期刊
RADIOTHERAPY AND ONCOLOGY
卷 167, 期 -, 页码 116-121出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.radonc.2021.12.021
关键词
SBRT; Lung cancer; Non small cell; Patient reported outcomes
资金
- Moffitt Lung Cancer Center of Excellence
- Participant Research, Interventions, and Measurements Core Facility at the H. Lee Moffitt Cancer Center & Research Institute, an NCI designated Comprehensive Cancer Center [5P30 CA076292-22]
The objective of this study was to investigate the association between longitudinal changes in patient-reported outcomes (PROs) and survival among early-stage non-small cell lung cancer (NSCLC) patients undergoing stereotactic body radiation therapy (SBRT). The results showed that longitudinal changes in ESAS scores were significantly associated with worse survival, and other factors including age, tumor diameter, gender, and smoking status were also significantly associated with worse survival.
Background and purpose: The study objective was to determine whether longitudinal changes in patient-reported outcomes (PROs) were associated with survival among early-stage, non-small cell lung cancer (NSCLC) patients undergoing stereotactic body radiation therapy (SBRT). Materials and methods: Data were obtained from January 2015 through March 2020. We ran a joint probability model to assess the relationship between time-to-death, and longitudinal PRO measurements. PROs were measured through the Edmonton Symptom Assessment Scale (ESAS). We controlled for other covariates likely to affect symptom burden and survival including stage, tumor diameter, comorbidities, gender, race/ethnicity, relationship status, age, and smoking status. Results: The sample included 510 early-stage NSCLC patients undergoing SBRT. The median age was 73.8 (range: 46.3-94.6). The survival component of the joint model demonstrates that longitudinal changes in ESAS scores are significantly associated with worse survival (HR: 1.04; 95% CI: 1.02-1.05). This finding suggests a one-unit increase in ESAS score increased probability of death by 4%. Other factors significantly associated with worse survival included older age (HR: 1.04; 95% CI: 1.03-1.05), larger tumor diameter (HR: 1.21; 95% CI: 1.01-1.46), male gender (HR: 1.87; 95% CI: 1.36-2.57), and current smoking status (HR: 2.39; 95% CI: 1.25-4.56). Conclusion: PROs are increasingly being collected as a part of routine care delivery to improve symptom management. Healthcare systems can integrate these data with other real-world data to predict patient outcomes, such as survival. Capturing longitudinal PROs-in addition to PROs at diagnosis-may add prognostic value for estimating survival among early-stage NSCLC patients undergoing SBRT. (C) 2021 Elsevier B.V. All rights reserved.
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