A randomized trial of the electronic Lung Cancer Symptom Scale for quality-of-life assessment in patients with advanced non-small-cell lung cancer
Introduction: Improving health-related quality of life (HRQL) is a key goal of systemic therapy in advanced lung cancer although routine assessment remains challenging. We aimed to analyze the impact of a real-time electronic HRQL tool, the eLCSS-QL, on palliative care referral (PCR) rates, patterns of chemotherapy treatment and use of other supportive interventions in patients with advanced non-small cell lung cancer (NSCLC) receiving first-line chemotherapy.
Methods: Patients with advanced NSCLC starting first-line chemotherapy were randomized to their oncologist receiving or not receiving their eLCSS-QL data before each clinic visit. Patients completed the eLCSS-QL scoring at baseline, prior to each chemotherapy cycle, and at subsequent follow-up visits until disease progression. Prospective data on PCR rate, HRQL and use of other supportive interventions were collected.
Results: A total of 95 advanced NSCLC patients participated. Oncologists received real-time eLCSS-QL data for 44 patients (eLCSS-QL arm) and used standard clinical assessment only (standard arm) for 51 patients. The primary end-point, the PCR rate, was numerically higher but statistically similar between patients in the eLCSS-QL and standard arms. HRQL scores over time were not significantly different between the two arms.
Conclusions: The eLCSS-QL is feasible as a tool for use in routine clinical practice, although no statistically significant impact was demonstrated in this study. Improving access to supportive care through the collection of patient reported outcomes and HRQL should be an important component of care for advanced lung cancer patients.