title: Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancers?
abstract: To examine whether weight loss at presentation influences outcome in patients who received chemotherapy for lung cancer or mesothelioma. Multivariate analysis of prospectively collected data 1994-2001. Data were available for age, gender, performance status, histology, stage, response, toxicity, progression-free and overall survival. The outcomes of patients with or without weight loss treated with chemotherapy for small cell lung cancer (SCLC; n=290), stages III and IV non-small-cell lung cancer (NSCLC; n=418), or mesothelioma (n=72) were compared. Weight loss was reported by 59, 58 and 76% of patients with SCLC, NSCLC and mesothelioma, respectively. Patients with weight loss and NSCLC (P=0.003) or mesothelioma (P=0.05) more frequently failed to complete at least three cycles of chemotherapy. Anaemia as a toxicity occurred significantly more frequently in NSCLC patients with weight loss (P=0.0003). The incidence of other toxicities was not significantly affected by weight loss. NSCLC patients with weight loss had fewer symptomatic responses (P=0.001). Mesothelioma patients with weight loss had fewer symptomatic (P=0.03) and objective responses (P=0.05). Weight loss was an independent predictor of shorter overall survival for patients with SCLC (P=0.003, relative risk (RR)=1.5), NSCLC (P=0.009, RR=1.33) and mesothelioma (P=0.03, RR=1.92) and an independent predictor of progression-free survival in patients with SCLC (P=0.01, RR=1.43). In conclusion, weight loss as a symptom of lung cancer predicts for toxicity from treatment and shorter survival.
authors.affiliation: Lung Unit, Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Ross
authors.forename: S
authors.initials: S
authors.lastname: Ashley
authors.forename: A
authors.initials: A
authors.lastname: Norton
authors.forename: K
authors.initials: K
authors.lastname: Priest
authors.forename: J S
authors.initials: JS
authors.lastname: Waters
authors.forename: T
authors.initials: T
authors.lastname: Eisen
authors.forename: I E
authors.initials: IE
authors.lastname: Smith
authors.forename: M E R
authors.initials: ME
authors.lastname: O'Brien
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology*; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000473:pathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D015431:Weight Loss