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Patient’s quality of life after high-dose radiation therapy for thoracic carcinomas

Changes over time and influence on clinical outcome

Lebensqualität von Patienten nach Hochdosis-Strahlentherapie thorakaler Karzinome

Zeitlicher Verlauf und Einfluss auf das klinische Ergebnis

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Abstract

Purpose

Quality of life (QoL) is an important factor in patient care. This analysis is focused on QoL before and after radio(chemo)therapy in patients with thoracic carcinomas, as well as on its influence on clinical follow-up and survival, and the correlation with treatment-related toxicities.

Materials and methods

The analysis included 81 patients with intrathoracic carcinoma receiving radio(chemo)therapy. For analysis of QoL, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the lung cancer-specific supplement (EORTC QLQ-LC13) were used. QoL data were collected before radiation treatment (RT), and 6 weeks, 12 weeks, 6 months, and 12 months after RT. Other factors were additionally analyzed, including clinical outcome, survival, and side effects.

Results

The functional scales showed maximum values or at least a recovery 12 weeks after RT. Symptoms with a high mean symptom score (> 40) at all appointments were fatigue, dyspnea, and coughing. Insomnia, peripheral neuropathy, appetite loss, dyspnea (from QLQ-LC13), and all pain parameters had an intermediate mean score (10–40). There were low mean scores of < 10 for nausea and vomiting, diarrhea, sore mouth, and hemoptysis. There was a significant correlation between clinical dysphagia and radiation pneumonitis with the associated symptom scales. None of the QoL scores had a significant influence on local and distant control or survival.

Conclusion

12 weeks after RT the QLQ-C30 functional scales show the highest scores or at least a temporary recovery. The symptom scales accurately reflect the common symptoms and treatment-related toxicities. QoL did not prove to be a significant predictor for local and distant control or survival.

Zusammenfassung

Zielsetzung

Die Lebensqualität (QoL) ist ein entscheidender Faktor in der Patientenversorgung. In der vorliegenden Untersuchung lag der Fokus auf der QoL vor und nach Radio(chemo)therapie von Patienten mit thorakalen Tumoren sowie deren Einfluss auf das klinische Ergebnis, das Überleben und die Korrelation mit therapieinduzierten Nebenwirkungen.

Material und Methoden

Analysiert wurden 81 Patienten mit thorakalen Tumoren, die mittels Radio(chemo)therapie behandelt wurden. Zur Objektivierung der QoL wurden der EORTC QLQ-C30 und der EORTC QLQ-LC13 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire) verwendet. QoL-Daten wurden vor Strahlentherapie (RT) sowie 6 Wochen, 12 Wochen, 6 Monate und 1 Jahr nach RT gesammelt. Zusätzlich wurden weitere Faktoren wie das klinische Ergebnis, Überleben und Nebenwirkungen analysiert.

Ergebnisse

Sämtliche Funktionsskalen zeigten ein Maximum oder zumindest eine Erholung 12 Wochen nach RT. Symptome mit hohem durchschnittlichen Symptomscore (> 40) zu allen Untersuchungszeitpunkten waren Fatigue, Dyspnoe und Husten. Schlaflosigkeit, periphere Neuropathie, Appetitverlust, Dyspnoe (aus QLQ-LC13) und alle Schmerzparameter zeigten durchschnittlich eine mittlere Punktzahl (10–40). Niedrige durchschnittliche Punktzahlen (< 10) hatten Übelkeit und Erbrechen, Diarrhö, Wunden im Mundbereich und Hämoptysis. Keine signifikante Korrelation mit den zugehörigen Symptomskalen bestand zwischen klinisch vorhandener Dysphagie und Pneumonitis. Kein QoL-Parameter hatte signifikanten Einfluss auf klinische Kontrolle oder Gesamtüberleben.

Schlussfolgerung

Die besten Werte oder zumindest eine Erholung der Funktionsskalen zeigen sich 12 Wochen nach RT. Die Symptomskalen spiegeln die häufigsten tumor- oder therapiebezogenen Symptome wieder. Die QoL hat keinen signifikanten Einfluss auf klinische Kontrolle oder Gesamtüberleben.

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Authors and Affiliations

  1. Clinic for Radiotherapy and Radiation Oncology, University Clinic Giessen and Marburg, Marburg, Germany

    Christina Schröder,  Rita Engenhart-Cabillic &  Hilke Vorwerk

  2. Clinic for Radiotherapy and Radiation Oncology, Ruppiner Kliniken GmbH, Neuruppin, Germany

    Christina Schröder,  Michael Schmidt,  Winfried Huhnt,  Eyck Blank,  Dietrich Sidow &  André Buchali

Authors
  1. Christina Schröder
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  2. Rita Engenhart-Cabillic
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  3. Hilke Vorwerk
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  4. Michael Schmidt
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  5. Winfried Huhnt
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  8. André Buchali
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Corresponding author

Correspondence to Christina Schröder.

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Conflict of interest

C. Schröder, R. Engenhart-Cabillic, H. Vorwerk, M. Schmidt, W. Huhnt, E. Blank, D. Sidow, and A. Buchali declare that they have no competing interests.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975 (in its most recently amended version). Informed consent was obtained from all patients included in the study.

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Schröder, C., Engenhart-Cabillic, R., Vorwerk, H. et al. Patient’s quality of life after high-dose radiation therapy for thoracic carcinomas. Strahlenther Onkol 193, 132–140 (2017). https://doi.org/10.1007/s00066-016-1068-7

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  • DOI: https://doi.org/10.1007/s00066-016-1068-7

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