How does pulmonary function impact QoL in patients with locally advanced NSCLC treated with chemoradiotherapy and durvalumab?

IF 2.7 3区 医学 Q3 ONCOLOGY
Frigg Å Sommervoll, Henrik Horndalsveen, Dag Einar Sommervoll, Jussi Koivonen, Tarje Onsøien Halvorsen, Bjørn Henning Grønberg, Marianne Aanerud, Saulius Cicenas, Nina Helbekkmo, Jarkko Ahvonen, Maria Silvoniemi, Gina Barrera, Maria M Bjaanæs, Vilde Haakensen, Åsa Öjlert, Kersti Oselin, Åslaug Helland, Tesfaye Madebo
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Abstract

Background: Impaired pulmonary function is common among patients with lung cancer and may negatively affect health-related quality of life (HRQoL). The primary objective of the present sub-study of the DART-trial was to assess the overall quality of life changes during treatment and stratified by the presence of Chronic Obstructive Pulmonary Disease (COPD).

Methods: The investigator-initiated DART trial (NCT04392505) included patients with unresectable stage III non-small cell lung cancer (NSCLC) treated with chemoradiotherapy followed by durvalumab. Baseline pulmonary function was measured by spirometry, and patients were stratified by FEV1/FVC <70% (COPD) or ≥70% (non-COPD). HRQoL was assessed regularly using the EORTC QLQ-C30 and QLQ-LC13 questionnaires at screening and during treatment. A difference in mean score of ≥10 was defined as clinically significant.

Results: A total of 86 patients initiated durvalumab and completed at least one HRQoL assessment; pulmonary function data were available for 64 patients. For the overall cohort, quality of life scores remained stable throughout treatment. Patients with COPD consistently reported lower global health scores than those with preserved lung function. The global health score among patients with COPD was not significantly different at end of treatment compared to baseline, however significantly lower than patients without COPD. Symptom trajectories across QLQ-C30 scales were stable in both groups. Dyspnoea was more prevalent among patients with COPD. In the LC13 module, no clinically significant differences were observed except for dyspnoea, which was consistently higher among patients with COPD.

Interpretation: The HRQoL remained stable during chemoradiotherapy and durvalumab treatment in stage III NSCLC patients. Impaired lung function was associated with modestly lower HRQoL, though larger studies are needed to confirm subgroup effects.

在接受放化疗和杜伐单抗治疗的局部晚期NSCLC患者中,肺功能如何影响生活质量?
背景:肺功能受损在肺癌患者中很常见,并可能对健康相关生活质量(HRQoL)产生负面影响。目前dart试验的子研究的主要目的是评估治疗期间的总体生活质量变化,并根据慢性阻塞性肺疾病(COPD)的存在进行分层。方法:研究者发起的DART试验(NCT04392505)纳入了接受放化疗和杜伐单抗治疗的不可切除的III期非小细胞肺癌(NSCLC)患者。通过肺活量计测量基线肺功能,并通过FEV1/FVC对患者进行分层。结果:共有86例患者开始使用durvalumab并完成至少一次HRQoL评估;64例患者的肺功能数据可用。对于整个队列,生活质量评分在整个治疗过程中保持稳定。COPD患者报告的整体健康评分始终低于肺功能完好的患者。在治疗结束时,COPD患者的总体健康评分与基线相比无显著差异,但明显低于非COPD患者。两组在QLQ-C30量表上的症状轨迹均稳定。呼吸困难在COPD患者中更为普遍。在LC13模块中,除了呼吸困难外,没有观察到临床显著差异,而呼吸困难在COPD患者中一直较高。结论:III期NSCLC患者的HRQoL在放化疗和杜伐单抗治疗期间保持稳定。肺功能受损与较低的HRQoL相关,但需要更大规模的研究来证实亚组效应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta Oncologica
Acta Oncologica 医学-肿瘤学
CiteScore
4.30
自引率
3.20%
发文量
301
审稿时长
3 months
期刊介绍: Acta Oncologica is a journal for the clinical oncologist and accepts articles within all fields of clinical cancer research. Articles on tumour pathology, experimental oncology, radiobiology, cancer epidemiology and medical radio physics are also welcome, especially if they have a clinical aim or interest. Scientific articles on cancer nursing and psychological or social aspects of cancer are also welcomed. Extensive material may be published as Supplements, for which special conditions apply.
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