title: Does change in health-related quality of life score predict survival? Analysis of EORTC 08975 lung cancer trial.
abstract: BACKGROUND
  Little is known about whether changes in health-related quality of life (HRQoL) scores from baseline during treatment also predict survival, which we aim to investigate in this study.
  
  
  METHODS
  We analysed data from 391 advanced non-small-cell lung cancer (NSCLC) patients enrolled in the EORTC 08975 study, which compared palliative chemotherapy regimens. HRQoL was assessed at baseline and after each chemotherapy cycle using the EORTC QLQ-C30 and QLQ-LC13. The prognostic significance of HRQoL scores at baseline and their changes over time was assessed with Cox regression, after adjusting for clinical and socio-demographic variables.
  
  
  RESULTS
  After controlling for covariates, every 10-point increase in baseline pain and dysphagia was associated with 11% and 12% increased risk of death with hazard ratios (HRs) of 1.11 and 1.12, respectively. Every 10-point improvement of physical function at baseline (HR=0.93) was associated with 7% lower risk of death. Every 10-point increase in pain (HR=1.08) was associated with 8% increased risk of death at cycle 1. Every 10-point increase in social function (HR=0.91) at cycle 2 was associated with 9% lower risk of death.
  
  
  CONCLUSIONS
  Our findings suggest that changes in HRQoL scores from baseline during treatment, as measured on subscales of the EORTC QLQ-C30 and QLQ-LC13, are significant prognostic factors for survival.
authors.affiliation: Quality of Life Department, European Organisation for Research and Treatment of Cancer, Avenue Mounier, 83 b11, 1200 Brussels, Belgium.
authors.forename: D E
authors.initials: DE
authors.lastname: Ediebah
authors.affiliation: Quality of Life Department, European Organisation for Research and Treatment of Cancer, Avenue Mounier, 83 b11, 1200 Brussels, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Coens
authors.affiliation: Quality of Life Department, European Organisation for Research and Treatment of Cancer, Avenue Mounier, 83 b11, 1200 Brussels, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Zikos
authors.affiliation: 1] Quality of Life Department, European Organisation for Research and Treatment of Cancer, Avenue Mounier, 83 b11, 1200 Brussels, Belgium [2] Department of Biostatistics, European Centre for Disease Prevention and Control, Surveillance and Response Support Unit, Tomtebodavägen 11a, 171 83 Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Quinten
authors.affiliation: Department of Radiation Oncology, The Princess Margaret Hospital and the University of Toronto, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
authors.forename: J
authors.initials: J
authors.lastname: Ringash
authors.affiliation: Department of Psychology, Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, New South Wales NSW 2006, Australia.
authors.forename: M T
authors.initials: MT
authors.lastname: King
authors.affiliation: Department of Ethics, University of Regensburg, Medical Ethics, Universitaetsstrasse 31, D-93040 Regensburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Schmucker von Koch
authors.affiliation: School of Population and Public Health, University of British Columbia, Room 162-2206 East Mall, Vancouver, British Columbia, Canada BC V6T 1Z3.
authors.forename: C
authors.initials: C
authors.lastname: Gotay
authors.affiliation: Department of Obstetrics and Gynecology, Medical University Graz, Auenbruggerplatz 14, AT 8036 Graz, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Greimel
authors.affiliation: Department of Child and Adolescent Psychiatry, University Magdeburg, Leipziger Str 44, 39120 Magdeburg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Flechtner
authors.affiliation: Psychosocial Department, Tumor Biology Center at the University of Freiburg, Breisacher Str. 117, 79106 Freiburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Weis
authors.affiliation: Department of Health Policy and Management, University of North Carolina at Chapel Hill, 1101-D McGavran-Greenberg Building Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: B B
authors.initials: BB
authors.lastname: Reeve
authors.affiliation: Department of Pulmonology, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
authors.forename: E F
authors.initials: EF
authors.lastname: Smit
authors.affiliation: Department of Neurology, VU University Medical Center/Medical Center Haaglanden 2501 CK, The Hague, The Netherlands.
authors.forename: M J B
authors.initials: MJ
authors.lastname: Taphoorn
authors.affiliation: Quality of Life Department, European Organisation for Research and Treatment of Cancer, Avenue Mounier, 83 b11, 1200 Brussels, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Bottomley
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000401:mortality* / Q000523:psychology; D002945:Cisplatin / Q000008:administration & dosage; D017326:Clinical Trials, Phase III as Topic / Q000706:statistics & numerical data; D003680:Deglutition Disorders / Q000453:epidemiology / Q000209:etiology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D007398:Interpersonal Relations; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000523:psychology; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D009325:Nausea / Q000453:epidemiology / Q000209:etiology; D017239:Paclitaxel / Q000008:administration & dosage; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D010166:Palliative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012306:Risk; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D017239:Paclitaxel; D002945:Cisplatin; D000093542:Gemcitabine
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