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M. Chen



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    P2.24 - Poster Session 2 - Supportive Care (ID 157)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P2.24-031 - Pre-treatment symptom profiles predict survival in patients with non-small cell lung cancer (ID 2312)

      09:30 - 09:30  |  Author(s): M. Chen

      • Abstract

      Background
      Fatigue, depression, sleep disturbance, and dyspnea are symptoms frequently reported by patients with non-small cell lung cancer before anti-cancer treatment. The purposes of this study were to identify latent subgroups of patients with NSCLC using the above four symptoms assessed at pre-chemotherapy and to determine whether different patient subgroups based on their symptom profiles can predict their survival.

      Methods
      Patients with stage III or IV NSCLC were recruited from a large teaching hospital located in northern Taiwan. Fatigue subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was used to measure fatigue. The Hospital Anxiety and Depression-Depression subscale was used to measure depressive symptom. The Pittsburg Sleep Quality Index (PSQI) was used to measure sleep disturbance. Four items from EORTC QLQ-C30 and QLQ-LC13 was used to measure dyspnea. All patients were followed up until the end of the study. The follow-up time ranged from 10 to 30 months. Latent class analysis was used to identify patient subgroups. Cox regression was used to examine the effect of patient subgroup on survival after adjusting the effect of covariates.

      Results
      The study sample consisted of 127 NSCLC patients. Two distinct patient subgroups were identified. The first group (30%) was characterized with high severity on all four symptoms (high symptom group), the second groups (70%) showed low severity on all four symptom (low symptom group). Before adjusting covariates, the “high symptom group” had significantly shorter survival time (median = 11.1 months) than the “low symptom group” (median = 21.1 months) (P = 0.016). After controlling for gender and disease stage, the group membership remain significantly associated with survival time (P=0.047). The risk of early death was 1.81 times higher in the “high symptom group” as compared to the “low symptom group” (HR=1.81, 95% CI=1.01 to 3.23).

      Conclusion
      The finding suggests that pre-treatment symptom profile has additional prognostic prediction in patients with advanced NSCLC. Early symptom assessment is recommended.