Quality of life and utility in patients with non-small cell lung cancer. Quality-of-life Study Group of the Master 2 Project in Pharmacoeconomics.
BACKGROUND
Although several studies have determined quality of life in patients with lung cancer, there is still little information about the use of generic questionnaires [e.g. the 36-item Short Form health survey (SF-36)] and utility questionnaires [e.g. the EuroQOL instrument (EQ-5D)] in this disease.


OBJECTIVE
To (i) measure quality of life and utility in patients with non-small cell lung cancer (NSCLC) using the SF-36 and the EuroQOL questionnaires; (ii) to evaluate the impact of some clinical variables on quality of life and utility; (iii) to assess the correlation between the measurements produced by the 2 questionnaires.


METHODS
Cross-sectional study.


METHODS
95 patients from 15 Italian hospitals with NSCLC (93% male, mean age 62 years) completed both questionnaires.


RESULTS
The mean scores for the 8 domains of the SF-36 ranged from 20.8 (physical role) to 63.0 (social functioning). The mean physical and mental summed scores of the SF-36 were 36.8 [standard deviation (SD) 9.8] and 43.0 (SD 11.5), respectively. The EuroQOL mean score was 0.58 (SD 0.32) in the self-classifier (SC) version and 0.58 (SD 0.20) in the visual analogue scale (VAS) version. Among the clinical variables that affected quality of life and utility, the presence of metastasis had the greatest impact: patients with metastasis had statistically significantly lower scores for 2 domains of the SF-36 (physical functioning, p = 0.009; bodily pain, p = 0.016), for the physical component summed score of the SF-36 (p = 0.015) and for both utility estimates (EuroQOL-SC, p = 0.027; EuroQOL-VAS, p = 0.038) than patients without metastasis. Both the SC and VAS EuroQOL scores showed a statistically significant correlation with each of the 8 domains of the SF-36. The scores for both the SF-36 and the EuroQOL in patients with NSCLC were considerably worse (relative differences ranging from -8 to -73%) than the corresponding values (normative data) previously reported for healthy individuals.


CONCLUSIONS
Our study quantified the degree to which quality of life is impaired in patients with NSCLC, showed that the presence of metastasis had an important role, and indicated a strong correlation between the measurements produced by the 2 questionnaires. The EuroQOL measurements obtained from these patients will aid evaluation of the cost-utility ratio for NSCLC therapies.
Trippoli
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Laboratorio SIFO di Farmacoeconomia e Instituto di Economia Sanitaria, Azienda Ospedallera Careggi, Firenze, Italy.
Vaiani
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M
Lucioni
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C
Messori
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A
D000368:Aged; D001294:Attitude to Health; D002289:Carcinoma, Non-Small-Cell Lung / Q000523:psychology* / Q000628:therapy; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007558:Italy; D008175:Lung Neoplasms / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010147:Pain Measurement; D011788:Quality of Life; D011795:Surveys and Questionnaires