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• W2801877866 abstract "Optimal treatment selection for clinical Stage I non-small cell lung cancer (NSCLC) patients currently involves consideration of an individual’s comorbidities and functional status. Pre-treatment quality of life (QoL) data for this population has been limited. Our goal was to prospectively compare pre-treatment QoL outcomes between Stage I NSCLC patients receiving either stereotactic body radiation therapy (SBRT) or surgical resection, as QoL may correlate with patient satisfaction and post-treatment outcomes. From 2013 – 2016, clinical Stage I NSCLC patients at our institution were approached to participate in a prospective QoL study. Consenting patients completed pre-treatment QoL surveys including the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EORTC lung cancer specific module (QLQ-CL13). Patient demographics, Charlson-Deyo comorbidity score (CDS) and validated psychosocial measures were also recorded. Patients’ self-reported levels of global health, physical functioning, role functioning, cognitive functioning, emotional functioning, social functioning and symptoms were captured. QLQ scores range from 0 – 100; higher global health/QoL/functional scale scores indicate higher functional status, while higher symptom scores indicate greater symptom burden. Analysis of variance (ANOVA) tested differences in QoL scores between SBRT and surgical patients. To control for patient variables associated with QoL on univariate analysis, the Estimated Marginal Means (EMM) of the QoL scores between the two treatment groups were compared using analysis of covariance (ANCOVA). 240 clinical stage I NSCLC patients completed the pre-treatment survey (SBRT = 133, surgery = 107). Compared to surgery patients, SBRT patients were older (mean age 71.0 versus 67.9, p=0.005) and more likely to have a CDS ≥3 (40.6% versus 29.9%, p<0.001). In univariate analysis, SBRT patients reported lower mean pre-treatment scores than surgery patients for global health (68.5 versus 77.9, p<0.001), physical functioning (73.5 versus 88.9, p<0.001), role functioning (80.1 versus 91.6, p=0.001), and social functioning (85.6 versus 91.0, p=0.04). SBRT patients reported worse pre-treatment symptom burden (higher scores) for fatigue (31.8 versus 20.9, p<0.001), pain (25.3 versus 17.1, p=0.03), dyspnea (38.4 versus 15.3, p<0.001), diminished appetite (15.3 versus 7.5, p=0.01), coughing (43.1 versus 28.6, p<0.001), peripheral neuropathy (22.3 versus 13.7, p=0.02), and financial difficulties (14.5 versus 6.9, p=0.01). In adjusted models (controlling for associations between QoL scores and age, CDS, BMI, depression status, and perceived levels of social support), SBRT patients still had significantly lower pre-treatment levels of global health (EMM = 69.5 versus 76.4, p=0.007), physical health (EMM= 74.1 versus 88.1, p<0.001), and role functioning (EMM= 81.5 versus 89.6, p=0.015), but higher scores for emotional functioning (EMM= 81.0 versus 76.2, p=0.04). Our study demonstrates significantly lower pre-treatment functional scores and increased symptom scores for Stage I NSCLC patients receiving SBRT compared to surgical patients. Given the continued debate regarding therapeutic selection for high-risk Stage I NSCLC patients, our findings suggest the importance of QoL assessments in comparisons between these treatment modalities. Future directions for this work will include following short- and long-term post-treatment QoL assessments, as well as analyzing the relationship between baseline QoL scores and overall survival." @default.
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• W2801877866 date "2018-06-01" @default.
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• W2801877866 title "(OA01) Prospective Baseline Quality of Life in Clinical Stage I Non-Small Cell Lung Cancer Patients Receiving Stereotactic Body Radiation Therapy Versus Surgery: The Starting Line Is not the Same" @default.
• W2801877866 doi "https://doi.org/10.1016/j.ijrobp.2018.02.040" @default.
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