title: Health-related quality of life and utility in patients with advanced non-small-cell lung cancer: a prospective cross-sectional patient survey in a real-world setting.
abstract: BACKGROUND
  Non-small-cell lung cancer (NSCLC) has a significant impact on patients' health-related quality of life (HRQOL). This study aimed to measure health state utility values representing the individual's preferences for specific health-related outcomes in advanced NSCLC patients and to assess predictive parameters.
  
  
  METHODS
  We conducted a prospective quality-of-life survey on advanced NSCLC patients in 25 hospitals in Europe, Canada, Australia, and Turkey. HRQOL was assessed using the EuroQol (EQ-5D) questionnaire and EQ-5D utility and EQ-visual analog (EQ-VAS) scores were estimated.
  
  
  RESULTS
  Three hundred nineteen patients were recruited of which 263 had evaluable data. Mean utility for progression-free (PF) patients on first-, second-, and third-/fourth-line treatment was 0.71 (SD = 0.24), 0.74 (SD = 0.18), and 0.62 (SD = 0.29), respectively. Mean utility for patients with progressive disease (PD) while on first-, second- and third-/fourth-line treatment was 0.67 (SD = 0.2), 0.59 (SD = 0.34), and 0.46 (SD = 0.38), respectively. Overall, patients with PD had lower mean utility scores than PF patients (0.58 versus 0.70). The results of the EQ-VAS showed that the score decreased with later treatment lines. Patients with PD had a 10-point decrease in VAS scores compared with PF patients (53.7 versus 66.6). The regression analysis revealed that stage IV disease, higher lines of treatment, and health state were significant predictors of utility at the 10% level.
  
  
  CONCLUSIONS
  The results presented indicate a substantial impact of lung cancer on patients' HRQOL, with stage IV disease, line of treatment, and PD, resulting in considerable deterioration of utility. The values obtained here will inform evaluations of cost-utility for NSCLC therapies.
authors.affiliation: Service de Pneumologie, Centre Hospitalier Intercommunal Créteil, Paris, France. christos.chouaid@chicreteil.fr
authors.forename: Christos
authors.initials: C
authors.lastname: Chouaid
authors.forename: Jason
authors.initials: J
authors.lastname: Agulnik
authors.forename: Erdem
authors.initials: E
authors.lastname: Goker
authors.forename: Gerarda J M
authors.initials: GJ
authors.lastname: Herder
authors.forename: Jason F
authors.initials: JF
authors.lastname: Lester
authors.forename: Johann
authors.initials: J
authors.lastname: Vansteenkiste
authors.forename: Henrik W
authors.initials: HW
authors.lastname: Finnern
authors.forename: Juliane
authors.initials: J
authors.lastname: Lungershausen
authors.forename: Jennifer
authors.initials: J
authors.lastname: Eriksson
authors.forename: Kun
authors.initials: K
authors.lastname: Kim
authors.forename: Paul L R
authors.initials: PL
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care; D064232:Visual Analog Scale