SCLC accounts for approximately 15% of all lung cancers and has a poorer prognosis and more aggressive course than other lung carcinomas. However, little is known about the humanistic burden of SCLC, specifically the impact on HRQoL. The objective of this study was to explore the impact of SCLC on HRQoL.
A systematic literature review was conducted using specific search terms in Medline® in process (PubMed), Embase, and PsycINFO. Searches were limited to human studies and the past 10 years (2005–March 2016). Additional pragmatic searches were conducted of oncology organisation websites and conference proceedings. A total of 373 articles were retrieved. Two reviewers independently screened titles and abstracts for eligibility. Fifty-eight articles were selected for full-text review, with 27 of these being deemed eligible for inclusion (clinical trials [n = 18], observational studies [n = 7], and qualitative studies [n = 2]).
Most articles provided data on limited and extensive stage SCLC. The most commonly used patient-reported outcomes (PROs) to assess SCLC impact on HRQoL were the EORTC QLQ-C30 (n = 15), often supplemented by the lung or brain cancer module (n = 7), and the Lung Cancer Symptom Scale (n = 5). SCLC patients had significantly impacted overall HRQoL, which was lower than normative reference values. HRQoL deteriorated further as disease progressed. Specific HRQoL domains most commonly reported included activities of daily living (ADL; n = 11), and physical (n = 10), emotional (n = 10), and cognitive functioning (n = 9). Differential impacts on each of these domains were noted, with ADL being the most severely impacted and emotional and cognitive functioning being the least. There was a difference in HRQoL between clinical trial and real world studies. Not all therapies provided improved or stable HRQoL, which may be due to tolerability differences.
These findings show that SCLC progression and treatment have a substantial impact on overall HRQoL and some of the HRQoL subdomains. Further research on the impact on specific HRQoL domains is required. Capturing HRQoL data in SCLC may help patients and clinicians make informed treatment choices.
Clinical trial identification
Not applicable to this study
Legal entity responsible for the study
C. Panter, B. Bennett: Research was sponsored by BMS. Y. Yuan, J. Penrod: Research was sponsored by BMS, co-author is an employee of BMS.