Prospective study on quality of life before and after radical radiotherapyin non-small-cell lung cancer

Purpose: The purpose of this study was to investigate changes in respirator y symptoms and quality of life (QoL) in patients with non-small-cell lung c ancer (NSCLC) receiving radical radiotherapy (60 Gy). Additionally, the ass ociation between the level of symptom relief and objective tumor response, as well as with radiation-induced pulmonary changes, was investigated. Patients and Methods: One hundred sixty-four patients were entered onto thi s prospective study. The European Organization for Research and Treatment o f Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and EORTC QLQ-LC ' 13 were used to investigate changes in QoL. Assessments were performed befo re radiotherapy and 2 weeks, 6 weeks, 3 months, 6 months, and 12 months aft er the completion of radiotherapy. Results: The QoL response rates were excellent for hemoptysis (83%); good f or chest pain (68%), arm/shoulder pain (63%), and appetite loss (60%); and poor for dyspnea (37%), cough (31%), and fatigue (28%). The QoL response ra tes for the five functioning scales of the QLQ-C30 varied from 35% for phys ical and role functioning to 55% for social and cognitive functioning. The response rate for global QoL was 36%. A significant association was found b etween tumor response and palliation of chest pain, arm/shoulder pain, and physical functioning. During radiotherapy, a significant increase for most general symptoms and a deterioration in functioning and QoL were noted. Conclusion: This study is the first to describe palliation and changes in Q oL in radically irradiated patients with NSCLC. Radical radiotherapy offers palliation of respiratory symptoms and improved QoL in a substantial propo rtion of patients with NSCLC who have relatively good prognostic features. Although tumor reduction is associated with palliation of respiratory sympt oms, it cannot serve as ct surrogate for palliation. (C) 2001 by American S ociety of Clinical Oncology.