title: Quality of life after the initial treatments of non-small cell lung cancer: a persistent predictor for patients' survival.
abstract: BACKGROUND
  Health-related quality of life (HRQoL) before treatment may predict survival of patients with non-small-cell lung cancer (NSCLC). We investigated the predictive role of HRQoL after the initial treatments, on the survival of these patients.
  
  
  METHODS
  A prospective multi-center study conducted in northeastern France. The SF-36 and European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core-30 (QLQ C-30) were mailed to patients 3 months after the end of the diagnostic process. High scores for functioning dimensions on both questionnaires indicated better QoL, and low scores for symptom dimensions on the QLQ C-30 indicated few symptoms. Cox regression modeling was used to identify predictive factors of survival.
  
  
  RESULTS
  In total, 230 (63.5%) patients responded to the SF-36 and QLQ C-30. Before completing the questionnaires, almost 60% of patients had undergone some chemotherapy, about 10% underwent radio/chemotherapy or both and more than 30% underwent surgery or surgery plus chemo/radiotherapy. On SF-36, the highest mean score was for social functioning dimension (55.5 ± 28), and the lowest was for the physical role dimension (17.9 ± 32.2). On QLQ C-30, for the functioning dimensions, the highest mean score was for cognitive functioning (74.6 ± 25.9) and the lowest was for role functioning (47.2 ± 34.1). For symptom dimensions, the lowest score was for diarrhoea (11.5 ± 24.2) and the highest was for fatigue (59.7 ± 27.7). On multivariate analysis, high bodily pain, social functioning and general health scores (SF-36) were associated with a lower risk of death (hazard ratio 0.580; 95% confidence interval [0.400-0.840], p = 0.004; HR 0.652 [0.455-0.935], p < 0.02; HR 0.625 [0.437-0.895] respectively). Better general QoL on QLQ C-30 was related to lower risk of death (HR 0.689 [0.501-0.946], p = 0.02).
  
  
  CONCLUSIONS
  Adding to previous knowledge about factors that may influence patients QoL, this study shows a persisting relationship between better perceived health in HRQoL after the initial treatment of NSCLC and better survival.
authors.affiliation: INSERM, CIC-EC CIC1433, Nancy, France. i.lemonnier@chu-nancy.fr.
authors.forename: Irawati
authors.initials: I
authors.lastname: Lemonnier
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
authors.forename: Patrick
authors.initials: P
authors.lastname: Arveux
authors.forename: Christelle
authors.initials: C
authors.lastname: Clément-Duchêne
authors.forename: Michel
authors.initials: M
authors.lastname: Velten
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Woronoff-Lemsi
authors.forename: Damien
authors.initials: D
authors.lastname: Jolly
authors.forename: Cédric
authors.initials: C
authors.lastname: Baumann
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome