Abstract: In a randomized trial, patients with inoperable non-small cell lung cancer with limited disease were randomly given either radiotherapy (42 Gy) or combination chemotherapy with cisplatin, 70 mg/m2, and etoposide, 100 mg/m2, given every third week with a maximum of 4 cycles. The patients were asked to fill in a questionnaire concerning psychosocial well-being, medical and treatment related symptoms, physical function and everyday activity. Of the chemotherapy patients 61% reported nausea 5 weeks after their last chemotherapy session and 44% had spells of vomiting. Only 14% of the radiotherapy patients had nausea and 5% vomited 14 weeks after start of treatment. Of the radiotherapy patients 64% experienced dysphagia compared to 8% of the chemotherapy patients 6 weeks after the start of treatment.
Abstract: The quality of life of patients treated with radiotherapy and chemotherapy for non-small cell lung cancer is compared in a randomized study. A standardized questionnaire composed of 12 questions covering psychosocial well-being (10 question index), and global quality of life evaluation (2 questions) was used to evaluate the patient's quality of life. Data were collected before treatment was started and at 7 different occasions up to 52 weeks after the beginning of the first treatment. The psychosocial well-being index and the 2 global questions were found to have a high degree of validity in a previous study. Two weeks after the start of treatment, the psychosocial well-being index for patients receiving radiotherapy was significantly higher than for patients treated by cytostatic drugs. This observation was confirmed by the 2 global questions. No differences in the quality of life were detected in the follow-up period (6-52 weeks).
Abstract: A combination of cisplatin (70 mg/m2 i.v. day one) and etoposide (100 mg/m2 i.v. day one, 200 mg/m2 orally days 2 and 3) repeated every third week to a maximum of 4 cycles were compared with high voltage radiotherapy, 42 Gy given in 15 fractions over a 3-week period to patients with inoperable non-small cell lung cancer (a shield was used in the posterior field to reduce the total spinal dose less than 40 Gy). One hundred and eighteen patients received radiotherapy; the median survival was 10.6 months compared to 10.5 months for the 116 chemotherapy patients (p = 0.81). The objective response rate (CR + PR) was 42% for the radiotherapy and 21% for the chemotherapy group (p = 0.009). At progression it was optional to cross over to the other treatment modality or to receive phase II chemotherapy. Thirty patients primarily treated with radiotherapy and 54 allocated to chemotherapy received second line antineoplastic treatment.
Abstract: Patients with inoperable non-small cell lung cancer, limited disease, were randomized to either chemotherapy (cisplatin and etoposide) or radiotherapy of the thorax. A set of questionnaires, covering 4 areas: psychosocial well-being, medical side effects, physical function, and everyday activity was filled out by 101 patients. The correlations between psychosocial well-being (dependent variable) on the one hand, and medical side effects, physical function, and everyday activity (independent variables) on the other were subjected to multiple regression analysis. No significant correlation was found between psychosocial well-being and chemotherapy- or radiotherapy-related subjective side effects. The disease-related symptoms correlated highly with psychosocial well-being during the observation period. Psychosocial well-being and the independent variables tended to be more strongly correlated during the follow-up period (14-52 weeks) than during the treatment period.
Abstract: In order to assess the quality of life of patients with inoperable lung cancer, a questionnaire for patient self-administration with 29 variables was designed including the following subjects: psychosocial well-being, medical side-effects, activities of daily living and physical performance. The questionnaire was validated by using a semistructured interview. Thirty-one patients treated for inoperable lung cancer with either radiotherapy (42%), chemotherapy (42%) or a combination of these two treatment modalities (16%) were included in the study. The multitrait-multimethod matrix (MTMM) was used in the analysis of the construct validity. The present validation study showed a high degree of validity for the majority of the items studied. Some of the items showed a low degree of validity, and are subject to future analysis in large scale studies.
Abstract: Neuropsychological tests were used to evaluate possible central nervous system dysfunction in patients treated with chemotherapy. Ninety-five patients with non-small cell lung cancer limited disease were randomized to either radiotherapy (2.8 Gy x 15) or combination chemotherapy with cisplatin and etoposide. In order to evaluate cognitive functions three neuropsychological tests were applied: Trail Making, Benton Visual Retention Test and Verbal Learning. Changes in the patients' test scores before and after treatment were compared. The chemotherapy patients showed reduced performance on some of the neuropsychological tests compared to the radiotherapy group. This indicates a treatment related effect on the central nervous system, possibly caused by the combination chemotherapy.
