Quality of life in patients receiving curative radiation therapy for non-small cell lung cancer

Despite increased interest in the study of quality of life (QOL) in recent years, there has been little research in lung cancer patients. Combined-modality lung cancer treatment regimens have had an impact on overall survival duration; however the impact of these increasingly toxic treatments on QOL has received scant attention. The purpose of this study was to determine if perceptions of QOL change over time in patients with non-small cell lung cancer (NSCLC) receiving curative radiation therapy (XRT) alone or in combination with other treatment modalities.

A descriptive, longitudinal design with repeated measures was used to study perceptions of QOL in NSCLC patients receiving curative XRT. A nonprobability, consecutive sampling technique was used to select 23 NSCLC patients receiving XRT in the radiotherapy clinic of a comprehensive cancer treatment center located in Southeast Texas. The Functional Assessment of Cancer Therapy-Lung (FACT-L) (Cella, 1994), a 37-item Likert-type questionnaire that measures QOL in lung cancer patients, was used to assess QOL prior to subjects' beginning XRT, during the fourth week of treatment, and one month and four months after XRT completion. A data sheet was used to record descriptive information.

The research question of the study, do perceptions of QOL change over time in NSCLC patients receiving curative XRT, was examined using a multivariate approach to analysis of variance for repeated measures with five planned comparisons. QOL was significantly lower during XRT than it was before XRT ($p=.006$) and was significantly greater one month after XRT than it was before XRT ($p=.01$) or during XRT (). QOL four months after XRT was not significantly different from the pretreatment level ($p=.15$).

These findings suggest that QOL does change in NSCLC patients receiving curative XRT. Although QOL declines significantly during XRT, it improves following XRT to a level higher than prior to treatment and then returns to the pre-treatment level. It may be concluded that additional nursing interventions need to be developed to support QOL in NSCLC patients while they are receiving curative XRT.