Closeness to death and quality of life in advanced lung cancer patients.
OBJECTIVE
It has been recommended that closeness to death is considered when designing and reporting quality-of-life (QoL) studies in patients with advanced cancer. The aim of this work was to assess whether this finding holds when adjusting for previous QoL.


METHODS
The study sample comprised 107 advanced non-small cell lung cancer patients randomised to the Big Lung Trial-QoL Study. Baseline and week 12 QoL data and patient characteristics were considered. Univariate and multivariate analysis of week 12 QoL considered baseline QoL scores, closeness to death, patient characteristics and treatment.


RESULTS
Univariate analyses showed significantly different week 12 QoL according to closeness to death for nine of 15 QoL domains. Multivariate analyses showed closeness to death to be independently predictive of only three QoL domains, with performance status and baseline QoL being more predominant.


CONCLUSIONS
In the present study, closeness to death was not found to be as important a factor in multivariate analysis as previously found. We recommend that previous QoL and performance status are considered in the design and analysis of QoL studies in which QoL is assessed at multiple time points in patients with advanced cancer, and that closeness to death may also be considered.
Brown
S
S
Clinical Trials Research Unit, University of Leeds, 17 Springfield Mount, Leeds LS2 9NG, UK. s.brown@leeds.ac.uk
Thorpe
H
H
Napp
V
V
Brown
J
J
D000203:Activities of Daily Living; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000523:psychology*; D003643:Death; D005260:Female; D006304:Health Status; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D013997:Time Factors