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Longitudinal patient-reported outcomes and survival among early-stage non-small cell lung cancer patients receiving stereotactic body radiotherapy.


ABSTRACT:

Background and purpose

The study objective was to determine whether longitudinal changes in patient-reported outcomes (PROs) were associated with survival among early-stage, non-small cell lung cancer (NSCLC) patients undergoing stereotactic body radiation therapy (SBRT).

Materials and methods

Data were obtained from January 2015 through March 2020. We ran a joint probability model to assess the relationship between time-to-death, and longitudinal PRO measurements. PROs were measured through the Edmonton Symptom Assessment Scale (ESAS). We controlled for other covariates likely to affect symptom burden and survival including stage, tumor diameter, comorbidities, gender, race/ethnicity, relationship status, age, and smoking status.

Results

The sample included 510 early-stage NSCLC patients undergoing SBRT. The median age was 73.8 (range: 46.3-94.6). The survival component of the joint model demonstrates that longitudinal changes in ESAS scores are significantly associated with worse survival (HR: 1.04; 95% CI: 1.02-1.05). This finding suggests a one-unit increase in ESAS score increased probability of death by 4%. Other factors significantly associated with worse survival included older age (HR: 1.04; 95% CI: 1.03-1.05), larger tumor diameter (HR: 1.21; 95% CI: 1.01-1.46), male gender (HR: 1.87; 95% CI: 1.36-2.57), and current smoking status (HR: 2.39; 95% CI: 1.25-4.56).

Conclusion

PROs are increasingly being collected as a part of routine care delivery to improve symptom management. Healthcare systems can integrate these data with other real-world data to predict patient outcomes, such as survival. Capturing longitudinal PROs-in addition to PROs at diagnosis-may add prognostic value for estimating survival among early-stage NSCLC patients undergoing SBRT.

SUBMITTER: Turner K 

PROVIDER: S-EPMC8934278 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Publications

Longitudinal patient-reported outcomes and survival among early-stage non-small cell lung cancer patients receiving stereotactic body radiotherapy.

Turner Kea K   Brownstein Naomi C NC   Thompson Zachary Z   El Naqa Issam I   Luo Yi Y   Jim Heather S L HSL   Rollison Dana E DE   Howard Rachel R   Zeng Desmond D   Rosenberg Stephen A SA   Perez Bradford B   Saltos Andreas A   Oswald Laura B LB   Gonzalez Brian D BD   Islam Jessica Y JY   Tabriz Amir Alishahi AA   Zhang Wenbin W   Dilling Thomas J TJ  

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 20211223


<h4>Background and purpose</h4>The study objective was to determine whether longitudinal changes in patient-reported outcomes (PROs) were associated with survival among early-stage, non-small cell lung cancer (NSCLC) patients undergoing stereotactic body radiation therapy (SBRT).<h4>Materials and methods</h4>Data were obtained from January 2015 through March 2020. We ran a joint probability model to assess the relationship between time-to-death, and longitudinal PRO measurements. PROs were measu  ...[more]

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