title: Monitoring changes in quality of life in patients with lung cancer by using specialised questionnaires: implications for clinical practice.
abstract: BACKGROUND
  Quality of life (QoL) in lung cancer patients is overlooked due to the severity of the disease. Changes in factors comprising QoL need further exploration to determine therapy targets.
  
  
  METHODS
  QoL was assessed in 282 patients referred to a specialised centre in Greece for chemotherapy using three reliable scales: Functional Assessment of Cancer Therapy-Lung (FACT-L, Greek version 4), Short Form (SF-36) Health Survey and Hospital Anxiety and Depression Scale (HAD)S.
  
  
  RESULTS
  Comparing QoL scores, it was observed that in comparison to the first chemotherapy, there was a statistically significant deterioration in patients' physical well-being (p < 0.0001) at the following chemotherapies. In contrast, there was a statistically significant improvement in patients' emotional well-being (p < 0.0001), mental health (p < 0.0001) and social functioning (p = 0.006) in the chemotherapies following the first. Observations deriving from survival analyses agree with literature findings: small cell lung cancer (SCLC) patients had significantly shorter survival than non-SLSC (NSCLC) patients, initial performance status was consistent with survival, radiotherapy improved survival, existence of metastases hindered survival, and the number of chemotherapies and QoL scores were positively correlated with survival.
  
  
  CONCLUSIONS
  Although patients' physical functioning deteriorated after chemotherapy, their psychological state, mental health and social functioning improved in comparison with their first chemotherapy. This may be due to the fear of the unknown and the stress patients experience before their treatment. Regarding survival analysis results, it could be stated that the better QoL scores, the longer the survival. The findings underline the importance of psychological support after diagnosis and during the initiation of treatment. This may result in a better QoL, hence leading to prolongation of survival.
authors.affiliation: Pulmonary Department-Oncology Unit, "G. Papanikolaou" Hospital, Aristotle University of Thessaloniki, Thessaloniki, 57010, Greece.
authors.forename: Hellie
authors.initials: H
authors.lastname: Lithoxopoulou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
authors.forename: Sevasti
authors.initials: S
authors.lastname: Bostantzopoulou
authors.forename: Ellada
authors.initials: E
authors.lastname: Eleftheriadou
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.forename: Haidong
authors.initials: H
authors.lastname: Huang
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Porpodis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kioumis
authors.forename: Theodora
authors.initials: T
authors.lastname: Tsiouda
authors.forename: Lonny
authors.initials: L
authors.lastname: Yarmus
authors.forename: Theodore
authors.initials: T
authors.lastname: Kontakiotis
mesh_terms: D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016019:Survival Analysis