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Longitudinal Changes in Function, Symptom Burden, and Quality of Life in Patients with Early-Stage Lung Cancer

  • Healthcare Policy and Outcomes
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Emerging evidence supports the integration of palliative care concurrently with disease-focused care in patients with serious illnesses, such as lung cancer. This paper describes how longitudinal changes in physical function, symptom burden, and QOL of patients with early-stage non-small cell lung cancer (NSCLC) informed the development of an interdisciplinary, tailored palliative care intervention.

Methods

Patients with early stage (I-IIIB) NSCLC were accrued into the usual care phase (Phase 1) of an NCI-funded Program Project Grant. Baseline and longitudinal (up to 52 weeks post-accrual) physical function, symptoms, and QOL were assessed in the thoracic ambulatory clinics of one NCI-designated Comprehensive Cancer Center. Outcome measures included geriatric assessments, psychological distress, symptoms, and QOL. The association between disease stage (I–II vs. III) and longitudinal changes in these domains was evaluated.

Results

A total of 103 patients were accrued. Stage I–II patients were significantly more likely to complete the study (p = 0.005). The stages (I–II vs. III) were equivalent at baseline on all demographic variables, clinical, and functional status. Physical function fluctuated longitudinally and was higher at 6 and 24 weeks than at baseline and 12 weeks. There was a longitudinal decrease in total number of symptoms (p < 0.001). Physical and social/family QOL fluctuated longitudinally (p < 0.001 and p = 0.016, respectively).

Conclusions

Patients with early-stage NSCLC report a significant longitudinal decrease in physical QOL, and fluctuations in objective and subjective measures of physical function over time were observed regardless of disease stage category. An interdisciplinary palliative care intervention is currently being tested to decrease symptom burden and improve QOL.

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Acknowledgment

The research described was supported by grant 5 P01 CA136396-02 from the National Cancer Institute. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute or NIH.

Disclosure

The authors have no conflicts of interest to report.

Author information

Authors and Affiliations

  1. Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA

    Marianna Koczywas MD, Mihaela Cristea MD & Karen Reckamp MD

  2. Nursing Research & Education,Department of Population Sciences, City of Hope, Duarte, CA, USA

    Anna Cathy Williams RN, BSN, PHN & Betty Ferrell PhD, FAAN, FPCN

  3. Thoracic Surgery, City of Hope, Duarte, CA, USA

    Frederic W. Grannis Jr. MD

  4. Pulmonary Critical Care, Department of Respiratory Diseases, City of Hope, Duarte, CA, USA

    Brian L. Tiep MD

  5. Vital Research, Los Angeles, CA, USA

    Gwen Uman PhD

Authors
  1. Marianna Koczywas MD
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  2. Anna Cathy Williams RN, BSN, PHN
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  3. Mihaela Cristea MD
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  4. Karen Reckamp MD
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  5. Frederic W. Grannis Jr. MD
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  6. Brian L. Tiep MD
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  7. Gwen Uman PhD
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  8. Betty Ferrell PhD, FAAN, FPCN
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Corresponding author

Correspondence to Betty Ferrell PhD, FAAN, FPCN.

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Koczywas, M., Williams, A.C., Cristea, M. et al. Longitudinal Changes in Function, Symptom Burden, and Quality of Life in Patients with Early-Stage Lung Cancer. Ann Surg Oncol 20, 1788–1797 (2013). https://doi.org/10.1245/s10434-012-2741-4

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  • DOI: https://doi.org/10.1245/s10434-012-2741-4

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