Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: A Prognostic analysis of the multicenter italian lung cancer in the elderly study

Paolo Maione, Francesco Perrone, Ciro Gallo, Luigi Manzione, Franco Vito Piantedosi, Santi Barbera, Silvio Cigolari, Francesco Rosetti, Elena Piazza, Sergio Federico Robbiati, Oscar Bertetto, Silvia Novella, Maria Rita Migliorino, Adolfo Favaretto, Mario Spatafora, Francesco Ferraù, Luciano Frontini, Alessandra Bearz, Lazzaro Repetto, Cesare Gridelli

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Abstract

Purpose: To study the prognostic value for overall survival of baseline assessment of functional status, comorbidity, and quality of life (QoL) in elderly patients with advanced non-small-cell lung cancer treated with chemotherapy. Patients and Methods: Data from 566 patients enrolled onto the phase III randomized Multicenter Italian Lung Cancer in the Elderly Study (MILES) study were analyzed. Functional status was measured as activities of daily living (ADL) and instrumental ADL (IADL). The presence of comorbidity was assessed with a checklist of 33 items; items 29 and 30 of the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire QLQ-C30 (EORTC QLQ-C30) were used to estimate QoL. ADL was dichotomized as none versus one or more dependency. For IADL and QoL, three categories were defined using first and third quartiles as cut points. Comorbidity was summarized using the Charlson scale. Analysis was performed by Cox model, and stratified by treatment arm. Results: Better values of baseline QoL (P = .0003) and IADL (P = .04) were significantly associated with better prognosis, whereas ADL (P = .44) and Charlson score (P = .66) had no prognostic value. Performance status 2(P = .006) and a higher number of metastatic sites (P = .02) also predicted shorter overall survival. Conclusions: Pretreatment global QoL and IADL scores, but not ADL and comorbidity, have significant prognostic value for survival of elderly patients with advanced non-small-cell lung cancer who were treated with chemotherapy. Using these scores in clinical practice might improve prognostic prediction for treatment planning.

Original languageEnglish
Pages (from-to)6865-6872
Number of pages8
JournalJournal of Clinical Oncology
Volume23
Issue number28
DOIs
Publication statusPublished - 2005

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ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Maione, P., Perrone, F., Gallo, C., Manzione, L., Piantedosi, F. V., Barbera, S., Cigolari, S., Rosetti, F., Piazza, E., Robbiati, S. F., Bertetto, O., Novella, S., Migliorino, M. R., Favaretto, A., Spatafora, M., Ferraù, F., Frontini, L., Bearz, A., Repetto, L., & Gridelli, C. (2005). Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: A Prognostic analysis of the multicenter italian lung cancer in the elderly study. Journal of Clinical Oncology, 23(28), 6865-6872. https://doi.org/10.1200/JCO.2005.02.527