Quality of life, symptom status and physical performance in patients with advanced non-small cell lung cancer undergoing chemotherapy: an exploratory analysis of secondary data

Shirin M Shallwani; Maureen J Simmonds; Goulnar Kasymjanova; Jadranka Spahija

doi:10.1016/j.lungcan.2016.06.018

Quality of life, symptom status and physical performance in patients with advanced non-small cell lung cancer undergoing chemotherapy: an exploratory analysis of secondary data

Lung Cancer. 2016 Sep:99:69-75. doi: 10.1016/j.lungcan.2016.06.018. Epub 2016 Jun 23.

Authors

Shirin M Shallwani¹, Maureen J Simmonds², Goulnar Kasymjanova³, Jadranka Spahija⁴

Affiliations

¹ School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Physiotherapy Department, McGill University Health Centre, Montreal, Quebec, Canada.
² Center for Research to Advance Community Health, University of Texas Health Science Center, San Antonio, TX, United States; Department of Physical Therapy, University of Texas Health Science Center, San Antonio, TX, United States.
³ Pulmonary Division, Department of Internal Medicine, Sir Mortimer B. David Jewish General Hospital, Montreal, Quebec, Canada.
⁴ School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada; Chronic Disease Research Division, Research Center, Sacré-Coeur Hospital, Montreal, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation in Greater, Jewish Rehabilitation Hospital, Montreal, Quebec, Canada. Electronic address: jadranka.spahija@mcgill.ca.

PMID: 27565917
DOI: 10.1016/j.lungcan.2016.06.018

Abstract

Objectives: Our objectives were: (a) to identify predictors of change in health-related quality of life (HRQOL) in patients with advanced non-small cell lung cancer (NSCLC) undergoing chemotherapy; and (b) to characterize symptom status, nutritional status, physical performance and HRQOL in this population and to estimate the extent to which these variables change following two cycles of chemotherapy.

Methods: A secondary analysis of a longitudinal observational study of 47 patients (24 men and 23 women) with newly diagnosed advanced NSCLC receiving two cycles of first-line chemotherapy was performed. Primary outcomes were changes in HRQOL (physical and mental component summaries (PCS and MCS) of the 36-item Short-Form Health Survey (SF-36)). Predictors in the models included pre-chemotherapy patient-reported symptoms (Schwartz Cancer Fatigue Scale (SCFS) and Lung Cancer Subscale), nutritional screening (Patient-Generated Subjective Global Assessment) and physical performance measures (6-min Walk Test (6MWT), one-minute chair rise test and grip strength).

Results: Mean SF-36 PCS score, 6MWT distance and grip strength declined following two cycles of chemotherapy (p<0.05). Multiple linear regression modelling revealed pre-chemotherapy SCFS score and 6MWT distance as the strongest predictors of change in the mental component of HRQOL accounting for 13% and 9% of the variance, respectively. No significant predictors were found for change in the physical component of HRQOL.

Conclusions: Pre-chemotherapy 6MWT distance and fatigue severity predicted change in the mental component of HRQOL in patients with advanced NSCLC undergoing chemotherapy, while physical performance declined during treatment. Clinical management of these factors may be useful for HRQOL optimization in this population.

Keywords: Drug therapy; Lung neoplasms; Physical performance; Quality of life; Symptom status.

MeSH terms

Aged
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Carcinoma, Non-Small-Cell Lung / diagnosis
Carcinoma, Non-Small-Cell Lung / drug therapy
Carcinoma, Non-Small-Cell Lung / epidemiology*
Female
Health Status*
Humans
Lung Neoplasms / diagnosis
Lung Neoplasms / drug therapy
Lung Neoplasms / epidemiology*
Male
Middle Aged
Neoplasm Staging
Patient Reported Outcome Measures
Physical Fitness*
Quality of Life*
Surveys and Questionnaires
Symptom Assessment