High-dose radiotherapy or concurrent chemo-radiation in lung cancer patients only induces a temporary, reversible decline in QoL.
OBJECTIVE
Aggressive radiotherapy or concurrent chemo-radiation therapy for lung cancer leads to a high incidence of severe, mostly esophageal, toxicity. The purpose of this study was to investigate the evolution of quality of life (QoL) in patients with lung cancer, selected for curative radiotherapy (RT) or chemo-RT.


METHODS
Seventy-five lung cancer patients completed a longitudinal the EORTC QLQ-C30 and LC13. Linear mixed regression models were fitted to investigate the impact of different factors on overall QoL.


RESULTS
Overall QoL decreased shortly after the end of RT (4 points, p=0.19), but increased back to baseline within 3months. Mean scores of role functioning (p=0.018), cognitive functioning (p=0.002), dyspnoea (EORTC QLQ-LC13; p=0.043), dysphagia (p=0.005) and hoarseness (p=0.029), showed a significant worsening over time. Emotional functioning (p=0.033) improved significantly over time. Severe esophagitis (> or = grade 2) was reported in only 12% of the patients. Next to maximal esophageal toxicity > or = grade 2 (p=.0.010), also tumor stage IIIA (p<0.001), tumor stage IIIB (p=0.003), gender (p=0.042) and fatigue (p<0.001) appeared to be significant predictors of QoL.


CONCLUSIONS
High-dose radiotherapy or concurrent chemo-radiation in the treatment of lung cancer seems to be a well-tolerated treatment option with preservation of QoL.
Pijls-Johannesma
Madelon
M
Department of Radiation Oncology (MAASTRO Clinic), Maastricht, The Netherlands. madelon.pijls@maastro.nl
Houben
Ruud
R
Boersma
Liesbeth
L
Grutters
Janneke
J
Seghers
Katarina
K
Lambin
Philippe
P
Wanders
Rinus
R
De Ruysscher
Dirk
D
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011832:Radiation Injuries / Q000453:epidemiology*; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000532:radiotherapy*; D016896:Treatment Outcome
D000970:Antineoplastic Agents