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19.01.2019 | Original Article

Assessment of baseline symptom burden in treatment-naïve patients with lung cancer: an observational study

verfasst von: Tito R. Mendoza, Kenneth L. Kehl, Oluwatosin Bamidele, Loretta A. Williams, Qiuling Shi, Charles S. Cleeland, George Simon

Erschienen in: Supportive Care in Cancer | Ausgabe 9/2019

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Abstract

Background

Patients with newly diagnosed lung cancer who have not yet begun treatment may already be experiencing major symptoms produced by their disease. Understanding the symptomatic effects of cancer treatment requires knowledge of pretreatment symptoms (both severity and interference with daily activities). We assessed pretreatment symptom severity, interference, and quality of life (QOL) in treatment-naïve patients with lung cancer and report factors that correlated with symptom severity.

Methods

This was a retrospective analysis of data collected at initial intake. Symptoms/interference were rated on the MD Anderson Symptom Inventory (MDASI) between 30 days prediagnosis and 45 days postdiagnosis. We examined symptom severity by disease stage and differences in severity by histology. Linear regression analyses identified significant predictors of severe pain and dyspnea.

Results

Of 460 eligible patients, 256 (62%) had adenocarcinoma, 30 (7%) had small cell carcinoma, and 100 (24%) had squamous cell carcinoma; > 30% reported moderate-to-severe (rated ≥ 5, 0–10 scale) pretreatment symptoms. The most-severe were fatigue, disturbed sleep, distress, pain, dyspnea, sadness, and drowsiness. Symptoms affected work, enjoyment of life, and general activity (interference) and physical well-being (QOL) the most. Patients with advanced disease (n = 289, 63%) had more-severe symptoms. Cancer stage was associated with pain severity; both histology and cancer stage were associated with severe dyspnea.

Conclusion

One third of lung cancer patients were symptomatic at initial presentation. Quantification of pretreatment symptom burden can inform patient-specific palliative therapy and differentiate disease-related symptoms from treatment-related toxicities. Poorly controlled symptoms could negatively affect treatment adherence and therapeutic outcomes.

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Titel: Assessment of baseline symptom burden in treatment-naïve patients with lung cancer: an observational study
verfasst von: Tito R. Mendoza
Kenneth L. Kehl
Oluwatosin Bamidele
Loretta A. Williams
Qiuling Shi
Charles S. Cleeland
George Simon
Publikationsdatum: 19.01.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 9/2019
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4632-0

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Assessment of baseline symptom burden in treatment-naïve patients with lung cancer: an observational study