Quality-Adjusted Time Without Symptoms or Toxicity Analysis of Adjuvant Chemotherapy in Non–Small-Cell Lung Cancer: An Analysis of the National Cancer Institute of Canada Clinical Trials Group JBR.10 Trial

Purpose National Cancer Institute of Canada Clinical Trials Group JBR.10 demonstrated that adjuvant vinorelbine and cisplatin after resection of stage IB-II non–small-cell lung cancer (NSCLC) improved relapse-free and overall survival. However, many patients either are not referred for chemotherapy or decline treatment. To aid in treatment decision making, quality-adjusted survival estimates of the JBR.10 trial were derived using a quality-adjusted time without symptoms or toxicity (Q-TWiST) analysis. Methods Survival curves for treatment (N = 242) and observation groups (N = 240) were partitioned into three health states: time with ≥ grade 2 (early or late) chemotherapy-related toxicity (TOX), time in relapse (REL), and time without toxicity or relapse (TWiST). Q-TWiST = uTOX × TOX + uTWiST × TWIST + uREL × REL, where weights uTOX, uTWIST, and uREL range from 0 to 1. Threshold utility analysis was performed to test the sensitivity of the results to changes in the weights. Weights were derived in an exploratory fashion using different methods. Methods included use of arbitrary values, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) quality-of-life data prospectively collected in JBR.10 (global assessment questions and symptom-based questions), and lastly weights European Quality of Life–Five Dimensions questionnaire collected from early-stage NSCLC (nontrial) patients after resection with discounting for toxicity and relapse. The α level was .05. Results Threshold utility analysis revealed that adjuvant chemotherapy was preferred for all possible weight values for relapse and toxicity (uREL, uTOX), although the result was not always statistically significant. The adjuvant chemotherapy group had better Q-TWiST in the range of 5 to 6 additional months, which was statistically significant using all methods. Conclusion Adjuvant chemotherapy in early-stage NSCLC improves quality-adjusted survival despite chemotherapy toxicity.

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O-58 Quality of life in a trial of adjuvant chemotherapy for early stage completely resected non-small cell lung cancer (NCIC CTG BR.10)

Lung Cancer ◽

10.1016/s0169-5002(03)91716-8 ◽

2003 ◽

Vol 41 ◽

pp. S20 ◽

Cited By ~ 5

Author(s):

Andrea Beziak ◽

Tim Winton ◽

Keyue Ding ◽

Barbara Graham ◽

Lesley Seymour ◽

...

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Adjuvant Chemotherapy ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung

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Quality-of-Life Outcomes for Adjuvant Chemotherapy in Early-Stage Non–Small-Cell Lung Cancer: Results From a Randomized Trial, JBR.10

Journal of Clinical Oncology ◽

10.1200/jco.2007.12.6094 ◽

2008 ◽

Vol 26 (31) ◽

pp. 5052-5059 ◽

Cited By ~ 39

Author(s):

Andrea Bezjak ◽

Christopher W. Lee ◽

Keyue Ding ◽

Michael Brundage ◽

Timothy Winton ◽

...

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Adjuvant Chemotherapy ◽

Small Cell Lung Cancer ◽

Randomized Trial ◽

Cell Lung Cancer ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung

Purpose Adjuvant chemotherapy for early stage non–small-cell lung cancer (NSCLC) is now the standard of care, but there is little information regarding its impact on quality of life (QOL). We report the QOL results of JBR.10, a North American, intergroup, randomized trial of adjuvant cisplatin and vinorelbine compared with observation in patients who have completely resected, stages IB to II NSCLC. Patients and Methods QOL was assessed with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 and a trial-specific checklist at baseline and at weeks 5 and 9 for those who received chemotherapy and at follow-up months 3, 6, 9, 12, 18, 24, 30 and 36. A 10-point change in QOL scores from baseline was considered clinically significant. Results Four hundred eighty-two patients were randomly assigned on JBR.10. A total of 173 patients (82% of the expected) in the observation arm and 186 (85% of expected) in the chemotherapy arm completed baseline QOL assessments. The two groups were comparable, with low global QOL scores and significant symptom burden, especially pain and fatigue, after thoracotomy. Changes in QOL during chemotherapy were relatively modest; fatigue, nausea, and vomiting worsened, but there was a reduction in pain and no change in global QOL. Patients in the observation arm showed considerable improvements in QOL by 3 months. QOL, except for symptoms of sensory neuropathy and hearing loss, in those treated with chemotherapy returned to baseline by 9 months. Conclusion The findings of this trial indicate that the negative effects of adjuvant chemotherapy on QOL appear to be temporary, and that improvements (with a return to baseline function) are likely in most patients.

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Prospective evaluation of anxiety, depression and quality of life in medically inoperable early stage non-small cell lung cancer patients treated with stereotactic ablative radiotherapy

Reports of Practical Oncology & Radiotherapy ◽

10.1016/j.rpor.2017.01.002 ◽

2017 ◽

Vol 22 (3) ◽

pp. 217-222 ◽

Cited By ~ 3

Author(s):

Jacek Rutkowski ◽

Magdalena Szymanik ◽

Maciej Blok ◽

Joanna Kozaka ◽

Renata Zaucha

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Early Stage ◽

Small Cell ◽

Stereotactic Ablative Radiotherapy ◽

Prospective Evaluation ◽

Small Cell Lung ◽

Lung Cancer Patients ◽

Anxiety Depression

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Sublobectomy versus lobectomy for postoperative cough-related quality of life and recovery in early-stage non-small cell lung cancer patients: a longitudinal study.

10.21203/rs.3.rs-1036556/v1 ◽

2021 ◽

Author(s):

Rongjia Lin ◽

Wen CHEN ◽

Leilei ZHU ◽

Xiaojie PAN

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Small Cell Lung Cancer ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung ◽

Vats Lobectomy ◽

Related Quality ◽

The Impact

Abstract Background To quantitatively evaluate postoperative cough regarding changes in health-related quality of life (HRQOL) and recovery trajectory with the Leicester Cough Questionnaire in Mandarin-Chinese (LCQ-MC) in patients undergoing video-assisted thoracic surgery (VATS) for early-stage non-small cell lung cancer (NSCLC). Methods Overall, 156 patients with NSCLC underwent either VATS lobectomy or VATS sublobectomy; LCQ-MC was used to report the impact of postoperative cough on HRQOL for 6 months after discharge. Recovery from postoperative cough was defined as LCQ-MC scores returning to preoperative levels. The sensitivity of LCQ-MC to changes in postoperative cough recovery over time was evaluated via its ability to distinguish between surgery types. Results The VATS sublobectomy group reported significantly higher mean LCQ-MC scores 1 month after discharge, but without no significant differences postoperatively at 3 and 6 months after discharge, and returned to preoperative physical (69 vs. 99 days), psychological (67 vs. 99 days), social (50 vs. 98 days) and total (69 vs. 99 days) scores faster than the VATS lobectomy group (all p <0.05). Conclusion The LCQ-MC can adequately assess the impact of postoperative cough on HRQOL. Routine monitoring of postoperative cough recovery through LCQ-MC scores could be added to enhanced recovery after surgery.

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