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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.

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