Patient attitudes towards chemotherapy and survival: a prospective observational study in advanced non-small cell lung cancer.
This multicenter, non-interventional, prospective, observational study aimed to determine whether patients' attitude to chemotherapy is an independent prognostic factor for survival in patients with advanced non-small cell lung cancer (NSCLC) who are treated with gemcitabine-platinum. Chemonaive patients (n=1895) with stage IIIB or IV NSCLC not amenable to curative surgery or radiotherapy were treated with a combination of gemcitabine plus cisplatin/carboplatin and followed for a maximum of 18 months. Patients' attitude to treatment was measured on a 5-point scale and responses were used to assign patients to one of the three need categories: A, maximum extension of survival with the acceptance of high toxicity (60.0% of patients); B, maximum extension of survival only if coupled with normal lifestyle (26.1%); C, relief of symptoms (13.8%). Median survival varied significantly among the need categories (A=13.00 months, B=15.70 months, C=15.33 months; log-rank test P=0.0415). Patient attitude to treatment (need categories) was not a significant prognostic factor for survival after adjusting for known prognostic factors (P=0.0503). After adjusting for baseline differences, patients in this study had a significantly lower risk of death than patients in three randomized trials (hazard ratio 0.879; 95% confidence interval: 0.775, 0.998; P=0.0458). In conclusion, in this observational study, patient attitude to chemotherapy was not an independent prognostic factor of survival.
Chu
Da-Tong
DT
Cancer Institute & Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Kim
Sang-We
SW
Hsu
Hon-Ki
HK
Cok
Gürsel
G
Roubec
Jaromir
J
Patil
Shekhar
S
Damyanov
Danail
D
West
Teena
T
Hall
Belinda
B
Altug
Sedat
S
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001294:Attitude to Health; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000523:psychology*; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004358:Drug Therapy / Q000523:psychology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000523:psychology*; D008297:Male; D019370:Observation; D010984:Platinum / Q000627:therapeutic use; D011446:Prospective Studies; D000093542:Gemcitabine
D000970:Antineoplastic Agents; D003841:Deoxycytidine; D010984:Platinum; D000093542:Gemcitabine