The prognostic impact of quality of life assessed with the EORTC QLQ-C30 in inoperable non-small cell lung carcinoma treated with radiotherapy

Purpose: The purpose of this study was to assess the prognostic significanc e of pretreatment quality of life (QoL) scores and symptom scores in a grou p of patients treated with high dose radiotherapy. Material and methods: A total of 198 patients treated with external irradia tion ( greater than or equal to 60 Gy) were included. In all these patients , baseline QoL was assessed using the EORTC QLQ-C30. The prognostic signifi cance of a number of non-QoL and QoL parameters with regard to survival was estimated in both univariate and multivariate analyses. Results: In a multivariate model including the non-QoL parameters, performa nce status, weight loss and N-classification were independent prognostic fa ctors for survival. After entering the QoL parameters in the model, global QoL was the strongest prognostic factor, while performance status lost its significance. Subsequently, a significant interaction term was found betwee n N-classification and global QoL, indicating that global QoL was an indepe ndent prognostic factor but that the effect varied as a function of N-statu s. In N+ patients, the median survival in the group with low scores for glo bal QoL was 4.5 months, which was significantly worse (P < 0.0001) compared with the high score group in which the median survival was 12.9 months. Conclusion: Global QoL is a strong prognostic factor for survival in patien ts with NSCLC who have pathological lymph nodes at presentation and who are treated with radical or curative radiotherapy. (C) 2000 Elsevier Science I reland Ltd. All rights reserved.