Impact of comprehensive geriatric assessment on quality of life, overall survival, and unplanned admission in patients with non-small cell lung cancer treated with stereotactic body radiotherapy

Stefan S Jeppesen, Lars-Erik Matzen, Carsten Brink, Rasa Bliucukiene, Søren Kasch, Tine Schytte, Charlotte Kristiansen, Olfred Hansen

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

OBJECTIVES: Overall survival ﴾OS﴿ for patients with localized non-small cell lung cancer ﴾NSCLC﴿ treated with stereotactic body radiotherapy ﴾SBRT﴿ is poorer than for patients undergoing surgery. Patients who undergo SBRT are often ineligible for surgery due to significant comorbidities that can impact their mortality. A comprehensive geriatric assessment (CGA) that identifies and treats aging related comorbidities could improve OS and quality of life (QoL). This randomized study investigated if a CGA added to SBRT impacts QoL, survival, and unplanned admissions.

MATERIALS AND METHODS: From January 2015 to June 2016, 51 patients diagnosed with T1-2N0M0 NSCLC treated with SBRT were enrolled. The patients were randomized 1:1 to receive SBRT +/- CGA. EuroQoL Group 5D (EQ-5D) health index and visual analogue scale (VAS) scores were assessed at start of SBRT, at five weeks, and every third month for a year after SBRT.

RESULTS: There were 26 and 25 patients randomized to receive ± CGA, respectively. The repeated measures one-way analysis of variance (ANOVA) test of the EQ-5D health index and VAS scores did not show statistically significant differences between groups. For the EQ-5D VAS scores at twelve months follow-up there was a small difference between the groups although not statistically significant. Even though more patients deceased in the no-CGA group, no statistically significant difference in survival rates and unplanned admission rate was observed between groups.

CONCLUSION: In patients with localized NSCLC treated with SBRT, a CGA did not impact the overall QoL, the prevalence/length of unplanned admissions, or survival. There was an indication of small differences in QoL and survival in the data, but such differences can only be validated in larger studies.

Original languageEnglish
JournalJournal of Geriatric Oncology
Volume9
Issue number6
Pages (from-to)575-582
ISSN1879-4068
DOIs
Publication statusPublished - Nov 2018

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Geriatric Assessment
Radiosurgery
Patient Admission
Quality of Life
Visual Analog Scale
Comorbidity
Health
Survival Rate

Keywords

  • Comprehensive geriatric assessment
  • Frailty
  • Non-small cell lung cancer
  • Overall survival
  • Quality of life
  • Randomized study
  • Stereotactic body radiation therapy

Cite this

@article{23038f3a673f4886ad637c682468a38a,
title = "Impact of comprehensive geriatric assessment on quality of life, overall survival, and unplanned admission in patients with non-small cell lung cancer treated with stereotactic body radiotherapy",
abstract = "OBJECTIVES: Overall survival ﴾OS﴿ for patients with localized non-small cell lung cancer ﴾NSCLC﴿ treated with stereotactic body radiotherapy ﴾SBRT﴿ is poorer than for patients undergoing surgery. Patients who undergo SBRT are often ineligible for surgery due to significant comorbidities that can impact their mortality. A comprehensive geriatric assessment (CGA) that identifies and treats aging related comorbidities could improve OS and quality of life (QoL). This randomized study investigated if a CGA added to SBRT impacts QoL, survival, and unplanned admissions.MATERIALS AND METHODS: From January 2015 to June 2016, 51 patients diagnosed with T1-2N0M0 NSCLC treated with SBRT were enrolled. The patients were randomized 1:1 to receive SBRT +/- CGA. EuroQoL Group 5D (EQ-5D) health index and visual analogue scale (VAS) scores were assessed at start of SBRT, at five weeks, and every third month for a year after SBRT.RESULTS: There were 26 and 25 patients randomized to receive ± CGA, respectively. The repeated measures one-way analysis of variance (ANOVA) test of the EQ-5D health index and VAS scores did not show statistically significant differences between groups. For the EQ-5D VAS scores at twelve months follow-up there was a small difference between the groups although not statistically significant. Even though more patients deceased in the no-CGA group, no statistically significant difference in survival rates and unplanned admission rate was observed between groups.CONCLUSION: In patients with localized NSCLC treated with SBRT, a CGA did not impact the overall QoL, the prevalence/length of unplanned admissions, or survival. There was an indication of small differences in QoL and survival in the data, but such differences can only be validated in larger studies.",
keywords = "Comprehensive geriatric assessment, Frailty, Non-small cell lung cancer, Overall survival, Quality of life, Randomized study, Stereotactic body radiation therapy",
author = "Jeppesen, {Stefan S} and Lars-Erik Matzen and Carsten Brink and Rasa Bliucukiene and S{\o}ren Kasch and Tine Schytte and Charlotte Kristiansen and Olfred Hansen",
note = "Copyright {\circledC} 2017 Elsevier Inc. All rights reserved.",
year = "2018",
month = "11",
doi = "10.1016/j.jgo.2018.05.009",
language = "English",
volume = "9",
pages = "575--582",
journal = "Journal of Geriatric Oncology",
issn = "1879-4068",
publisher = "Elsevier",
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}

TY - JOUR

T1 - Impact of comprehensive geriatric assessment on quality of life, overall survival, and unplanned admission in patients with non-small cell lung cancer treated with stereotactic body radiotherapy

AU - Jeppesen, Stefan S

AU - Matzen, Lars-Erik

AU - Brink, Carsten

AU - Bliucukiene, Rasa

AU - Kasch, Søren

AU - Schytte, Tine

AU - Kristiansen, Charlotte

AU - Hansen, Olfred

N1 - Copyright © 2017 Elsevier Inc. All rights reserved.

PY - 2018/11

Y1 - 2018/11

N2 - OBJECTIVES: Overall survival ﴾OS﴿ for patients with localized non-small cell lung cancer ﴾NSCLC﴿ treated with stereotactic body radiotherapy ﴾SBRT﴿ is poorer than for patients undergoing surgery. Patients who undergo SBRT are often ineligible for surgery due to significant comorbidities that can impact their mortality. A comprehensive geriatric assessment (CGA) that identifies and treats aging related comorbidities could improve OS and quality of life (QoL). This randomized study investigated if a CGA added to SBRT impacts QoL, survival, and unplanned admissions.MATERIALS AND METHODS: From January 2015 to June 2016, 51 patients diagnosed with T1-2N0M0 NSCLC treated with SBRT were enrolled. The patients were randomized 1:1 to receive SBRT +/- CGA. EuroQoL Group 5D (EQ-5D) health index and visual analogue scale (VAS) scores were assessed at start of SBRT, at five weeks, and every third month for a year after SBRT.RESULTS: There were 26 and 25 patients randomized to receive ± CGA, respectively. The repeated measures one-way analysis of variance (ANOVA) test of the EQ-5D health index and VAS scores did not show statistically significant differences between groups. For the EQ-5D VAS scores at twelve months follow-up there was a small difference between the groups although not statistically significant. Even though more patients deceased in the no-CGA group, no statistically significant difference in survival rates and unplanned admission rate was observed between groups.CONCLUSION: In patients with localized NSCLC treated with SBRT, a CGA did not impact the overall QoL, the prevalence/length of unplanned admissions, or survival. There was an indication of small differences in QoL and survival in the data, but such differences can only be validated in larger studies.

AB - OBJECTIVES: Overall survival ﴾OS﴿ for patients with localized non-small cell lung cancer ﴾NSCLC﴿ treated with stereotactic body radiotherapy ﴾SBRT﴿ is poorer than for patients undergoing surgery. Patients who undergo SBRT are often ineligible for surgery due to significant comorbidities that can impact their mortality. A comprehensive geriatric assessment (CGA) that identifies and treats aging related comorbidities could improve OS and quality of life (QoL). This randomized study investigated if a CGA added to SBRT impacts QoL, survival, and unplanned admissions.MATERIALS AND METHODS: From January 2015 to June 2016, 51 patients diagnosed with T1-2N0M0 NSCLC treated with SBRT were enrolled. The patients were randomized 1:1 to receive SBRT +/- CGA. EuroQoL Group 5D (EQ-5D) health index and visual analogue scale (VAS) scores were assessed at start of SBRT, at five weeks, and every third month for a year after SBRT.RESULTS: There were 26 and 25 patients randomized to receive ± CGA, respectively. The repeated measures one-way analysis of variance (ANOVA) test of the EQ-5D health index and VAS scores did not show statistically significant differences between groups. For the EQ-5D VAS scores at twelve months follow-up there was a small difference between the groups although not statistically significant. Even though more patients deceased in the no-CGA group, no statistically significant difference in survival rates and unplanned admission rate was observed between groups.CONCLUSION: In patients with localized NSCLC treated with SBRT, a CGA did not impact the overall QoL, the prevalence/length of unplanned admissions, or survival. There was an indication of small differences in QoL and survival in the data, but such differences can only be validated in larger studies.

KW - Comprehensive geriatric assessment

KW - Frailty

KW - Non-small cell lung cancer

KW - Overall survival

KW - Quality of life

KW - Randomized study

KW - Stereotactic body radiation therapy

U2 - 10.1016/j.jgo.2018.05.009

DO - 10.1016/j.jgo.2018.05.009

M3 - Journal article

C2 - 29871849

VL - 9

SP - 575

EP - 582

JO - Journal of Geriatric Oncology

JF - Journal of Geriatric Oncology

SN - 1879-4068

IS - 6

ER -