Effect of chemotherapy for advanced non-small cell lung cancer on patients' quality of life. A randomized controlled trial.
BACKGROUND
Patients with advanced non-small cell lung cancer (NSCLC) do not have curative treatment options; therefore, treatments should prolong survival and improve quality of life (QoL). We compared the effect on QoL of two docetaxel-platinum regimens with vinorelbine-cisplatin.


METHODS
QoL was assessed by the Lung Cancer Symptom Scale (LCSS) and the general EuroQol five-dimensional questionnaire (EQ-5D) in 926 chemotherapy-naïve patients with stages IIIB to IV NSCLC. Patients were randomly assigned to receive: docetaxel 75 mg/m2 plus cisplatin 75 mg/m2, every 3 weeks (DC); docetaxel 75 mg/m2 and carboplatin 6 mg/ml min, every 3 weeks (DCb); or vinorelbine 25 mg/m2/week plus cisplatin 100 mg/m2, every 4 weeks (VC).


RESULTS
Overall, patients treated with either docetaxel-containing regimen had better QoL than VC-treated patients (LCSS global item "QoL today": P=0.064 for DC and P=0.016 for DCb versus VC; EQ-5D global item "health state today": P=0.016 for DC and P<0.001 for DCb versus VC). DC-treated patients experienced improved pain relief compared with VC (P=0.033), whereas pain relief with DCb and VC was similar. Patients treated with either docetaxel regimen had more favorable changes in performance status (P=0.065 for DC and P<0.001 for DCb versus VC) and mean weight loss (0.06 kg, gain of 0.08 kg, and 2.27 kg for DC, DCb, and VC, respectively; P<0.001 for both DC versus VC and DCb versus VC).


CONCLUSIONS
The TAX 326 study shows that docetaxel-platinum regimens relieve symptoms and improve QoL in patients with advanced NSCLC. DCb and DC were superior to VC in all QoL outcomes assessed except for the difference between DC and VC in LCSS "QoL today", which was not significant.
Belani
Chandra P
CP
University of Pittsburgh School of Medicine, Lung and Thoracic Malignancies Program, University of Pittsburgh Cancer Institute, Cancer Pavilion, Floor 5, 5150 Centre Avenue Pittsburgh, PA 15232, USA.
Pereira
Jose R
JR
von Pawel
Joachim
J
Pluzanska
Anna
A
Gorbounova
Vera
V
Kaukel
Eckhard
E
Mattson
Karin V
KV
Ramlau
Rodryg
R
Szczesna
Aleksandra
A
Fidias
Panos
P
Millward
Michael
M
Fossella
Frank
F
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control; D010349:Patient Compliance; D010984:Platinum / Q000008:administration & dosage; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000187:drug effects; D011788:Quality of Life; D018434:Sickness Impact Profile; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
D043823:Taxoids; D000077143:Docetaxel; D010984:Platinum; D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine