Quality of life and utility in patients with non-small cell lung cancer

Background: Although several studies have determined quality of life in pat ients with lung cancer, there is still little information about the use of generic questionnaires [e.g. the 36-item Short Form health survey (SF-36)] and utility questionnaires [e.g. the EuroQOL instrument (EQ-5D)] in this di sease. Objectives: To (i) measure quality of life and utility in patients with non -small cell lung cancer (NSCLC) using the SF-36 and the EuroQOL questionnai res; (ii) to evaluate the impact of some clinical variables on quality of l ife and utility; (iii) to assess the correlation between the measurements p roduced by the 2 questionnaires. Study design: Cross-sectional study. Participants: 95 patients from 15 Italian hospitals with NSCLC (93% male, m ean age 62 years) completed both questionnaires. Results: The mean scores for the 8 domains of the SF-36 ranged from 20.8 (p hysical role) to 63.0 (social functioning). The mean physical and mental su mmed scores of the SF-36 were 36.8 [standard deviation (SD) 9.8] and 43.0 ( SD 11.5), respectively. The EuroQOL mean score was 0.58 (SD 0.32) in the se lf-classifier (SC) version and 0.58 (SD 0.20) in the visual analogue scale (VAS) version. Among the clinical variables that affected quality of life a nd utility, the presence of metastasis had the greatest impact: patients wi th metastasis had statistically significantly lower scores for 2 domains of the SF-36 (physical functioning, p = 0.009; bodily pain, p = 0.016), for t he physical component summed score of the SF-36 (p = 0.015) and for both ut ility estimates (EuroQOL-SC, p = 0.027; EuroQOL-VAS, p = 0.038) than patien ts without metastasis. Both the SIC and VAS EuroQOL scores showed a statist ically significant correlation with each of the 8 domains of the SF-36. The scores for both the SF-36 and the EuroQOL in patients with NSCLC were cons iderably worse (relative differences ranging from -8 to -73%) than the corr esponding values (normative data) previously reported for healthy individua ls. Conclusions: Our study quantified the degree to which quality of life is im paired in patients with NSCLC, showed that the presence of metastasis had a n important role, and indicated a strong correlation between the measuremen ts produced by the 2 questionnaires. The EuroQOL measurements obtained from these patients will aid evaluation of the cost-utility ratio for NSCLC the rapies.