Using the validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 version 3.0 (EORTC QLQ-C30 (v3)), we evaluated the impact of interventional bronchoscopic procedures aimed at re-establishing airway patency, on quality of life (QoL) of individuals who were considered inoperable and unsuitable for chemotherapy and/or radiation therapy.
Over a six months period, we prospectively enrolled all patients who fulfilled the above criteria and performed laser ablation, cryotherapy, and/or airway stenting in order to re-establish airway patency. Quality of life was evaluated by EORTC QLQ-C30 (v3)) at baseline (T1; 1 day prior to procedure), 7 days after (T2), and 1 month after procedure (T3).
Final analysis could be performed on 88% (21/24) of the participants (Male/Female 15/6, mean age 61.9/66.7 years, range 37 –78/53 –75). Although dyspnea scores had improved in 87% of participants (T3 vs. T1, P = 0.02), only 13/21 (62%) reported an improvement or stabilization of their overall global health status (T3 vs. T1, P=0.002). These individuals also noted improvements in their symptoms of fatigue, appetite loss, and insomnia which did not achieve statistical significance. During the study period 8/21 (38%, T3 vs. T1) reported a decline in global health status (P = 0.02) and emotional functioning (P = 0.05). Also, patients reported increased difficulty with pain, nausea and vomiting, fatigue, appetite loss, and finances, with changes in pain scores achieving statistical significance (P = 0.03). The reduction of dyspnea scores in this group was not statistically significant (P = 0.23).
Endoscopic procedures can effectively palliate symptoms associated with malignant central airway obstruction (CAO), but this may not translate into improvements of individual’s overall QoL, given the progressive nature of malignant disease and the multi-factorial constitution of QoL.
Administration of QoL questionnaires is feasible, may help identify domains contributing to patient’s decline, and thereby improve patient care. The results of this study emphasize the need for a multi-disciplinary approach for the care of patients with malignant CAO.
Kayvan Amjadi, None.