scholarly journals Assessment of Financial Toxicity Among Patients With Advanced Lung Cancer in Western China

2022 ◽  
Vol 9 ◽  
Author(s):  
Tianqi Xu ◽  
Leidi Xu ◽  
Hangtian Xi ◽  
Yong Zhang ◽  
Ying Zhou ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Sick Leave ◽  
Univariate Analysis ◽  
Well Being ◽  
Western China ◽  
Psychological Status ◽  
Advanced Lung Cancer ◽  
Financial Toxicity ◽  
Younger Age ◽  
Life Years

Background: Lung cancer is the leading source of cancer-caused disability-adjusted life years. Medical cost burden impacts the well-being of patients through reducing income, cutting daily expenses, curtailing leisure activities, and depleting exhausting savings. The COmprehensive Score for Financial Toxicity (COST) was created and validated by De Souza and colleagues. Our study intends to measure the financial burdens of cancer therapy and investigate the link between financial toxicity and health-related quality of life (HRQoL) in an advanced lung cancer population.Methods: Patients aged ≥ 18 years with confirmed stage III to IV lung cancer were eligible. The COST questionnaire verified by de Souza et al. was used to identify financial toxicity. Multivariable linear regression analysis with log transformation univariate analysis and Pearson correlations were used to perform the analysis.Results: The majority of the patients (90.8%, n = 138/152) had an annual income of $50,000 ($7,775). The cohort's insurance situation was as follows: 64.5% of the cohort had social insurance, 20.4% had commercial insurance, and 22.0% had both. Patients who were younger age (50–59, P < 0.001), employed but on sick leave, and had lower income reported increased levels of financial toxicity (P < 0.05). The risk factors for high financial toxicity: (i) younger age (50–59), (ii) <1 month of savings, and (iii) being employed but on sick leave. Increased financial toxicity is moderately correlated with a decrease in QoL.Conclusion: Poorer psychological status and specific demographics are linked to increased financial toxicity (lower COST). Financial toxicity has a modest relationship with HRQoL and may have a clear link with HRQoL measurements.

scholarly journals Assessment of Financial Toxicity Among Advanced Lung Cancer Patients in Western China

2021 ◽  
Author(s):  
Tianqi Xu ◽  
Ying Zhou ◽  
Wenhui Yang ◽  
Hangtian Xi ◽  
Liangliang Xing ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Sick Leave ◽  
Univariate Analysis ◽  
Well Being ◽  
Western China ◽  
Psychological Status ◽  
Advanced Lung Cancer ◽  
Financial Toxicity ◽  
Younger Age ◽  
Life Years

Abstract Background: Lung cancer is the primary reason of cancer-caused disability adjusted life years. Medical cost burden impacts patient’s well-being through decreasing income, cutting daily expenses, leisure activities and exhausting savings. De Souza and colleagues developed and validated the COmprehensive Score for Financial Toxicity (COST). Our study aims to quantify the financial burdens of cancer therapy, to explore the relationship between financial toxicity and HRQoL in advanced lung cancer population.Methods: Patients aged ≥ 18 years with confirmed stage III to IV lung cancer were eligible. The COST questionnaire verified by de Souza et al. was used to identify financial toxicity. Multivariable linear regression analysis with log transformation univariate analysis and Pearson correlations were used to performed the analysis.Results: Most of the patients had an income of < ¥50,000 ($7,775) annually (90.8%, n = 138/152). The insurance condition of the cohort was that the majority of the cohort had social insurance (64.5%), 20.4% of them had commercial insurance, 22.0% of them had both. Patients who were younger age (50 ~ 59, P < 0.001), employed but on sick leave, and lower income reported increased levels of financial toxicity (P < 0.05). The risk factors for high financial toxicity: (i) younger age (50 ~ 59), (ii) <1 month of savings, and (iii) being employed but on sick leave. Increased financial toxicity is moderately correlated with a decrease in QoL.Conclusion: Increased financial toxicity(lower COST) is related to poorer psychological status and certain demographics. Financial toxicity is moderately correlated with a HRQoL, and it may have a demonstrable correlation with HRQoL measures.

scholarly journals Analysis of systemic inflammatory biomarkers in neuroendocrine carcinomas of the lung: prognostic and predictive significance of NLR, LDH, ALI, and LIPI score

2020 ◽  
Vol 12 ◽  
pp. 175883592094237
Author(s):  
Antonio Galvano ◽  
Marta Peri ◽  
Aurelia Ada Guarini ◽  
Marta Castiglia ◽  
Antonino Grassadonia ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Neuroendocrine Carcinoma ◽  
Group Performance ◽  
Univariate Analysis ◽  
Eastern Cooperative Oncology Group ◽  
Prognostic Index ◽  
Inflammatory Biomarkers ◽  
Advanced Lung Cancer ◽  
First Line ◽  
Line Chemotherapy

Background: Lung neuroendocrine carcinoma (NEC) is characterized by aggressive clinical behavior and lack of treatment advances. We evaluate the prognostic and the predictive roles of systemic inflammatory biomarkers in patient circulating blood: neutrophil–lymphocyte ratio (NLR), lactate dehydrogenase (LDH), advanced lung cancer inflammation index (ALI), and the Lung Immune Prognostic Index (LIPI) score. Methods: A total of 120 patients with small-cell lung cancer (SCLC) ( n = 110) and large cell neuroendocrine carcinoma (LCNEC) ( n = 10) were enrolled. Overall survival (OS) was evaluated by Kaplan–Meier estimator and univariate and multivariate Cox proportional hazard analyses were performed to determine prognostic factors associated with OS while χ2 test was used for categorical data. Results: NLR cutoff value was 1.93. NLR was measured before and after first-line chemotherapy; 25 (21%) patients had higher NLR (delta NLR >1), whereas NLR was lower in 37 (31%). At the univariate analysis, median OS was 12 months: OS for SCLC and LCNEC were 11 months and 14 months, respectively. OS had a prognostic positive value in patients with pre-treatment NLR <1.93 ( p = 0.0002), LDH <600 U/L ( p = 0,03) and ALI ⩾34 ( p = 0,0065). At the multivariate analysis, Eastern Cooperative Oncology Group performance status, LDH levels and response after first-line chemotherapy were independently associated with OS. Median OS for good, intermediate, and poor LIPI was 15 months, 11 months, and 9 months, respectively( p = 0.091). Patients with higher NLR (>1.93) had an increased probability of tumor progression ( p = 0.045, χ2 test). Conclusion: This study demonstrated that systemic inflammatory biomarkers could facilitate the understanding of survival differences in the clinical management of lung NEC patients, underlying the need for prospective biomarker-driven studies in the immune checkpoint inhibitors setting.

Understanding the daily needs and challenges of caregivers of patients with lung cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24173-e24173
Author(s):  
Yanyan Zhu ◽  
Fatima Scipione ◽  
Renee Anderson ◽  
Robin Y. DiPaolo ◽  
Ros Miller ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Side Effects ◽  
Family Relationships ◽  
Group Discussion ◽  
Treatment Decision ◽  
Well Being ◽  
Advanced Lung Cancer ◽  
Emotional States ◽  
Eligibility Criteria ◽  
Role Shift

e24173 Background: Informal caregivers provide critical support in the management of all aspects of care for patients with cancer. Although caring for loved ones with cancer can be rewarding, it can also have a significant impact on caregivers’ quality of life. The aim of this study was to understand how caring for someone with advanced lung cancer affects caregivers’ lives. Methods: A targeted review of the caregiver literature (Medline, Embase, and Psych Info; year limits 2006-19) using a single search strategy, and qualitative focus group discussion among caregivers (N = 6) who have been or are currently caring for a loved one with advanced lung cancer was conducted. Results: The search identified 99 articles; however, few articles met eligibility criteria (N = 12). Impacts focused on: caring for patient, psycho-social well-being, ability to work, hopes for future, and physical well-being. Several gaps describing the caregiver experience remained based on the results from the literature review alone. Qualitative insights from caregivers included: (1) Caregivers must deal with all aspects of the patient’s experience, as well as the broader physical and emotional well-being of themselves and family members. (2) Disease-related symptoms and treatment-related side effects can result in physical and emotional distress for both caregivers and patients. (3) Caregivers feel hopeless, frustrated, and discouraged regarding side effects, particularly when they cannot perceive the benefits of treatment. (4) Caregivers are often compelled to mask or suppress their feelings to maintain a sense of (relative) normalcy. (5) Negative emotional states directly affect family relationships and dynamics, heightening stress and loneliness for caregivers. (6) Caregivers’ contributions to shared treatment decision-making relative to the patient’s role shift throughout the cancer journey based on their loved one’s ability to cope. Conclusions: These results provide valuable insights into the under-studied experience of caregivers of patients with lung cancer. Future quantitative research will improve understanding of the unique challenges associated with cancer caregiving, as well as facilitate development of personalized, evidence-based support programs and interventions for caregivers.

Advanced Lung Cancer Inflammation Index: Prognostic value in a retrospective lung cancer cohort.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21624-e21624
Author(s):  
Konstantinos N. Syrigos ◽  
Stavroula Patsilinakou ◽  
Dimitra Grapsa ◽  
Evangelia Chrysanthopoulou ◽  
Ioannis Gkiozos ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Value ◽  
Performance Status ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Disease Stage ◽  
Smoking History ◽  
Advanced Lung Cancer ◽  
Routine Practice ◽  
Cancer Inflammation

e21624 Background: As shown in recent studies, inflammation plays a key role in lung cancer (LC) pathogenesis and evolution, while the potential prognostic and predictive value of various inflammation markers in different disease stages is being extensively studied. We herein aimed to further evaluate the potential prognostic value of a new inflammation marker (ALI, Advanced Lung Cancer Inflammation Index = BMI x Alb / NLR), which combines previous markers of systematic inflammation with markers of nutrition or cachexia at the time of LC diagnosis. Methods: The medical records of 67 patients, diagnosed with LC in Sismanoglio Athens General hospital, within a two-year period (January 2016-January 2017) were retrospectively studied. Demographic, clinicopathological and laboratory features of patients, including pre-treatment ALI, were recorded and correlated with prognosis (overall survival, OS). Results: A total of 67 patients were included with a mean age of 60 (± 8) years. The majority of cases were men (39/67,58.2 %), with positive smoking history (62/67, 92.5%), performance status (PS) 1-2 (43/67, 64.2%) and disease stage IV (54/67, 80.6%). Adenocarcinoma was the commonest histological type observed (19/67, 28.5%). Values of ALI ranged from 7.8 to 37.2 (mean: 21±6). The cut-off point of ALI was 19 (based on ROC curve analysis) and patients were divided into two groups: those with ALI < 19 and those with ALI ≥ 19. In univariate analysis, PS and the presence of metastatic disease, as well as ALI values < 19, were all correlated with reduced survival (p = 0.002, p = 0.028 and p = 0.018, respectively). In multivariate analysis, PS was the only parameter that retained its statistically significant correlation with an adverse prognosis (p = 0.048), although its prognostic significance was increased when combined with ALI. Conclusions: Although failing to confirm an independent prognostic value for ALI, the results of our study suggest that combination of ALI with standard prognostic predictors such as PS may improve prediction of patients’ survival. Additional prospective studies are warranted to validate the prognostic significance of this promising biomarker and expand its use in routine practice.

High-quality basic care and support needed in lung cancer survivors.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 54-54
Author(s):  
Ping Yang ◽  
Roberto P. Benzo ◽  
Stephen D. Cassivi ◽  
Andrea L. Cheville ◽  
Matthew M. Clark ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Survivors ◽  
Well Being ◽  
Care Utilization ◽  
Basic Care ◽  
Care And Support ◽  
Life Years ◽  
Adult Cancer Survivors ◽  
Health Related ◽  
And Function

54 Background: After diagnosis and treatment, lung cancer survivors do not return to a health-related quality of life (QOL) and function comparable to pre-diagnosis levels as observed in other adult cancer survivors. We hypothesize that inadequate attention has been paid to addressing and improving QOL and function among lung cancer survivors. Our primary goal is to evaluate existing symptoms and QOL deficits among lung cancer survivors. Methods: We are evaluating patterns of QOL deficits (scored 5 or less on the scale from 0 [worst] to 10 [best]) in relation to time of lung cancer diagnosis, treatments, progression and/or recurrence, and health-related conditions. We are collecting and analyzing relevant health care utilization for selected QOL deficits, and identifying availability, accessibility, and effectiveness of evidence-based interventions. The expected outcomes will be new knowledge on patterns of QOL deficits, quality-adjusted life years in relation to the availability, accessibility, and adequacy of needed care and the effectiveness of interventions targeting improvement in QOL and symptoms. Results: In our initial analysis, among 3,707 lung cancer survivors who were diagnosed in 1999 to 2010, post-cancer treatment, and followed through 2011, 39% (1,442) reported deficits in overall QOL, 71% fatigue, 60% dyspnea, 41% being sedentary, 17% low spiritual well-being (SWB), and 10% currently smoking cigarettes. Among the 1,442 lung cancer survivors with a deficit in overall QOL, 97.5% reported severe fatigue or dyspnea, being sedentary or smoking, or having low SWB. In the remaining 36 of the 1,442, 24 had pain, cough, poor appetite, or other symptoms; only 12 (<1%) did not report deficit in any of the measured QOL domains. Analyses are ongoing. Conclusions: Based on evidence gained to date, we are developing and testing interventions targeting symptoms and QOL deficits. We expect to gain strong evidence for recommendations in redefining and delivering care and support that are necessary for improving the health and QOL of lung cancer survivors.

Venous thromboembolism among patients with advanced lung cancer randomized to prinomastat or placebo, plus chemotherapy

2003 ◽  
Vol 90 (10) ◽  
pp. 734-737 ◽  
Author(s):  
Rolando Ruiz ◽  
Carolyn Behrendt
Keyword(s):  
Lung Cancer ◽  
Multivariate Analysis ◽  
Venous Thromboembolism ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Performance Status ◽  
Univariate Analysis ◽  
Combined Treatment ◽  
Advanced Lung Cancer ◽  
Double Blind

SummaryTwo clinical trials have suggested that the combination of vascular endothelial growth factor inhibitor with chemotherapy is associated with venous thromboembolism (VTE). This retrospective cohort study investigates whether a similar association exists when matrix metalloproteinase inhibitor (prinomastat) is combined with chemotherapy.Patients (n=1,023) with stage IIIB, IV, or recurrent non-small cell lung cancer (NSCLC) were followed during 2 randomized, double-blind trials of prinomastat versus placebo orally bid, plus gemcitabine/cisplatin (GC) or paclitaxel/carboplatin (PC). VTE included deep venous thrombosis (DVT) or pulmonary embolism (PE) confirmed by imaging or autopsy. Risks identified in univariate analysis (incidence densities compared by t test) were confirmed in multivariate analysis (proportional hazards model).During 7,500.3 patient-months, 58 VTE (31 PE, 27 isolated DVT) were confirmed in 54 patients. On univariate analysis, VTE was associated with central venous catheter placed within 3 months,15 mg prinomastat plus GC, and to a lesser extent, 15 mg prinomastat plus PC, baseline performance status, and histologic type. VTE incidence was not increased by 15 mg prinomastat alone (post-discontinuation of chemotherapy), by chemotherapy plus placebo, or by 5 or 10 mg prinomastat plus chemotherapy. On multivariate analysis, VTE hazards (95% confidence interval) were 5.69 (2.61, 12.40) with recently placed central catheter, 2.78 (1.42, 5.43) with 15 mg prinomastat plus GC, and 2.06 (0.98, 4.31) with 15 mg prinomastat plus PC; performance status and histology were nonsignificant.We can conclude that combined treatment with 15 mg prinomastat plus chemotherapy approximately doubles the hazard of VTE among patients with advanced NSCLC.Research support: Pfizer Inc

scholarly journals Short-Term Changes in Quality of Life in Patients with Advanced Lung Cancer during In-Hospital Exercise Training and Chemotherapy Treatment: A Randomized Controlled Trial

2021 ◽  
Vol 10 (8) ◽  
pp. 1761
Author(s):  
Anna Rutkowska ◽  
Sebastian Rutkowski ◽  
Adam Wrzeciono ◽  
Oliver Czech ◽  
Jan Szczegielniak ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Exercise Training ◽  
Short Form ◽  
Well Being ◽  
Advanced Lung Cancer ◽  
Control Group ◽  
Sf 36 ◽  
The Impact

The aim of this study was to assess the impact of exercise training on the quality of life (QoL) of patients diagnosed with stage IIIB and stage IV non–small cell lung cancer (NSCLC) compared to a passive control group (CG). The exercise-trained group (ETG) consisted of 18 patients, and the CG consisted of 8 patients. The training program in the ETG consisted of two 2-week running cycles interspersed with consecutive rounds of chemotherapy with cytostatic drugs. A comparison of the changes in the Short Form (36) Health Survey (SF-36), St. George’s Respiratory Questionnaire (SGRQ), and the Functional Assessment of Cancer Therapy-Lung (FACT-L) was the primary outcome. Analysis of the results of the SGRQ and the SF-36 questionnaire did not reveal any statistically significant differences in the assessment of QoL between the examined groups. The analysis of FACT-L questionnaires showed statistically significant changes, indicating deterioration of QoL in domains describing physical well-being in the CG. Therefore, the analysis of the results of the QoL assessment did not show any significant improvements in the group of patients undergoing comprehensive exercise training, although deterioration of QoL was noted in the CG.

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