Background Identification of patient-related factors associated with Health-Related Quality of Life (HRQoL) and Quality of Life (QoL) at the start of treatment may identify patients who are prone to a decrease in HRQoL and/or QoL resulting from chemotherapy. Identification of these factors may offer opportunities to enhance patient care during treatment by adapting communication strategies and directing medical and psychological interventions. The aim was to examine the association of sociodemographic factors, personality traits, and depressive symptoms with HRQoL and QoL in patients with advanced-stage lung cancer at the start of chemotherapy. Methods Patients ( n = 151) completed the State-Trait Anxiety Inventory (trait anxiety subscale), the Neuroticism-Extraversion-Openness-Five Factor Inventory (NEO-FFI), the Center for Epidemiologic Studies Depression (CES-D), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Simple linear regression analyses were performed to select HRQoL and QoL associated factors (a P ≤ 0.10 was used to prevent non-identification of important factors) followed by multiple linear regression analyses ( P ≤ 0.05). Results In the multiple regression analyses, CES-D score (β = − 0.63 to − 0.53; P -values < 0.001) was most often associated with the WHOQOL-BREF domains and general facet, whereas CES-D score (β = − 0.67 to − 0.40; P -values < 0.001) and Eastern Cooperative Oncology Group (ECOG) performance status (β = − 0.30 to − 0.30; P -values < 0.001) were most often associated with the scales of the EORTC QLQ-C30. Personality traits were not related with HRQoL or QoL except for trait anxiety (Role functioning: β = 0.30; P = 0.02, Environment: β = − 0.39; P = 0.007) and conscientiousness (Physical health: β = 0.20; P -value < 0.04). Conclusions Higher scores on depressive symptoms and ECOG performance status were related to lower HRQoL and QoL in patients with advanced-stage non-small cell lung cancer. Supportive care interventions aimed at improvement of depressive symptoms and performance score may facilitate an increase of HRQoL and/or QoL during treatment.

In lung cancer, the preservation of well-being is warranted given the limited prognosis. Chemotherapy may negatively influence health-related quality of life (HRQoL) due to adverse events. However, patients’ judgement about this negative impact is not well understood. We examined the relationship between expectations, feelings about side effects, and satisfaction with therapy and (HR)QoL in advanced-stage thoracic cancer and investigated which of these factors has the highest impact on (HR)QoL.

To determine the psychometric properties and minimal clinically important differences (MCIDs) of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) in advanced stage lung cancer patients.

To gain insight into the patient-centered value of treatment harms and benefits, we prospectively evaluated the satisfaction with therapy (SWT) in patients with advanced non-small-cell lung cancer undergoing chemotherapy. Our results showed that SWT covers different aspects of patient-reported impact of the effect of treatment than quality of life and adverse events. Therefore, SWT could be useful in clinical decision-making. Introduction: In patients with advanced non-small-cell lung cancer, the treatment benefits and risks need to be constantly weighed. We explored patient-reported satisfaction with therapy (SWT) and assessed its value in addition to quality of life (QoL) and adverse events (AEs). Patients and Methods: In a prospective multicenter cohort study, patients with stage IIIB/IV non-small-cell lung cancer received platinum-pemetrexed chemotherapy. They completed the World Health Organization Quality of Life-BREF (WHOQoL-BREF) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) before and during chemotherapy. After the last cycle, patients reported on SWT, expectations of therapy, and feelings about side effects (FSE) using the Cancer Therapy Satisfaction Questionnaire. The explained variance (R-2) of QoL after treatment by SWT was calculated. Using multivariable linear regression, we examined the association of SWT with patient- and treatment-related variables, FSE, and AEs. Results: Eighty-nine patients finished 4 cycles of chemotherapy, 65 of whom completed the Cancer Therapy Satisfaction Questionnaire. Fifty-six patients (86.2%) would probably or definitely decide to undergo the same treatment again, regardless of deterioration or improvement in QoL or a high or low frequency of AEs during chemotherapy. The explained variance of QoL by SWT was greatest for the EORTC QLQ C-30 global health status/QoL scale (R-2 = 0.170). Patient age (beta = 0.43; 95% confidence interval [CI], 0.05-0.82), FSE (beta = 0.17; 95% CI, 0.06-0.29), and tumor response (beta = 7.93; 95% CI (1.64 to 14.22)) were independently associated with SWT. Conclusion: SWT could provide important supplementary information in addition to QoL assessments and treatment toxicities. Tumor response, older age, and FSE score were associated with better SWT. These insights could affect decision-making during palliative chemotherapy. (C) 2018 Elsevier Inc. All rights reserved.

Background: Depression and Health Related Quality of Life have been associated with prognosis in lung cancer. As the Distress Thermometer measures emotional problems and may share similarities with aspects of Health Related Quality of Life, we aimed to retrospectively assess the prognostic value of the Distress Thermometer in lung cancer patients treated with chemotherapy.Methods: Patients with stage III lung cancer who were treated at the day-care oncology unit with chemotherapy containing carboplatin from 2009 to 2014 and in whom a Distress Thermometer was performed at the time of the first cycle of chemotherapy were included in this study.Results: In total, one hundred and thirteen patients were included in the analysis. In the simple Cox regression analysis, overall survival did not significantly differ according to Distress Thermometer score. No significant differences in Distress Thermometer score according to stage, histology, (intended) treatment, age, sex, and comorbidity were observed. Also in a multivariable model the Distress Thermometer was not prognostic for overall survival, whereas sex and (intended) treatment was.Conclusions: In this study no prognostic value of the Distress Thermometer could be established in patients with stage III lung cancer treated with carboplatin. Further research is warranted to address this issue.

In advanced non-small cell lung cancer (NSCLC) treatment decisions regarding palliative chemotherapy are complex due to limited survival gain and treatment-related toxicities. Insight into determinants of patients' treatment satisfaction may impact decision-making and patient care. We determined the relation of patient- and treatment-related variables to treatment satisfaction. In a prospective observational multi-center study, patients with stage IIIB or IV NSCLC receiving pemetrexed (PEM)-based chemotherapy as first- or second-line treatment were enrolled. After four cycles of chemotherapy, patients completed the WHO Quality of Life-BREF (WHOQoL-BREF), which contains one item measuring overall QoL on a 1-5 scale, and the Cancer Therapy Satisfaction Questionnaire (CTSQ). The CTSQ was recently validated (Cheung et al, Qual Life Res. 2016;25(1):71-80). It consists of 16 items scored on a 1-5 scale and contains three domains. Only satisfaction with therapy (SWT) and feelings about side effects (FSE) were used. The domain scores range between 0-100, with higher scores representing better SWT and more positive FSE. We collected sociodemographic information and ECOG performance status at baseline. Adverse events (cancer- or therapy-related) during treatment were weekly registered (CTCAE 3.0). Tumor response measurements were obtained (RECIST 1.1). Patient- and treatment-related determinants uni-variably associated with SWT (p<0.05) were analyzed using multivariable linear regression (method: Enter). Of the 95 patients receiving four cycles of chemotherapy, 69 patients completed the CTSQ. The majority of these patients had stage IV NSCLC (87.7%) and received PEM-based therapy as first-line treatment (92.3%). Treatment resulted in stable disease (SD; 53.8%), partial response (PR; 40.0%) and progressive disease (PD; 6.2%). The mean SWT domain score was 79.6±13.1. Uni-variably, higher patients' age (p=0.034), tumor response (PR vs. SD or PD, p=0.040), overall QoL (p=0.008) and FSE (p=0.004) were significantly related to SWT. The frequency of (severe) adverse events was not associated with SWT (p=0.546). After including these variables in the multivariable analysis, only age (β=0.44; 95%CI (0.09-0.79)) and FSE (β=0.13; 95%CI (0.00-0.26) were independently related to SWT. Importantly, higher SWT in elderly supports the opinion that palliative chemotherapy should not be reserved for younger age groups. Although symptomatic adverse events are known key contributors to QoL, the frequency of (severe) adverse events was not related with SWT. However, in patients with better FSE treatment satisfaction was higher. Therefore, patients' education about and management of adverse events may have added value in maintaining patients' well-being during chemotherapy, ultimately resulting in higher treatment satisfaction. This study is funded by ZonMw, the Netherlands.

Background: Invasive pulmonary aspergillosis (IPA) is a life-threatening complication in immunocompromised patients. Early diagnosis and therapy improves outcome. Assessment of galactomannan (GM) in bronchoalveolar lavage (BAL) fluid is a proposed tool to diagnose IPA. Little is known about the diagnostic value of BAL GM in children. Materials and Methods: Retrospectively, 72 bronchoscopies were analyzed for GM in patients fulfilling the host factor criteria as defined by the EORTC/MSG. A cut-off index value GM of >= 0.5 was used. Clinical data, results of chest CT-scans and BAL cultures were collected. Results: Sensitivity, specificity, PPV, and NPV of BAL GM for a diagnosis of proven and probable IPA (n = 41) were 82.4%, 87.5%, 82.4%, and 87.5% respectively. A significant relation was found for BAL GM and abnormal chest CT (P = 0.01). No significant relationship was observed between BAL Aspergillus sp. culture and chest CT (n = 47). BAL GM and serum GM correlated significantly. In 9 out of 12 patients classified as possible IPA, antifungal therapy was continued or started, despite a negative BAL GM. Conclusions: BAL GM test had good diagnostic value in children suspected of IPA. However, the decision to continue or start antifungal therapy was mainly determined by the clinical suspicion of IPA based on chest CT-outcome, serum GM index values and failure of antibiotic therapy. (C) 2012 Wiley Periodicals, Inc.