title: Symptom burden and quality of life in advanced non-small cell lung cancer patients in France and Germany.
abstract: BACKGROUND
  To assess patient reported symptom burden and impact on disease specific health related quality of life (HRQOL) in advanced non-small cell lung cancer (NSCLC) patients.
  
  
  METHODS
  Patients with advanced (stage IIIB/IV) NSCLC in France (n = 613) and Germany (n = 600) were recruited into a multicenter, patient record-based cross-sectional study. Patient reported symptoms using the Lung Cancer Symptom Scale, which assesses fatigue, loss of appetite, shortness of breath, cough, pain and blood in sputum on a 0-100 visual analog scale. Disease specific and generic HRQOL were assessed using the Functional Assessment of Cancer Therapy-Lung (FACT-L) and the EuroQol five-dimensional questionnaire (EQ-5D) respectively. A multivariate regression analysis was performed with total FACT-L score as the dependent variable and symptom scores as predictors. Age, gender, stage and performance status were used as control variables.
  
  
  RESULTS
  Majority of the patients were male (67%), Caucasian (93%) with an average age of 63 years. Fatigue, loss of appetite, shortness of breath, cough and pain were reported by ≥ 90% of patients. The mean health utility index score was found to be 0.58 and the mean general health status score was 58.0. Fatigue (β = -0.122; p < 0.001), loss of appetite (β = -0.170; p < 0.001), pain (β = -0.145; p < 0.001), shortness of breath (β = -0.118; p < 0.001) were found to be significant predictors of lung cancer specific quality of life as measured by the FACT-L total score.
  
  
  CONCLUSIONS
  Fatigue, loss of appetite, shortness of breath and pain have a significant negative impact on patient reported disease specific HRQOL in advanced NSCLC patients.
authors.affiliation: Pfizer Oncology, New York, NY 10017, USA. shrividya.iyer@pfizer.com
authors.forename: Shrividya
authors.initials: S
authors.lastname: Iyer
authors.forename: Gavin
authors.initials: G
authors.lastname: Taylor-Stokes
authors.forename: Adam
authors.initials: A
authors.lastname: Roughley
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D005858:Germany; D006305:Health Status Indicators; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: EQ-5D; FACT-L; LCSS; Lung cancer; Patient reported outcomes; Quality of life; Symptoms