benjamin Movsas, MD, from the department of radiation oncology at Henry Ford Hospital in Detroit, Michigan, and colleagues wrote. “[D]espite few differences in clinician-reported toxic effects between [radiation therapy] dose arms, the patient-reported outcomes demonstrated significantly worse QOL in the high-dose arm at 3 months, confirming the primary QOL hypothesis.”

Patients with non–small lung cell cancer were randomly assigned two cycles of consolidation chemotherapy (either 74 Gy or 60 Gy) after receiving weekly paclitaxel (45 mg/m²) and carboplatin. In addition, patients were randomly assigned 400 mg/m² of cetuximab on day 1 followed by weekly doses of 250 mg/m². Patients also underwent either 3-D conformal radiation therapy or intensity-modulated radiation therapy. Researchers used the Functional Assessment of Cancer Therapy (FACT) Trial Outcome Index, which measures patients’ QOL using Physical Well Being, Functional Well Being and a Lung Cancer Subscale (LCS).

Of 424 eligible patients, 313 completed the baseline QOL questionnaire. Seventy percent (n = 219) then completed the 3-month questionnaire and 57% (n = 137) completed the 12-month questionnaire, according to the abstract. At 3 months, 45% of patients in the 74-Gy dose group reported a clinically meaningful decline in their LCS score compared with 30% of patients in the 60-Gy group (P = .02). Twenty-one percent of patients who received intensity-modulated radiation therapy reported a clinically meaningful decline in LCS at 12 months compared with 46% of patients who underwent 3-D conformal radiation therapy. Further, FACT Trial Outcome Index scores at baseline were linked to a higher overall survival, according to a multivariate analysis. – by Jeff Craven

Disclosure: Movsas reports research support from Philips Inc. and Varian Inc. Please see the full study for a list of all other researchers’ financial disclosures.