Skip to main content

Advertisement

Log in

The health-related quality of life and survival of small-cell lung cancer patients: Results of a companion study to CALGB 9033

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

The purposes of this study were 2-fold: to evaluate the impact of the schedule dependency of etoposide (3-day IV short course vs. a 21-day oral prolonged course) with cisplatin on the quality of life of small-cell lung cancer (SCLC) patients; and to examine the effect of baseline quality of life variables on long-term survival, after adjustment for known demographic and clinical prognostic factors. Participants were 70 patients enrolled in the cancer and leukemia group B (CALGB) protocol 9033. Quality of life was assessed at baseline, 6 and 12 weeks by: the EORTC QLQ-30, the Centers for epidemiology studies – Depression short form, the medical outcomes study (MOS) social support questionnaire, and a scale of sleep quality. Contrary to expectations, study results suggested no significant differences in the patients' life quality and treatment response based on whether they received etoposide in a 3-day IV vs. a 21-day oral regimen. The use of the baseline variables in predicting overall survival indicated that patients who were non-white and with liver involvement had decreased survival. Brain involvement, being male, and higher depressive symptoms were also found to be borderline significant in predicting decreased survival in this patient population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Feinstein AR, Gelfman NA, Yesner R. The diverse effects of histopathology on manifestations and outcome of lung cancer. Chest 1974; 66: 225-239.

    Google Scholar 

  2. Stanley KE, Matthews MJ. Analysis of a pathology review of patients with tumors of the lung. J Natl Cancer Inst 1981; 66(6): 989-992.

    Google Scholar 

  3. Seifter EJ, Ihde DC. Small cell lung cancer: A distinct clinicopathologic entity. In: Bitran JD, Golomb HM, Little AG, Weichselbaum RR (eds), Lung Cancer. A Comprehensive Treatise. Orlando, FL: Grune & Stratton, 1988: 257-279.

    Google Scholar 

  4. Johnson BE. Management of small-cell lung cancer. Clin Chest Med 1993; 4(1): 173-187.

    Google Scholar 

  5. Earl HM, Rudd RM, Spiro SG, et al. A randomised trial of planned versus as required chemotherapy in small cell lung cancer: A Cancer Research Campaign trial. Br J Cancer 1991; 64(3): 566-572.

    Google Scholar 

  6. Giaccone G, Dalesio O, McVie GJ, et al. Maintenance chemotherapy in small-cell lung cancer: Long term results of a randomized trial. European Organization for Research and Treatment of Cancer Lung Cancer Cooperative Group. J Clin Oncol 1993; 11(7): 1230-1240.

    Google Scholar 

  7. Michel G, Leyvraz S, Bauer J, Aapro M, Stahel R, Alberto P. Weekly carboplatin and VM-26 for elderly patients with small-cell lung cancer. Ann Oncol 1994; 5(4): 369-370.

    Google Scholar 

  8. Joss RA, Alberto P, Hurny C, et al. for the Swiss Group for Clinical Cancer Research (SAKK). Quality versus quantity of life in the treatment of patients with advanced small-cell lung cancer: A randomized phase III comparison of weekly carboplatin and teniposide versus cisplatin, adriamycin, etoposide alternating with cyclophosphamide, methotrexate, vincristine and lomustine. Ann Oncol 1995; 6(1): 41-48.

    Google Scholar 

  9. Rowland KM Jr, Loprinzi CL, Shaw EG, et al. Randomized double-blind placebo-controlled trial of cisplatin and etoposide plus megestrol acetate/placebo in extensive-stage small-cell lung cancer: A North Central Cancer Treatment Group Study. J Clin Oncol 1996; 14(1): 135-141.

    Google Scholar 

  10. Wolff AC, Ettinger DS, Neuberg D, et al. Phase II study of ifosfamide, carboplatin, and oral etoposide chemotherapy for extensive-disease small-cell lung cancer: An Eastern Cooperative Oncology Group Pilot Study. J Clin Oncol 1995; 13(7): 1615-1622.

    Google Scholar 

  11. Souhami Rl, Law K. Longevity in small cell lung cancer. A report to the Lung Cancer Subcommittee of the United Kingdom Coordinating Committee for Cancer Research. Br J Cancer 1990; 61(4): 584-589.

    Google Scholar 

  12. Geddes DM, Dones L, Hill E, et al. Quality of life during chemotherapy for small cell lung cancer: Assessment and use of a daily diary card in a randomized trial. Eur J Cancer 1990; 26(4): 484-492.

    Google Scholar 

  13. Gower NH, Rudd RM, Ruiz de Elvira MC, et al. Assessment of 'quality of life' using a daily diary card in a randomised trial of chemotherapy in small-cell lung cancer. Ann Oncol 1995; 6(6): 575-580.

    Google Scholar 

  14. Bergman B, Sullivan M, Sorenson S. Quality of life during chemotherapy for small cell lung cancer. II. A longitudinal study of the EORTC Core Quality of Life Questionnaire and comparison with the Sickness Impact Profile. Acta Oncol 1992; 31(1): 19-28.

    Google Scholar 

  15. Bleehen NM, Girling DJ, Machin D, Stephens RJ. A randomised trial of three or six courses of etoposide cyclophosphamide methotrexate and vincristine or six courses of etoposide and ifosfamide in small cell lung cancer (SCLC). II: Quality of life. Medical Research Council Lung Cancer Working Party. Br J Cancer 1993; 68(6): 1157-1166.

    Google Scholar 

  16. Hurny C, Bernhard J, Joss R, et al. 'Fatigue and malaise' as a quality-of-life indicator in small-cell lung cancer patients. The Swiss Group for Clinical Research (SAKK). Support Care Cancer 1993; 1(6): 316-320.

    Google Scholar 

  17. James LE, Gower NH, Rudd RM, et al. A randomised trial of low dose/high-frequency chemotherapy as palliative treatment of poor-prognosis small-cell lung cancer: A Cancer Research Campaign Trial. Br J Cancer 1996; 73(12): 1563-1568.

    Google Scholar 

  18. Miller AA, Herndon II, JE, Hollis DR, et al. Schedule dependency of 21-day oral versus 3-day intravenous etoposide in combination with intravenous cisplatin in extensive-stage small-cell lung cancer: A randomized phase III study of the Cancer and Leukemia Group B. J Clin Oncol 1995; 13(8): 1871-1879.

    Google Scholar 

  19. Anderson H, Hopwood P, Prendiville J, Radford JA, Thatcher N, Ashcroft L. A randomised study of bolus vs. continuous pump infusion of ifosfamide and doxorubicin with oral etoposide for small cell lung cancer. Br J Cancer 1993; 67(6): 1385-1390.

    Google Scholar 

  20. Cull A, Gregor A, Hopwood P, et al. Neurological and cognitive impairment in long-term survivors of small cell lung cancer. Eur J Cancer 1994; 30A(8): 1067-1074.

    Google Scholar 

  21. Chute JP, Venzon DJ, Hankins L, et al. Outcome of patients with small-cell lung cancer during 20 years of clinical research at the US National Cancer Institute. Mayo Clin Proc 1997; 72(10): 901-912.

    Google Scholar 

  22. Sarna L. Women with lung cancer: Impact on quality of life. Qual Life Res 1993; 2(1): 13-22.

    Google Scholar 

  23. Albain KS, Crowley JJ, Livingston RB. Long-term survival and toxicity in small cell lung cancer. Expanded Southwest Oncology Group experience. Chest 1991; 99(6): 1425-1432.

    Google Scholar 

  24. Bleehen NM, Girling DJ, Machin D, Stephens RJ. A randomised trial of three or six courses of etoposide cyclophosphamide methotrexate and vincristine or six courses of etoposide and ifosfamide in small cell lung cancer (SCLC). I: Survival and prognostic factors. Medical Research Council Lung Cancer Working Party. Br J Cancer 1993; 68(6): 1150-1156.

    Google Scholar 

  25. Kaasa S, Mastekaasa A, Lund E. Prognostic factors for patients with inoperable non-small cell lung cancer, limited disease. Radiother Oncol 1989; 15(3): 235-242.

    Google Scholar 

  26. Schonwetter RS, Robinson BE, Ramirez G. Prognostic factors for survival in terminal lung cancer patients. J Gen Intern Med 1994; 9(7): 366-371.

    Google Scholar 

  27. Ganz PA, Lee JJ, Siau J. Quality of life assessment. An independent prognostic variable for survival in lung cancer. Cancer 1991; 67(12): 3131-3135.

    Google Scholar 

  28. Dancey J, Zee B, Osoba M, et al. for the National Cancer Institute of Canada Clinical Trials Group. Quality of life scores: An independent prognostic variable in a general population of cancer patients receiving chemotherapy. Qual Life Res 1997; 6(2): 151-158.

    Google Scholar 

  29. Ruckdeschel JC, Piantadosi S. Quality of life in lung cancer surgical adjuvant trials. Chest 1994; 106(Suppl 6): 324S-328S.

    Google Scholar 

  30. Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: A quality of life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993; 85(5): 365-376.

    Google Scholar 

  31. Burnam MA, Wells KB, Leake B, Landsverk J. Development of a brief screening instrument for detecting depressive disorders. Med Care 1988; 26(8): 775-789.

    Google Scholar 

  32. Sherbourne CD, Stewart AL. The MOS Social Support Survey. Soc Sci Med 1991; 32(6): 705-714.

    Google Scholar 

  33. Littell RC, Milliken GA, Stroup WW, Wolfujer RD. SAS System for Mixed Models. Cary, NC: SAS Institute, Inc., 1996.

    Google Scholar 

  34. Harrell FE Jr, Lee KL, Califf RM, Pryor DB, Rosati R. Regression modelling strategies for improved prognostic prediction. Statistics in Medicine 1984; 3:143-152.

    Google Scholar 

  35. Marubini E, Valsecch MG. Analyzing survival data from clinical trials and observational studies. New York: John Wiley, 1995.

    Google Scholar 

  36. Cavalli F, Sontag RW, Jungi F, et al. VP-16-213 monotherapy for remission induction of small cell lung cancer. A randomized trial using three dosage schedules. Cancer Treat Rep 1978; 62(3): 473-475.

    Google Scholar 

  37. Slevin ML, Clark PI, Joel SP, et al. A randomized trial to evaluate the effect of schedule on the activity of etoposide in small-cell lung cancer. J Clin Oncol 1989; 7(9): 1333-1340.

    Google Scholar 

  38. Abratt RP, Willcox PA, de Grot M, et al. Prospective study of etoposide scheduling in combination chemotherapy for limited disease small cell lung cancer. Eur J Cancer 1991; 27(1): 28-30.

    Google Scholar 

  39. Clark PI, Slevin ML, Joel SP, et al. A randomized trial of two etoposide schedules in small-cell lung cancer: The in-fluence of pharmacokinetics on efficacy and toxicity. J Clin Oncol 1994; 12(7): 1427-1435.

    Google Scholar 

  40. Hainsworth JD, Johnson DH, Frazier SR, Grew FA. Chronic daily administration of oral etoposide. A phase I trial. J Clin Oncol 1989; 7(3): 396-401.

    Google Scholar 

  41. Johnson DH, Greco FA, Strupp J, Hande KR, Hainsworth JD. Prolonged administration of oral etoposide in patients with relapsed or refractory small-cell lung cancer: A phase II trial. J Clin Oncol 1990; 8(10): 1613-1617.

    Google Scholar 

  42. Einhorn LH, Pennington K, McClean J. Phase II trial of daily oral VP-16 in refractory small cell lung cancer: A Hoosier Oncology Group study. Semin Oncol 1990; 17(Suppl 2): 32-35.

    Google Scholar 

  43. Watson M, Haviland JS, Greer S, Davison J, Bliss JM. Influence of psychological response on survival in breast cancer: A population-based cohort study. Lancet 1999; 354: 1331-1336.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M.J. Naughton.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Naughton, M., Herndon, J., Shumaker, S. et al. The health-related quality of life and survival of small-cell lung cancer patients: Results of a companion study to CALGB 9033. Qual Life Res 11, 235–248 (2002). https://doi.org/10.1023/A:1015257121369

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1015257121369

Navigation