Changes in and Determinants of Quality of Life in Patients With Advanced Non-Small-Cell Lung Cancer Undergoing Initial Chemotherapy

Yu-Lee Dai ； Cheng-Ta Yang ； Kang-Hua Chen ； Siew-Tzuh Tang

《The Journal of Nursing Research》 25卷3期 (2017/06) Pp. 203-215

https://doi.org/10.1097/jnr.0000000000000148

摘要

Background: Few studies have evaluated completely the changes in quality of life (QOL) that occur from pretreatment through the first four consecutive cycles of chemotherapy or determined its determinants in patients with advanced non-small-cell lung cancer (NSCLC). Purpose: The aim of this study was to explore the changes to and determinants of QOL in patients with advanced NSCLC under initial chemotherapy from pretreatment through Cycle 4 of chemotherapy. Methods: The QOL of 139 patients with advanced NSCLC was assessed from prechemotherapy through Cycle 4 of chemotherapy. Changes to and determinants of QOL were evaluated using multivariate linear regression, which used generalized estimation equation models. Results: No significant changes were observed in the global QOL or the physical, role, emotional, or cognitive functional domains of QOL during the course of chemotherapy. However, the social functional domain of QOL improved significantly at Cycle 3 in comparison with the prechemotherapy values. Better global QOL was determined as better performance status, less frequent physical symptoms, and less severe anxiety and depressive symptoms. Important determinants of better QOL in the five functional domains included younger age, better performance status, less frequent physical symptoms, less severe anxiety and depressive symptoms, and weaker perceived social support. Furthermore, patients who achieved a partial response after chemotherapy enjoyed stronger improvements in global QOL and the QOL emotional functional domain than those who did not. Conclusions: To help patients with advanced NSCLC optimize their QOL, healthcare professionals should enhance their ability to identify patients who are at elevated risk of poor QOL throughout the course of chemotherapy and to appropriately detect and manage the related physical symptoms and side effects, strengthen patients' social support, and lessen the anxiety and depressive symptoms of patients.

關鍵字

quality of life ； chemotherapy ； advanced non-small-cell lung cancer

參考文獻

Bloechl-Daum, B.,Deuson, R. R.,Mavros, P.,Hansen, M.,Herrstedt, J.(2006).Delayed nausea and vomiting continue to reduce patients' quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment.Journal of Clinical Oncology.24(27),4472-4478.

Burton, P.,Gurrin, L.,Sly, P.(1998).Extending the simple linear regression model to account for correlated responses: An introduction to generalized estimating equations and multi-level mixed modeling.Statistics in Medicine.17(11),1261-1291.

Cao, J.,Wang, Y.,Zhang, L.,Ma, L.(2011).Investigation of the change of quality of life and depression in lung cancer patients before and after chemotherapy.Chinese Journal of Lung Cancer.14(4),358-361.

Chen, L. K.,Liang, Y.,Yang, Q. Y.,Xu, F.,Zhou, N. N.,Xu, G. C.,Wei, W. D.(2012).Triplet platinum-based combination sequential chemotherapy improves survival outcome and quality of life of advanced non-small cell lung cancer patients.Asian Pacific Journal of Cancer Prevention.13(5),1863-1867.

Chen, M. L.,Yu, C. T.,Yang, C. H.(2008).Sleep disturbances and quality of life in lung cancer patients undergoing chemotherapy.Lung Cancer.62(3),391-400.