Quality of life after the initial treatments of non-small cell lung cancer: a persistent predictor for patients' survival

{Background: Health-related quality of life (HRQoL) before treatment may predict survival of patients with non-small-cell lung cancer (NSCLC). We investigated the predictive role of HRQoL after the initial treatments, on the survival of these patients. Methods: A prospective multi-center study conducted in northeastern France. The SF-36 and European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core-30 (QLQ C-30) were mailed to patients 3 months after the end of the diagnostic process. High scores for functioning dimensions on both questionnaires indicated better QoL, and low scores for symptom dimensions on the QLQ C-30 indicated few symptoms. Cox regression modeling was used to identify predictive factors of survival. Results: In total, 230 (63.5%) patients responded to the SF-36 and QLQ C-30. Before completing the questionnaires, almost 60% of patients had undergone some chemotherapy, about 10% underwent radio/chemotherapy or both and more than 30% underwent surgery or surgery plus chemo/radiotherapy. On SF-36, the highest mean score was for social functioning dimension (55.5 +/- 28), and the lowest was for the physical role dimension (17.9 +/- 32.2). On QLQ C-30, for the functioning dimensions, the highest mean score was for cognitive functioning (74.6 +/- 25.9) and the lowest was for role functioning (47.2 +/- 34.1). For symptom dimensions, the lowest score was for diarrhoea (11.5 +/- 24.2) and the highest was for fatigue (59.7 +/- 27.7). On multivariate analysis, high bodily pain, social functioning and general health scores (SF-36) were associated with a lower risk of death (hazard ratio 0.580; 95% confidence interval [0.400-0.840]