Treatment Satisfaction of Patients With Advanced Non–Small-cell Lung Cancer Receiving Platinum-based Chemotherapy

To gain insight into the patient-centered value of treatment harms and benefits, we prospectively evaluated the satisfaction with therapy (SWT) in patients with advanced non–small-cell lung cancer undergoing chemotherapy. Our results showed that SWT covers different aspects of patient-reported impact of the effect of treatment than quality of life and adverse events. Therefore, SWT could be useful in clinical decision-making. Introduction: In patients with advanced non–small-cell lung cancer, the treatment benefits and risks need to be constantly weighed. We explored patient-reported satisfaction with therapy (SWT) and assessed its value in addition to quality of life (QoL) and adverse events (AEs). Patients and Methods: In a prospective multicenter cohort study, patients with stage IIIB/IV non–small-cell lung cancer received platinum-pemetrexed chemotherapy. They completed the World Health Organization Quality of Life-BREF (WHOQoL-BREF) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) before and during chemotherapy. After the last cycle, patients reported on SWT, expectations of therapy, and feelings about side effects (FSE) using the Cancer Therapy Satisfaction Questionnaire. The explained variance (R2) of QoL after treatment by SWT was calculated. Using multivariable linear regression, we examined the association of SWT with patient- and treatment-related variables, FSE, and AEs. Results: Eighty-nine patients finished 4 cycles of chemotherapy, 65 of whom completed the Cancer Therapy Satisfaction Questionnaire. Fifty-six patients (86.2%) would probably or definitely decide to undergo the same treatment again, regardless of deterioration or improvement in QoL or a high or low frequency of AEs during chemotherapy. The explained variance of QoL by SWT was greatest for the EORTC QLQ C-30 global health status/QoL scale (R2 = 0.170). Patient age (β = 0.43; 95% confidence interval [CI], 0.05-0.82), FSE (β = 0.17; 95% CI, 0.06-0.29), and tumor response (β = −7.93; 95% CI −14.22 to −1.64) were independently associated with SWT. Conclusion: SWT could provide important supplementary information in addition to QoL assessments and treatment toxicities. Tumor response, older age, and FSE score were associated with better SWT. These insights could affect decision-making during palliative chemotherapy.

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