title: Symptom frequency and severity in patients with metastatic or locally recurrent lung cancer: a prospective study using the Lung Cancer Symptom Scale in a community hospital.
abstract: OBJECTIVE
  To define symptoms and therapeutic requirements for patients with metastatic or locally recurrent lung cancer.
  
  
  METHODS
  Data were collected from 69 consecutive patients with locally advanced lung cancer seen in consultation at a radiation oncology facility serving a community hospital in Virginia. The Lung Cancer Symptom Scale, a validated quality of life instrument, measured the incidence of symptoms in this group.
  
  
  RESULTS
  Average survival for the entire group was 7 months. Fifty-seven patients received 81 courses of radiation therapy, 33 directed at thoracic disease and 48 delivered to sites of metastasis. Thirty-three percent of those who received radiation therapy required treatment to more than one anatomic site. Every patient was symptomatic at the time of consultation, with the number (p = 0.001) and severity (p = 0.001) of symptoms they suffered worse in the patient group seen 0 to 3 months prior to death rather than 4 to 6 months prior to death. With the exception of cough, symptoms were marked in their severity.
  
  
  CONCLUSIONS
  Patients with advanced lung cancer suffer frequent and severe symptoms that worsen in the final months of life. The appropriate timing and combination of radiotherapy and chemotherapy are yet to be resolved. Future studies will require use of validated quality of life instruments to better catalogue palliation and treatment toxicity.
authors.affiliation: Department of Radiation Oncology, Methodist Healthcare System, Memphis, Tennessee, USA. DNSSL@worldnet.att.net
authors.forename: S
authors.initials: S
authors.lastname: Lutz
authors.forename: R
authors.initials: R
authors.lastname: Norrell
authors.forename: C
authors.initials: C
authors.lastname: Bertucio
authors.forename: L
authors.initials: L
authors.lastname: Kachnic
authors.forename: C
authors.initials: C
authors.lastname: Johnson
authors.forename: D
authors.initials: D
authors.lastname: Arthur
authors.forename: M
authors.initials: M
authors.lastname: Schwarz
authors.forename: G
authors.initials: G
authors.lastname: Palardy
mesh_terms: D000368:Aged; D000855:Anorexia / Q000145:classification* / Q000209:etiology* / Q000523:psychology; D001859:Bone Neoplasms / Q000150:complications* / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D001932:Brain Neoplasms / Q000150:complications* / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D002637:Chest Pain / Q000145:classification* / Q000209:etiology* / Q000523:psychology; D003131:Combined Modality Therapy; D003371:Cough / Q000145:classification* / Q000209:etiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000145:classification* / Q000209:etiology* / Q000523:psychology; D005221:Fatigue / Q000145:classification* / Q000209:etiology* / Q000523:psychology; D005260:Female; D006469:Hemoptysis / Q000145:classification* / Q000209:etiology* / Q000523:psychology; D006764:Hospitals, Community; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000150:complications*; D010166:Palliative Care / Q000379:methods; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014768:Virginia / Q000453:epidemiology