Nh. Gower et al., ASSESSMENT OF QUALITY-OF-LIFE USING A DAILY DIARY CARD IN A RANDOMIZED TRIAL OF CHEMOTHERAPY IN SMALL-CELL LUNG-CANCER, Annals of oncology, 6(6), 1995, pp. 575-580
Background: Quality of life (QOL) was assessed using a daily diary car
d within a multicentre randomised trial of treatment of small-cell lun
g cancer. The trial compared a weekly dose-intensive regimen with a 3-
weekly conventional treatment in good prognosis patients, that is pati
ents with limited disease or extensive disease with a good performance
status (ECOG 0 or 1) and alkaline phosphatase of less than one and a
half times the upper limit of normal. The trial which has been previou
sly reported detected no difference in response or survival. Patients
and methods: Daily diary cards (DDCs) were collected for up to eight m
onths from the first day of chemotherapy in a cohort of 75 patients at
one centre. Percentages of scores over a specified level were calcula
ted for each of the eight diary card questions and comparisons were ma
de between treatment arms. Results: During the period of chemotherapy
compliance in completing DDCs was 72.5% in the weekly arm and 77.2% in
the 3 weekly. Significantly worse scores were reported with weekly ch
emotherapy during this period for six of the eight parameters, namely:
nausea, vomiting, happiness, appetite, general well-being and sleep.
Recognised problems of QOL data collection, in particular, compliance,
attrition and generalisability are highlighted by this study and are
discussed in the paper. Conclusions: The QOL measurements indicate tha
t 3 weekly chemotherapy is the preferred treatment. This study demonst
rates that QOL measurements may be helpful in choosing between treatme
nt alternatives where no difference in outcome is observed.