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M. De Mol
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P1.06 - Poster Session with Presenters Present (ID 458)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.06-014 - What Factors Determine Treatment Satisfaction in Patients with Advanced NSCLC Receiving Chemotherapy? (ID 6025)
14:30 - 14:30 | Author(s): M. De Mol
- Abstract
Background:
In advanced non-small cell lung cancer (NSCLC) treatment decisions regarding palliative chemotherapy are complex due to limited survival gain and treatment-related toxicities. Insight into determinants of patients’ treatment satisfaction may impact decision-making and patient care. We determined the relation of patient- and treatment-related variables to treatment satisfaction.
Methods:
In a prospective observational multi-center study, patients with stage IIIB or IV NSCLC receiving pemetrexed (PEM)-based chemotherapy as first- or second-line treatment were enrolled. After four cycles of chemotherapy, patients completed the WHO Quality of Life-BREF (WHOQoL-BREF), which contains one item measuring overall QoL on a 1-5 scale, and the Cancer Therapy Satisfaction Questionnaire (CTSQ). The CTSQ was recently validated (Cheung et al, Qual Life Res. 2016;25(1):71-80). It consists of 16 items scored on a 1-5 scale and contains three domains. Only satisfaction with therapy (SWT) and feelings about side effects (FSE) were used. The domain scores range between 0-100, with higher scores representing better SWT and more positive FSE. We collected sociodemographic information and ECOG performance status at baseline. Adverse events (cancer- or therapy-related) during treatment were weekly registered (CTCAE 3.0). Tumor response measurements were obtained (RECIST 1.1). Patient- and treatment-related determinants univariably associated with SWT (p<0.05) were analyzed using multivariable linear regression (method: Enter).
Results:
Of the 95 patients receiving four cycles of chemotherapy, 69 patients completed the CTSQ. The majority of these patients had stage IV NSCLC (87.7%) and received PEM-based therapy as first-line treatment (92.3%). Treatment resulted in stable disease (SD; 53.8%), partial response (PR; 40.0%) and progressive disease (PD; 6.2%). The mean SWT domain score was 79.6±13.1. Univariably, higher patients’ age (p=0.034), tumor response (PR vs. SD or PD, p=0.040), overall QoL (p=0.008) and FSE (p=0.004) were significantly related to SWT. The frequency of (severe) adverse events was not associated with SWT (p=0.546). After including these variables in the multivariable analysis, only age (β=0.44; 95%CI (0.09-0.79)) and FSE (β=0.13; 95%CI (0.00-0.26) were independently related to SWT.
Conclusion:
Importantly, higher SWT in elderly supports the opinion that palliative chemotherapy should not be reserved for younger age groups. Although symptomatic adverse events are known key contributors to QoL, the frequency of (severe) adverse events was not related with SWT. However, in patients with better FSE treatment satisfaction was higher. Therefore, patients’ education about and management of adverse events may have added value in maintaining patients’ well-being during chemotherapy, ultimately resulting in higher treatment satisfaction. This study is funded by ZonMw, the Netherlands.
