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Multicenter Study
. 2022 Apr;30(4):3131-3140.
doi: 10.1007/s00520-021-06736-2. Epub 2021 Dec 7.

Impact of molecular alterations on quality of life and prognostic understanding over time in patients with incurable lung cancer: a multicenter, longitudinal, prospective cohort study

Jonas Kuon  1 , Miriam Blasi  2 , Laura Unsöld  2 , Jeannette Vogt  3 , Anja Mehnert  4 , Bernd Alt-Epping  5 , Birgitt van Oorschot  6 , Jochen Sistermanns  7 , Miriam Ahlborn  8 , Ulrike Ritterbusch  9 , Susanne Stevens  10 , Christoph Kahl  11 , Anne Ruellan  12 , Kathrin Matthias  13 , Thomas Kubin  14 , Kerstin Stahlhut  15 , Andrea Heider  16 , Florian Lordick  17 , Michael Thomas  2 ; Arbeitsgemeinschaft Palliativmedizin (APM) of the German Cancer Society (DKG)
Affiliations
Multicenter Study

Impact of molecular alterations on quality of life and prognostic understanding over time in patients with incurable lung cancer: a multicenter, longitudinal, prospective cohort study

Jonas Kuon et al. Support Care Cancer. 2022 Apr.

Abstract

Purpose: The purpose of this study is to investigate changes over time in quality of life (QoL) in incurable lung cancer patients and the impact of determinants like molecular alterations (MA).

Methods: In a prospective, longitudinal, multicentric study, we assessed QoL, symptom burden, psychological distress, unmet needs, and prognostic understanding of patients diagnosed with incurable lung cancer at the time of the diagnosis (T0) and after 3 (T1), 6 (T2) and 12 months (T3) using validated questionnaires like FACT-L, National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT), PHQ-4, SCNS-SF-34, and SEIQoL.

Results: Two hundred seventeen patients were enrolled, 22 (10%) with reported MA. QoL scores improved over time, with a significant trend for DT, PHQ-4, and SCNS-SF-34. Significant determinants for stable or improving scores over time were survival > 6 months, performance status at the time of diagnosis, and presence of MA. Patients with MA showed better QoL scores (FACT-L at T1 104.4 vs 86.3; at T2 107.5 vs 90.0; at T3 100.9 vs 92.8) and lower psychological distress (NCCN DT at T1 3.3 vs 5; at T2 2.7 vs 4.5; at T3 3.7 vs 4.5; PHQ-4 at T1 2.3 vs 4.1; at T2 1.7 vs 3.6; at T3 2.2 vs 3.6), but also a worsening of the scores at 1 year and a higher percentage of inaccurate prognostic understanding (27 vs 17%) compared to patients without MA.

Conclusion: Patients with tumors harboring MA are at risk of QoL deterioration during the course of the disease. Physicians should adapt their communication strategies in order to maintain or improve QoL.

Keywords: Lung cancer; Molecular alterations; Prognostic awareness; Quality of life.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A FACT-L (higher scores indicate better QoL), B NCCN DT (lower scores indicate less distress), and C PHQ-4 (lower scores indicate less psychological impairment) trends over time in patients with (yes) or without (no) detected molecular alterations
See this image and copyright information in PMC

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