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Cited by 120Lung Cancer Diagnosis and TreatmentLung Cancer Treatments and MutationsLung Cancer Research Studies

Influence of comorbidity on survival, toxicity and health-related quality of life in patients with advanced non-small-cell lung cancer receiving platinum-doublet chemotherapy

Grønberg, Bjørn H., Sundstrøm, Stein, Kaasa, Stein, Bremnes, Roy M., Fløtten, Øystein, Amundsen, Tore, Hjelde, Harald H., Plessen, Christian von +1 more·2010·European Journal of Cancer
DOI 10.1016/j.ejca.2010.04.009
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Abstract

Aim of the study To investigate whether patients with severe comorbidity receiving platinum-based chemotherapy for advanced non-small-cell lung cancer (NSCLC) have a shorter overall survival, experience more toxicity or more deterioration of health-related quality of life (HRQoL) than other patients during treatment.Patients and methods Patients enrolled onto a phase III trial comparing pemetrexed/carboplatin with gemcitabine/carboplatin as first-line therapy of stage IIIB/IV NSCLC were analysed. Eligible patients had performance status 0-2 and adequate kidney/liver/bone-marrow function. Comorbidity was assessed from hospital medical records using the Cumulative Illness Rating Scale for Geriatrics (CIRS-G). Toxicity was graded using the CTCAE v3.0 and the patients reported HRQoL on the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30/LC13.Results Data from 402 of the 436 of the patients enrolled onto the phase III trial were analysed. The patients with severe comorbidity had similar survival as other patients (6.9 versus 8.1months; p=.34), similar frequency of neutropenia (48% versus 42%; p=.16), but experienced more neutropenic fevers (12% versus 5%; p=.012) and deaths from neutropenic infections (3% versus 0%; p=.027). They had more thrombocytopenia (46% versus 36%; p=.03), but not more thrombocytopenic bleedings (3% versus 4%; p=.65). In general, the patients with severe comorbidity reported poorer HRQoL, but not significantly more deterioration of HRQoL.Conclusions The results from our study suggest that patients with advanced NSCLC who have severe co-existing disorders benefit from and tolerate platinum-doublet chemotherapy as well as other patients. They do, however, appear to have a higher risk of acquiring infections when neutropenic.

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Authors
Grønberg, B. H., Sundstrøm, S., Kaasa, S., Bremnes, R. M., Fløtten, Ø., Amundsen, T., Hjelde, H. H., Plessen, C. V., & Jordhøy, M.
Affiliations
  • Norwegian University of Science and Technology (NO)
  • University Hospital of North Norway (NO)
  • Haukeland University Hospital (NO)
  • St Olav's University Hospital (NO)
  • Oslo University Hospital (NO)
Corresponding author
Grønberg, Bjørn H.
ORCID
Venue
European Journal of Cancer
Publisher
Elsevier BV
Published
2010-08
Volume
46
Issue
12
Pages
2225-2234
ISSN
0959-8049 (ISSN-L)
DOI
10.1016/j.ejca.2010.04.009
OpenAlex
W2013072422
Cited by
120
References
29
Citations by year
2026: 3 · 2025: 1 · 2024: 5 · 2023: 4 · 2022: 5 · 2021: 9 · 2020: 8 · 2019: 11 · 2018: 16 · 2017: 6 · 2016: 10 · 2015: 10 · 2014: 6 · 2013: 11 · 2012: 8
FWCI
6.94
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • European Journal of Cancer (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
  • Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
Keywords
comorbidities, advanced non-small cell lung cancer, platinum-based chemotherapy, carboplatin, pemetrexed, gemcitabine, overall survival, chemotherapy toxicity, febrile neutropenia, neutropenic infection, thrombocytopenia, health-related quality of life, CIRS-G, first-line therapy
MeSH terms
Gemcitabine, Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Non-Small-Cell Lung, Deoxycytidine, Female, Hematologic Diseases, Humans, Lung Neoplasms, Male, Middle Aged, Neutropenia, Quality of Life, Surveys and Questionnaires, Thrombocytopenia, Comorbidity, Carboplatin, Disease-Free Survival, Young Adult

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