New approaches to symptom improvements in lung cancer patients

The efficacy of chemotherapy in treating lung cancer continues to be assessed by the impact treatment has on disease progression and survival. Where differences between treatments are marginal and survival times cannot be realistically extended, symptom relief and improving health-related quality of life (QoL) become treatment priorities. Clinical trials in lung cancer often now include an assessment of symptom relief and QoL, and have confirmed the benefit of chemotherapy compared with best supportive care. Collection of symptom relief and QoL data is based on subjective reporting by patients, which can be influenced by extraneous and confounding factors. To ensure reproducibility and interpretability, standardized, validated instruments with known psychometric properties and culturally adapted language are required to capture QoL data from lung cancer patients in clinical trials. A number of available questionnaires, developed and validated for use in oncology studies, are reviewed in this paper. A selection of published lung cancer studies that have used these instruments are described and their outcomes summarized. These studies show that symptom assessment can be integrated in study protocols successfully, but there is a recognized need for improved and consistent measurement in future studies.