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The symptom burden of non-small cell lung cancer in the USA: a real-world cross-sectional study

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Abstract

Purpose

Disease symptom management in patients with advanced non-small cell lung cancer (NSCLC) is a critical aspect of therapy. The main objective of our study was to assess patient-reported outcomes and the degree of concordance between physician and patient perceptions of symptom severity in advanced NSCLC in the USA.

Methods

Patients with advanced (stage IIIB/IV) NSCLC (N = 450) were recruited in a nationwide (USA) lung cancer study. Patients and their oncologists completed patient and physician versions of the Lung Cancer Symptom Scale (LCSS). Patient-reported lung cancer-specific quality of life was assessed with the Functional Assessment of Cancer Therapy—Lung (FACT-L). Concordance was assessed using the kappa-statistic. Regression analysis was performed with FACT-L total score as the dependent variable and patient-reported LCSS symptom scores as predictors.

Results

A high proportion of patients experienced lung cancer symptoms: fatigue (100 %), loss of appetite (97 %), shortness of breath (95 %), cough (93 %), pain (92 %), and blood in sputum (63 %). Concordance between physician and patients was lowest for loss of appetite (kappa 0.1701) and greatest for hemoptysis (kappa 0.4586). Loss of appetite (β = −0.204; p < 0.001), cough (β = −0.145; p < 0.01), pain (β = −0.265; p < 0.001), and shortness of breath (β = −0.145; p < 0.01) were found to be significant predictors of the quality of life.

Conclusions

Symptom burden in patients with advanced NSCLC is high and has a negative impact on the quality of life. Patient-reported outcomes data could help optimize disease outcomes and therapy management in NSCLC.

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Acknowledgments

The Adelphi Lung Cancer Disease Specific Program was supported by Pfizer and other pharmaceutical companies; the collection of patient-reported outcomes and related analyses was sponsored by Pfizer Inc. Editorial assistance was provided by Martin Quinn at ACUMED® (Tytherington, UK) and funded by Pfizer Inc.

Conflicts of interest

Shrividya Iyer is an employee of Pfizer Inc. Adam Roughley, Alex Rider, and Gavin Taylor-Stokes are employees of Adelphi Real World, who were paid contractors to Pfizer Inc and were involved in study design, data collection, analyses, and manuscript preparation.

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Authors and Affiliations

  1. Global Health Economics & Outcomes Research, Pfizer Inc, 235, E 42nd Street, New York, NY, 10017, USA

    Shrividya Iyer

  2. Adelphi Real World (Manchester), Adelphi Mill, Bollington, Cheshire, UK

    Adam Roughley, Alex Rider & Gavin Taylor-Stokes

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  1. Shrividya Iyer
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  2. Adam Roughley
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Correspondence to Shrividya Iyer.

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Iyer, S., Roughley, A., Rider, A. et al. The symptom burden of non-small cell lung cancer in the USA: a real-world cross-sectional study. Support Care Cancer 22, 181–187 (2014). https://doi.org/10.1007/s00520-013-1959-4

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  • DOI: https://doi.org/10.1007/s00520-013-1959-4

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