Analysing HR-QoL trends and predictors in lung cancer

Physician's Weekly - 14/06/2024 - Health-related quality of life (HR-QoL) often faces significant challenges among lung cancer survivors. This study aimed to elucidate the complex interplay of patient characteristics, tumour attributes, and treatment modalities influencing HR-QoL trajectories over time, providing insights for tailored survivorship care.

Materials and Methods involved longitudinal assessment of HR-QoL using the Functional Assessment of Cancer Therapy – Lung (FACT-L) instrument at diagnosis, 6 months, 1 year, and 2 years from the Yale Lung Cancer Biorepository. The analysis focused on 513 patients, stratified by disease stage: early-stage non-small cell lung cancer (NSCLC) (n=355), advanced-stage NSCLC (n=158), and small cell lung cancer (SCLC) (n=21). Mixed effects modeling and multivariable analyses adjusted for covariates were employed to explore changes in FACT-L scores over the study period, with sensitivity analysis conducted among patients with early-stage disease and complete FACT-L data at baseline and year 2 (n=91).

Results revealed distinct HR-QoL profiles at diagnosis, with average FACT-L scores of 121.0 (SD 11.4) for early-stage NSCLC, 109.2 (SD 18.7) for advanced-stage NSCLC, and 98.7 (SD 20.2) for SCLC. Throughout follow-up, patients with early-stage NSCLC consistently reported higher HR-QoL than their advanced-stage counterparts.

While HR-QoL improved numerically at years 1 and 2 post-diagnosis in NSCLC groups, these changes did not achieve clinical significance. Factors associated with higher HR-QoL at diagnosis included older age, better performance status, engagement in physical activity, adenocarcinoma histology, and (in advanced NSCLC) anticipated chemotherapy. At follow-up, higher HR-QoL correlated with higher BMI and improved performance status.

The discussion underscores the multifactorial nature of HR-QoL in NSCLC survivors, influenced by demographic, clinical, and treatment-related variables. To enhance HR-QoL outcomes, survivorship strategies should prioritize managing comorbidities, promoting physical activity, maintaining a healthy weight, and mitigating treatment-related side effects. These findings advocate for personalized care approaches tailored to the specific needs of lung cancer survivors, aiming to optimise long-term quality of life beyond initial diagnosis and treatment.

Source: sciencedirect.com/science/article/abs/pii/S0169500224001016

Originally Published By Physician’s Weekly. Reused by Medicom Medical Publishers with permission.

©2024 Physician’s Weekly. All rights reserved. No works may be reproduced without expressed written consent from Physician’s Weekly. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by Physician’s Weekly.



Posted on 18 June 202424 June 2024