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D. Kızılgöz
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P2.11 - Poster Session/ Palliative and Supportive Care (ID 230)
- Event: WCLC 2015
- Type: Poster
- Track: Palliative and Supportive Care
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.11-002 - Identifying Relationship between Symptom Burden and Overall Survival in Patients with Advanced Nonsmall Cell Lung Cancer: A Prospective Study (ID 2883)
09:30 - 09:30 | Author(s): D. Kızılgöz
- Abstract
Background:
Prognostic factors in nonsmall cell lung carsinoma (NSCLC) has been described in many studies in medical literature. It is unclear the relationship between overall survival and symptom burden. The aim of our study is defining the prognostic factors in advanced NSCLC and to describe relationship between symptoms and overall survival.
Methods:
In this study, the patients newly diagnosed stage 3b and 4 with NSCLC and Eastern Cooperative Oncology Group Performans Status (ECOG PS) of 0 to 2, from August 2011 to May 2013 in Ataturk Chest Diseases and Chest Surgery Education and Training Hospital were included. We obtained the demographic, diseases related and laboratory data for all patients. Symptoms were analyzed with The Edmonton Symptom Assessment Scale (ESAS) before and after chemotherapy. The study was designed prospectively and the patients were followed up to 826 days. Cox model proportional risk analysis was performed at the end of the the followed-up period to assess the beginning symptoms, symptoms differences after chemotheraphy and the relationship between the general characteristics and the survival.
Results:
We conducted a multivariate analysis and it is found that as one of the general characteristics; the stage of the diseases (p= 0,004 HR: 2,373 95% CI: 1,317-4,274) and the histopathologic subtypes (p=0,006 HR: 2,311 95% CI:1,271-4,202) were prognostically significant. The patients with fatigue as the beginning symptoms (p=0,001 HR:2,389 %95 % CI: 1,460-3,908) and the sadness score 4 and over (p= 0,032 HR:2,311 95% CI: 1,271-4,202) had lower survival, it is also found that patients with cough intensity increasing after chemotheraphy (p=0,006 HR: 1,933 95% CI: 1,128-3,314) had lower survival and high mortality risk as well in multivariate analysis.
Conclusion:
During the treatment process, together with performance scores of patients with symptom score monitoring will be meaningful. Further prospective studies including a larger group of patients are required in order to describe better the relationship between the symptoms and the prognosis.
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P3.11 - Poster Session/ Palliative and Supportive Care (ID 231)
- Event: WCLC 2015
- Type: Poster
- Track: Palliative and Supportive Care
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.11-003 - Contribution of the Comprehensive Geriatric Assessment on Management of the Cancer Theraphy in Elderly Patients (ID 2895)
09:30 - 09:30 | Author(s): D. Kızılgöz
- Abstract
Background:
Lung cancer is getting more common and important especially in 6th-7th decade. Several recently published studies showed that eveluating the elderly patients with only Eastern Cooperative Oncology Group (ECOG) to manage the treatment is not eough. It is needed to consider this elderly group of patients precisely. In our study we aim to search the the clinical value of the comprehensive geriatric assessment of the elderly patients as a a parameter that can be used to guide the treatment decision.
Methods:
In our study 65 years old and over newly diagnosed 74 lung cancer patients in our hospital from April 2013 to April 2014 were included. In order to evaluate the comprehensive geriatric assessment, we applied the activities of daily living (ADL’s), instrumental activities of daily living ( IADLs), mini-mental test, mini-nutritional test, Yesavage depression scale and Charlson comorbidity index . Receiving treatment and the survival were assessed with 6 other tests and ECOG in single and multi variable analysis.
Results:
Men were 94.6 % of all patients. In this group 6.8% in small cell carsinoma, 90.5% in non-small cell carsinoma, 2.7 % in malignant epithelial tumour were diagnosed. According to ADL’s 86.5 % was independent and 13.5 % was semi-dependent as well as to IADLs 60.8 % was independent, 20.3 % semi-dependent and 18.9 % was dependent. %12.2 of the patients had malnutrition, %56.7 had malnutrition risk. The data provided that 54 % of all patients had severe dementia and 17.6 % has mild dementia. According to Yesavade depression scale 13.5% of patients were developed depression. Charlson comorbidity index provided the data that 2 % of patients had very high risk probability, 5% high risk, 42.5 % moderate, 25% low risk probability. It is found significant the relationship between the receiving treatment and results of ADL’s, IADLs, mini-mental test, Yesavage depression scale, and ECOG as well as ADL’s, IADLs, mini-mental test, Yesavage depression scale, ECOG and mini-nutritional test and the survival in single variable analysis (p<0,05). In order to consider which test will have more prominent role to receive the treatment ,multivariable analysis was performed and only IADLs was found significant as a determining factor for receiving or not receiving treatment (p=0,003). Yesavage depression scale was found more efficient to find out the factors affecting the survival in multivariable comparison analysis (p=0,011).
Conclusion:
The study published by Maione and collegues evaluating the relationship between functional status, comorbidity, life quality and the survival in 566 advanced stage non-small cell cancer patients showed that patients with beter IADLs ( p= 0.04) have better survival as similarly obtained from our study. Buccheri and his group reported the data from 133 heterogeneous bronchogenic cancer patients developed depression,have a worse survival comparing with the patients having no depression. The results of our study indicates that assessing with ECOG is not enough for considering the treatment,but how CGA is important to consider it as well. Improving the life quality and the survival of the advanced stage elderly patients with cancer, future research requires a more wide population
