title: Health-related quality of life in elderly patients with advanced non-small cell lung cancer comparing carboplatin and weekly paclitaxel doublet chemotherapy with monotherapy.
abstract: In the Intergroupe Francophone de Cancérologie Thoracique 0501 trial the carboplatin-paclitaxel chemotherapy increased toxicity (most frequent, decreased neutrophil count, asthenia). We longitudinally compared health-related quality of life (HRQoL) of the two treatment arms.In total, 451 patients aged 70-89 years with advanced non-small cell lung cancer (NSCLC) were randomly assigned to receive carboplatin plus paclitaxel or vinorelbine or gemcitabine. HRQoL was assessed by means of the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire at baseline, week 6 and week 18.Using a five-point decrease as the minimal clinically important difference, patients treated with the chemotherapy doublet exhibited a significant longer time until definitive deterioration (TUDD) for two HRQoL dimensions: physical functioning (median TUDD: 2.04 for the doublet versus 1.71 months for monotherapy; log-rank p=0.01) and nausea and vomiting (median: not reached versus 4.83, respectively; log-rank p=0.046). Cox multivariate analysis revealed the carboplatin and paclitaxel arm to be independently associated with longer TUDD for these two HRQoL dimensions. In addition, TUDD didn't significantly differ between the two arms for all the other HRQoL dimensions.The chemotherapy doublet did not reduce TUDD in elderly patients with advanced NSCLC. Moreover, TUDD was prolonged for two HRQoL dimensions, namely physical functioning and nausea and vomiting.
authors.affiliation: Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France Dept of Medical Oncology, University Hospital of Besançon, Besançon, France EA 3181 University of Franche-Comté, Besançon, France fredericfiteni@gmail.com.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Fiteni
authors.affiliation: Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France EA 3181 University of Franche-Comté, Besançon, France Platform Quality of Life and Cancer, France.
authors.forename: Amélie
authors.initials: A
authors.lastname: Anota
authors.affiliation: Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France EA 3181 University of Franche-Comté, Besançon, France Platform Quality of Life and Cancer, France EORTC QOL Group, Brussels, Belgium.
authors.forename: Franck
authors.initials: F
authors.lastname: Bonnetain
authors.affiliation: Chest Disease Dept, Hospital of Colmar, Colmar, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Oster
authors.affiliation: Chest Disease Dept, University Hospital of Tours, Tours, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Pichon
authors.affiliation: Chest Disease Dept, Assistance Publique Hôpitaux de Paris (AP-HP), Tenon Hospital, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Wislez
authors.affiliation: Oncology Dept, University Hospital of Mont-de-Marsan, Mont-de-Marsan, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Dauba
authors.affiliation: Chest Disease Dept, Hospital of Mulhouse, Mulhouse, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Debieuvre
authors.affiliation: Chest Disease Dept, University Hospital of Lyon-Sud, Lyon, France.
authors.forename: Pierre-Jean
authors.initials: PJ
authors.lastname: Souquet
authors.affiliation: Chest Disease Dept, University Hospital of Toulouse, Toulouse, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Bigay-Game
authors.affiliation: Chest Disease Dept, Hospital of Le Mans, Le Mans, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Molinier
authors.affiliation: Cancer Centre O. Lambret, Lille, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Dansin
authors.affiliation: Cancer Centre A. Lacassagne, Nice, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Poudenx
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 Dept of Thoracic Oncology, Assistance, Publique Hôpitaux de Paris, Bichat-Claude Bernard Hospital, Paris, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Zalcman
authors.affiliation: Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France Chest Disease Department, University Hospital of Strasbourg, Strausbourg, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Quoix
authors.affiliation: Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France Chest Disease Dept, University Hospital of Besançon, Besançon, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Westeel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D003657:Decision Making; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005060:Europe; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D014747:Vinblastine; D016190:Carboplatin; D017239:Paclitaxel; D000077235:Vinorelbine; D000093542:Gemcitabine