Quality of life measurement in cancer patients receiving palliative radiotherapy for symptomatic lung cancer: A literature review
Approximately 27% of North American cancer deaths are attributable to cancer of the lung. Many lung cancers are found at an advanced stage, rendering the tumours inoperable and the patients palliative. Common symptoms associated with palliative lung cancer include cough, hemoptysis, and dyspnea, which can significantly debilitate and diminish quality of life (QoL). In studies of the effects of cancer therapies, frequent evaluative endpoints are survival and prognosis; however, it is imperative that clinical trials with palliative patients have a QoL focus when a cure is unattainable. A literature review was conducted to investigate the use of QoL instrument tools in trials studying quality of life or symptom palliation of primary lung cancer or lung metastases through the use of radiotherapy. Forty-four studies were identified: 20 employed a QoL tool and 24 studies examined symptom palliation without the use of a QoL instrument. The EORTC QLQ-C30 survey was the most commonly used questionnaire employed in 14 of the 20 trials. Nine the 14 also incorporated the lung specific QoL survey EORTC QLQ-LC13(or EORTC QLQ-LC17). The second lung specific survey (FACT-L) was utilized in only 2 of the 20 trials. In total, only 11 out of 44 (25%) trials used a lung-specific QoL tool, suggesting low focus on QoL as an endpoint and underutilization of measures created for lung cancer patients. We encourage future trials to include specific QoL instruments like EORTC QLQ-LC13 or FACT-L more consistently for studies of palliative thoracic radiotherapy.