Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, ON, M5G2M9, Canada.
Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Qual Life Res. 2021 Feb;30(2):445-454. doi: 10.1007/s11136-020-02615-1. Epub 2020 Aug 26.
Small cell lung cancer (SCLC) is a highly fatal disease associated with significant morbidity, with a need for real-world symptom and health utility score (HUS) data. HUS can be measured using an EQ-5D-5L questionnaire, however most captured data is available in non-SCLC (NSCLC) only. As new treatment regimens become available in SCLC it becomes important to understand factors which influence health-related quality of life and health utility.
A prospective observational cohort study (2012-2017) of ambulatory histologically confirmed SCLC evaluated patient-reported EQ-5D-5L-derived HUS, toxicity and symptoms. A set of NSCLC patients was used to compare differential factors affecting HUS. Clinical and demographic factors were evaluated for differential interactions between lung cancer types. Comorbidity scores were documented for each patient.
In 75 SCLC and 150 NSCLC patients, those with SCLC had lower mean HUS ((SCLC vs NSCLC: mean 0.69 vs 0.79); (p < 0.001)) when clinically stable and with progressive disease: ((SCLC mean HUS = 0.60 vs NSCLC mean HUS = 0.77), (p = 0.04)). SCLC patients also had higher comorbidity scores ((1.11 vs 0.73); (p < 0.015)). In multivariable analyses, increased symptom severity and comorbidity scores decreased HUS in both SCLC and NSCLC (p < 0.001); however, only comorbidity scores differentially affected HUS (p < 0.0001), with a greater reduction of HUS adjusted per unit of comorbidity in SCLC.
Patients with advanced SCLC had significantly lower HUS than NSCLC. Both patient cohorts are impacted by symptoms and comorbidity, however, comorbidity had a greater negative effect in SCLC patients.
小细胞肺癌（SCLC）是一种高度致命的疾病，与显著的发病率相关，需要真实世界的症状和健康效用评分（HUS）数据。HUS 可以使用 EQ-5D-5L 问卷进行测量，但是大多数捕获的数据仅适用于非小细胞肺癌（NSCLC）。随着新的治疗方案在 SCLC 中的应用，了解影响健康相关生活质量和健康效用的因素变得非常重要。
一项前瞻性观察队列研究（2012-2017 年），对门诊组织学证实的 SCLC 患者进行了患者报告的 EQ-5D-5L 衍生的 HUS、毒性和症状评估。一组 NSCLC 患者用于比较影响 HUS 的差异因素。评估了临床和人口统计学因素对肺癌类型之间的差异相互作用。为每位患者记录了合并症评分。
在 75 例 SCLC 和 150 例 NSCLC 患者中，在临床稳定和进展性疾病时，SCLC 患者的平均 HUS 较低（（SCLC 与 NSCLC：平均 0.69 与 0.79）；（p<0.001））：（（SCLC 平均 HUS=0.60 与 NSCLC 平均 HUS=0.77），（p=0.04））。SCLC 患者的合并症评分也较高（（1.11 与 0.73）；（p<0.015））。在多变量分析中，症状严重程度和合并症评分的增加降低了 SCLC 和 NSCLC 患者的 HUS（p<0.001）；然而，只有合并症评分对 HUS 有差异影响（p<0.0001），SCLC 患者每单位合并症的 HUS 调整值降低幅度更大。
晚期 SCLC 患者的 HUS 明显低于 NSCLC。两个患者队列都受到症状和合并症的影响，但在 SCLC 患者中，合并症的负面影响更大。
