title: Prognostic value of health-related quality of life for overall survival in elderly non-small-cell lung cancer patients.
abstract: BACKGROUND
  We investigated whether the health-related quality of life (HRQoL) score is a prognostic factor for overall survival (OS) in elderly patients with advanced non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  We included 451 NSCLC patients aged 70-89 years enrolled in the Intergroupe Francophone de Cancérologie Thoracique 0501 trial, using scores of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 at baseline to investigate the prognostic value of HRQoL for OS, in addition to conventional factors. Cox regression model was used for both univariate and multivariate analyses of OS.
  
  
  RESULTS
  Global health status (GH) dimension score at baseline was associated with favourable OS when adjusted for clinical, functional, and histological factors (hazard ratio [HR]: 0.986; 95% confidence interval [CI]: 0.980-0.992). We distinguished three groups according to GH score: high (GH <46), intermediate (46 ≤ GH ≤ 67), and low (GH >67) mortality risk. The median OS values were 14.5, 8.2, and 5.3 months in the low-, intermediate-, and high-risk categories, respectively (log-rank P <0.0001). In the high-risk group, doublet chemotherapy was not associated with favourable OS (HR: 0.70; 95% CI: 0.49-1.003; P=0.052), whereas in the intermediate- and low-risk groups, doublet chemotherapy was associated with favourable OS (HR: 0.72; 95% CI: 0.54-0.96; P=0.023 and HR: 0.50; 95% CI: 0.30-0.84; P=0.0089, respectively).
  
  
  CONCLUSIONS
  This study supports the additional prognostic value of HRQoL data at diagnosis to identify vulnerable subpopulations in elderly NSCLC patients. HRQoL could thus be valuable in selecting patients who will benefit from doublet chemotherapy.
authors.affiliation: University Hospital of Besançon, Methodology and Quality of Life in Oncology Unit, Besançon, France; University Hospital of Besançon, Department of Medical Oncology, Besançon, France; EA 3181 University of Franche-Comté, Besançon, France. Electronic address: fredericfiteni@gmail.com.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Fiteni
authors.affiliation: University Hospital of Besançon, Methodology and Quality of Life in Oncology Unit, Besançon, France.
authors.forename: Dewi
authors.initials: D
authors.lastname: Vernerey
authors.affiliation: University Hospital of Besançon, Methodology and Quality of Life in Oncology Unit, Besançon, France; EA 3181 University of Franche-Comté, Besançon, France; Platform Quality of Life and Cancer, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Bonnetain
authors.affiliation: Instruction Hospital of the Armies, Department of Pneumology, Percy-Clamart, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Vaylet
authors.affiliation: CLCC René Gauducheau, Department of Medical Oncology, Nantes, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Sennélart
authors.affiliation: St Joseph Hospital, Department of Medical Oncology, Paris, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Trédaniel
authors.affiliation: University Hospital of Grenoble, Pneumology Department, Grenoble, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Moro-Sibilot
authors.affiliation: Hospital of Nevers, Pneumology Department, Nevers, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Herman
authors.affiliation: Hospital of Sceaux, Pneumology Department, Sceaux, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Laizé
authors.affiliation: Hospital of Cholet, Pneumology Department, Cholet, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Masson
authors.affiliation: Private Hospital, Pneumology Department, Maubeuge, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Derollez
authors.affiliation: University Hospital of Nancy, Pneumology Department, Nancy, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Clément-Duchêne
authors.affiliation: Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Milleron
authors.affiliation: Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Morin
authors.affiliation: Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France; University Hospital of Caen, Pneumology Department, Caen, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Zalcman
authors.affiliation: Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France; University Hospital of Strasbourg, Pneumology Department, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Quoix
authors.affiliation: Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France; University Hospital of Besançon, Pneumology Department, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Westeel
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000523:psychology*; D003661:Decision Support Techniques; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000523:psychology*; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D018579:Patient Selection; D016016:Proportional Hazards Models; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: Lung cancer; Methodology; Prognostic factor; Quality of life