Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: a prognostic analysis of the multicenter Italian lung cancer in the elderly study.
OBJECTIVE
To study the prognostic value for overall survival of baseline assessment of functional status, comorbidity, and quality of life (QoL) in elderly patients with advanced non-small-cell lung cancer treated with chemotherapy.


METHODS
Data from 566 patients enrolled onto the phase III randomized Multicenter Italian Lung Cancer in the Elderly Study (MILES) study were analyzed. Functional status was measured as activities of daily living (ADL) and instrumental ADL (IADL). The presence of comorbidity was assessed with a checklist of 33 items; items 29 and 30 of the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire QLQ-C30 (EORTC QLQ-C30) were used to estimate QoL. ADL was dichotomized as none versus one or more dependency. For IADL and QoL, three categories were defined using first and third quartiles as cut points. Comorbidity was summarized using the Charlson scale. Analysis was performed by Cox model, and stratified by treatment arm.


RESULTS
Better values of baseline QoL (P = .0003) and IADL (P = .04) were significantly associated with better prognosis, whereas ADL (P = .44) and Charlson score (P = .66) had no prognostic value. Performance status 2 (P = .006) and a higher number of metastatic sites (P = .02) also predicted shorter overall survival.


CONCLUSIONS
Pretreatment global QoL and IADL scores, but not ADL and comorbidity, have significant prognostic value for survival of elderly patients with advanced non-small-cell lung cancer who were treated with chemotherapy. Using these scores in clinical practice might improve prognostic prediction for treatment planning.
Maione
Paolo
P
S Giuseppe Moscati Hospital, Avellino, Italy.
Perrone
Francesco
F
Gallo
Ciro
C
Manzione
Luigi
L
Piantedosi
FrancoVito
F
Barbera
Santi
S
Cigolari
Silvio
S
Rosetti
Francesco
F
Piazza
Elena
E
Robbiati
Sergio Federico
SF
Bertetto
Oscar
O
Novello
Silvia
S
Migliorino
Maria Rita
MR
Favaretto
Adolfo
A
Spatafora
Mario
M
Ferraù
Francesco
F
Frontini
Luciano
L
Bearz
Alessandra
A
Repetto
Lazzaro
L
Gridelli
Cesare
C
Barletta
Emiddio
E
Barzelloni
Maria Luisa
ML
Iaffaioli
Rosario Vincenzo
RV
De Maio
Ermelinda
E
Di Maio
Massimo
M
De Feo
Gianfranco
G
Sigoriello
Giuseppe
G
Chiodini
Paolo
P
Cioffi
Angela
A
Guardasole
Vincenzo
V
Angelini
Valentina
V
Rossi
Antonio
A
Bilancia
Domenico
D
Germano
Domenico
D
Lamberti
Alfredo
A
Pontillo
Vittorio
V
Brancaccio
Luigi
L
Renda
Francesco
F
Romano
Francesco
F
Esani
Gabriella
G
Gambaro
Anna
A
Vinante
Orazio
O
Azzarello
Giuseppe
G
Clerici
Maurizia
M
Bollina
Roberto
R
Belloni
Paolo
P
Sannicolò
Mirella
M
Ciuffreda
Libero
L
Parello
Giuseppe
G
Cabiddu
Mary
M
Sacco
Cosimo
C
Sibau
Angela
A
Porcile
Gianfranco
G
Castiglione
Federico
F
Ostellino
Oliviero
O
Monfardini
Silvio
S
Stefani
Micaela
M
Scagliotti
Giorgio
G
Selvaggi
Giovanni
G
De Marinis
Filippo
F
Martelli
Olga
O
Gasparini
Giampietro
G
Morabito
Alessandro
A
Gattuso
Domenico
D
Colucci
Giuseppe
G
Galetta
Domenico
D
Giotta
Francesco
F
Gebbia
Vittorio
V
Borsellino
Nicola
N
Testa
Antonio
A
Malaponte
Emilia
E
Capuano
Matteo A
MA
Angiolillo
Michele
M
Sollitto
Francesco
F
Tirelli
Umberto
U
Spazzapan
Simona
S
Adamo
Vincenzo
V
Altavilla
Giuseppe
G
Scimone
Antonio
A
Hopps
Maria Raffaella
MR
Tartamella
Francesco
F
Ianniello
Giovanni Pietro
GP
Tinessa
Vincenza
V
Failla
Giuseppe
G
Bordonaro
Roberto
R
Gebbia
Nicola
N
Valerio
Maria Rosaria
MR
D'Aprile
Modesto
M
Veltri
Enzo
E
Tonato
Maurizio
M
Darwish
Samir
S
Romito
Sante
S
Carrozza
Francesco
F
Barni
Sandro
S
Ardizzoia
Antonio
A
Corradini
Giuliana Mara
GM
Pavia
Gianfranco
G
Belli
Mario
M
Colantuoni
Giuseppe
G
Galligioni
Enzo
E
Caffo
Orazio
O
Labianca
Roberto
R
Quadri
Antonello
A
Cortesi
Enrico
E
D'Auria
Giuliana
G
Fava
Sergio
S
Calcagno
Anna
A
Luporini
Gino
G
Locatelli
M Cristina
MC
Di Costanzo
Francesco
F
Gasperoni
Silvia
S
Isa
Luciano
L
Candido
Paola
P
Gaion
Fernando
F
Palazzolo
Giovanni
G
Nettis
Giuseppe
G
Annamaria
Anselmo
A
Rinaldi
Massimo
M
Lopez
Massimo
M
Felletti
Raffaella
R
Di Negro
Giorgio Bernabò
GB
Rossi
Nestore
N
Calandriello
Antonio
A
Maiorino
Luigi
L
Mattioli
Rodolfo
R
Celano
Alfredo
A
Schiavon
Stefania
S
Illiano
Alfonso
A
Raucci
Carlo Alberto
CA
Caruso
Michele
M
Foa
Paolo
P
Tonini
Giuseppe
G
Curcio
Carlo
C
Cazzaniga
Marina
M
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D015897:Comorbidity; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006304:Health Status; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D011379:Prognosis; D011788:Quality of Life; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine; D000093542:Gemcitabine
D003841:Deoxycytidine; D014747:Vinblastine; D000077235:Vinorelbine; D000093542:Gemcitabine