1442 - Survival prediction in ambulatory stage III/ IV non small cell lung cancer patients using the palliative performance scale, ECOG and lung cancer sym...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Non-Small-Cell Lung Cancer, Locally Advanced
Non-Small-Cell Lung Cancer, Metastatic
Palliative Care
Presenter Roozbeh Mohajer
Authors R. Mohajer1, S. Nathan2, K. Wells2, N. Kern2, M. Batus3, M. Fidler3, P. Bonomi3, S. O'Mahony2
  • 1Hematology And Oncology, Stroger Hospital of Cook County, 60612 - chicago/US
  • 2Palliative Care, Rush University Medical Center, 60614 - chicago/US
  • 3Hematology And Oncology, Rush University Medical Center, 60614 - chicago/US

Abstract

Objectives

Patients with advanced NSCLC have a life expectancy of less than one year, therefore, it is important to maximize their quality of life and to find a tool that gives the patients more accurate means of survival prediction.

Materials

The Palliative Performance Scale has been designed and used for patients with far advanced disease for predicting survival probabilities. It has five functional dimensions: ambulation, activity level and evidence of disease, self-care, oral intake, and level of consciousness. It is scored in 11 levels from PPS 0 % to PPS 100% in 10 percent increments- PPS 0% represents death and PPS 100% represents fully ambulatory and healthy status.

PPS has been shown to be an effective tool in life expectancy prognostication in palliative and hospice patients. The value of PPS in ambulatory cancer patients has not been examined to date.

The Lung Cancer Symptom Scale is a tool designed to measure the quality of life of lung cancer patients. It evaluates six major symptoms associated with lung malignancies and their affect on overall symptomatic distress and activity.

We evaluated 62 adult patients with stage III or IV NSCLC in the thoracic oncology clinic. All of them had ECOG 1 or greater at the time of baseline evaluation. Symptoms and performance status were evaluated at baseline for 62 patients, of those 54 patients followed- up after 4 week using LCCS, PPS and ECOG.

Results and conclusions

54 patients completed baseline and follow-up measures. The mean age for patients was 63.7 years. 63% were receiving active chemotherapy at the time of evaluation. Seventeen patients died. Mean (range) baseline measures score were as follows: LCSS 6.18(1-14); PPS 66.6(40-90) and 1.82(1-4) for the ECOG. Censored survival times were calculated from the enrollment of the first subject for 380 days. The last subject was recruited 357 days after the first subject. A proportional hazardous model was computed for survival status. Hazards ratios for death were 1.25(p= 0.013) for LCCS, 2.12(p= 0.027) for the ECOG and 1.02 for PPS (p= 0.49). The LCCS performed best as a predictor of prognosis in this study. Further analysis will include an assessment of association between symptom clusters and biomarkers. The PPS only functioned well as a predictor of survival time in patients receiving active treatment for advanced cancer.

Disclosure

All authors have declared no conflicts of interest.