High-dose radiotherapy or concurrent chemo-radiation in lung cancer patients only induces a temporary, reversible decline in QoL

Radiother Oncol. 2009 Jun;91(3):443-8. doi: 10.1016/j.radonc.2009.02.010. Epub 2009 Mar 16.

Abstract

Background and purpose: Aggressive radiotherapy or concurrent chemo-radiation therapy for lung cancer leads to a high incidence of severe, mostly esophageal, toxicity. The purpose of this study was to investigate the evolution of quality of life (QoL) in patients with lung cancer, selected for curative radiotherapy (RT) or chemo-RT.

Methods: Seventy-five lung cancer patients completed a longitudinal the EORTC QLQ-C30 and LC13. Linear mixed regression models were fitted to investigate the impact of different factors on overall QoL.

Results: Overall QoL decreased shortly after the end of RT (4 points, p=0.19), but increased back to baseline within 3months. Mean scores of role functioning (p=0.018), cognitive functioning (p=0.002), dyspnoea (EORTC QLQ-LC13; p=0.043), dysphagia (p=0.005) and hoarseness (p=0.029), showed a significant worsening over time. Emotional functioning (p=0.033) improved significantly over time. Severe esophagitis (> or = grade 2) was reported in only 12% of the patients. Next to maximal esophageal toxicity > or = grade 2 (p=.0.010), also tumor stage IIIA (p<0.001), tumor stage IIIB (p=0.003), gender (p=0.042) and fatigue (p<0.001) appeared to be significant predictors of QoL.

Conclusion: High-dose radiotherapy or concurrent chemo-radiation in the treatment of lung cancer seems to be a well-tolerated treatment option with preservation of QoL.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / radiotherapy*
  • Combined Modality Therapy
  • Female
  • Humans
  • Linear Models
  • Longitudinal Studies
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life*
  • Radiation Injuries / epidemiology*
  • Small Cell Lung Carcinoma / drug therapy*
  • Small Cell Lung Carcinoma / radiotherapy*
  • Treatment Outcome

Substances

  • Antineoplastic Agents