Influence of clinical parameters on quality of life during chemotherapy in patients with advanced non-small cell lung cancer: application of a general linear model.
OBJECTIVE
The aim of this study was to determine the relative influence of physician-assessed clinical parameters, including non-hematological adverse events and performance status, on quality of life (QOL) during chemotherapy.


METHODS
QOL questionnaires consisting of four domains (functional, physical, mental and psychosocial) were self-administered every week during chemotherapy by patients with advanced non-small cell lung cancer in two phase III clinical trials; 377 patients who completed the questionnaires at baseline and at least once during the first course of therapy were analyzed. A general linear model was applied, where the four domains and the clinical parameters (nausea/vomiting, anorexia, diarrhea, fever, peripheral neuropathy and performance status) were used as the response and explanatory variables, respectively. In this model, the multi-dimensional and longitudinal aspects of QOL data were taken into account.


RESULTS
All four domains were significantly affected by the occurrence of nausea/vomiting, anorexia and diarrhea. No influence of peripheral neuropathy on the domains was detected. Performance status was significantly related to the domains (except the psychosocial domain).


CONCLUSIONS
This study revealed, by examination of multi-dimensional repeated QOL data, that clinical parameters had significant effects on QOL in patients undergoing chemotherapy. Our findings suggest that supportive care to control non-hematological adverse events, especially gastrointestinal, could maintain overall QOL in cancer patients in an earlier phase of chemotherapy.
Morita
Satoshi
S
Department of Epidemiological and Clinical Research Information Management, Kyoto University Graduate School of Medicine, Yoshidakonoe-cho, Sakyo-ku, Kyoto 606-8501, Japan. smorita@pbh.med.kyoto-u.ac.jp
Kobayashi
Kunihiko
K
Eguchi
Kenji
K
Matsumoto
Taketoshi
T
Shibuya
Masahiko
M
Yamaji
Yasufumi
Y
Sakamoto
Junichi
J
Ohashi
Yasuo
Y
D000368:Aged; D000855:Anorexia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000523:psychology*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003967:Diarrhea / Q000139:chemically induced; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D000077146:Irinotecan; D016014:Linear Models; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D011788:Quality of Life; D014751:Vindesine / Q000008:administration & dosage; D014840:Vomiting, Anticipatory / Q000209:etiology
D000077146:Irinotecan; D002945:Cisplatin; D014751:Vindesine; D002166:Camptothecin