A RETROSPECTIVE QUALITY-OF-LIFE ANALYSIS USING THE LUNG-CANCER SYMPTOM SCALE IN PATIENTS TREATED WITH PALLIATIVE RADIOTHERAPY FOR ADVANCED NONSMALL CELL LUNG-CANCER

Purpose: To measure symptom palliation in patients treated with radiat ion therapy for advanced nonsmall cell lung cancer (NSCLC), Methods an d Materials: Five hundred thirty patients with NSCLC were treated at t he Medical College of Virginia between 1988 and 1993, Sixty-three pati ents with the least favorable prognostic features received palliative radiation to 30 Gy in 10 or 12 fractions for symptoms related to the p resence of intrathoracic tumor, The observer portion of the Lung Cance r Symptom Scale (LCSS) was employed in a retrospective chart review, s coring measures of appetite, fatigue, cough, dyspnea, hemoptysis, and pain. Results: In 54 evaluable patients, median survival was 4 months and was independent of age, stage, performance status, or histology, N inety-six percent of the patients had at least one LCSS symptom at pre sentation. Fatigue was unaffected by therapy, Improvements in appetite (p = 0.68) and pain (p = 0.61) were not statistically significant, Th ere was, however, a statistically significant reduction in cough (p = 0.01), hemoptysis (p = 0.001), and dyspnea (p = 0.0003), Self-limiting acute side effects included transient esophagitis in 37 % of patients , though no severe toxicities were noted. Conclusions: These results s uggest symptomatic benefit from radiotherapy even in those NSCLC patie nts with advanced disease and a limited life expectancy, Treatment sho uld be given to patients whose symptoms are most amenable to palliatio n, A site-specific quality of life instrument such as the LCSS should be included within any future clinical trial of NSCLC management so th at symptom control may be scored as a treatment outcome in addition to disease-free survival. Copyright (C) 1997 Elsevier Science Inc.