Recovery of quality of life in 574 patients with inoperable lung cancer undergoing (chemo)radiotherapy

Introduction: Quality of life (QoL) of patients with inoperable lung cancer can be negatively affected by both the disease and its treatment, generally consisting of (chemo)radiotherapy. The aim of this study was to prospectively assess QoL in patients with inoperable lung cancer, treated with (chemo)radiotherapy and to assess whether patient- and/or treatment-related characteristics were associated with poorer QoL.

Methods: This prospective cohort study evaluated QoL and patient-, tumor-, and treatment characteristics from inoperable lung cancer patients, treated with fractionated (≥40 Gy) (chemo)radiotherapy. Patients were evaluated at baseline, upon finishing radiotherapy, and 3 months, 6 months, 1 year, and yearly thereafter up to 5 years after radiotherapy. The QoL assessment consisted of questionnaires evaluating lung cancer-specific and treatment-related complaints using scale scores.

Results: Compliance rates of the 574 analyzed patients ranged from 87 to 97 % during follow-up. Complaints increased after radiotherapy, as the QoL scale scores increased from median 8 (interquartile range, IQR 4–14) to 17 (IQR 4–25) after completing radiotherapy (P < 0.0004), indicating more complaints. From 3 months to 24 months of follow-up, scale scores returned to a median of 13, but were significantly higher compared to baseline (P < 0.0004). However, no clinically relevant differences compared to baseline were observed. Patients with pulmonary comorbidity and WHO scores ≥ 2 generally reported more complaints.

Conclusion: Patients experienced a temporary increase in complaints after finishing (chemo)radiotherapy, QoL returned to baseline level and remained stable up to five years of follow-up.