Role of Quality of Life in Daily Functioning, Communication with Care Teams, and Treatment Decisions in Patients with ALK+ NSCLC

生活质量在ALK阳性非小细胞肺癌患者的日常功能、与医疗团队的沟通以及治疗决策中的作用

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Abstract

INTRODUCTION: This study investigated quality of life (QoL) and its role in treatment decision making among patients with anaplastic lymphoma kinase (ALK)+ NSCLC. METHODS: Adult patients with self-reported ALK+ NSCLC residing in the United States from the Lung Cancer Registry from GO2 for Lung Cancer were included. Measures included a core patient survey derived from Quality of Life Questionnaire - Core 30 items (QLQ-C30) and QLQ - lung cancer module 29 items domains and an ALK+ NSCLC module (ALK module). Associations were assessed between key domains and module questions using polyserial or Spearman's correlations and Cochran-Mantel-Haenszel tests. RESULTS: Seventy-one patients with ALK+ NSCLC completed the ALK module. Most patients (85%) felt their current therapy helped stop cancer growth, helped them live longer, and was worth taking despite side effects; however, 80% reported some cancer scan-related anxiety and only 32% reported having received "quite a bit" or "very much" mental health support information from their care team. Most patients (75%) reported QoL as a top concern in treatment decisions, regardless of responses to other ALK module questions (all associations p ≥ 0.50). Although most patients (87%) perceived their physicians as interested in their QoL, only 51% reported their physicians discussed QoL as a top concern in treatment decisions. QLQ-C30 composite global health status-QoL score had significant moderate to strong correlations with all other QLQ-C30 and lung cancer module 29 items domains (p ≤ 0.004) and some components of communication with care teams, treatment confidence, and impact on daily life. CONCLUSIONS: QoL is important in treatment decision making for patients with ALK+ NSCLC. These findings highlight areas for improvement in mental health support and patient-provider communication.

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