Histological subtype of lung cancer affects acceptance of illness, severity of pain, and quality of life

Figures & data

Table 1 Demographic and clinical characteristics of the study group

Variables	SCLC; n=72, n (%)	NSCLC; n=185, n (%)	Total; n=257, n (%)	p-value
Sex
Woman	31 (43.06%)	84 (45.41%)	115 (44.75%)	0.841
Men	41 (56.94%)	101 (54.59%)	142 (55.25%)
Marital status
In a relationship	45 (62.50%)	109 (58.92%)	154 (59.92%)	0.701
Alone	27 (37.50%)	76 (41.08%)	103 (40.08%)
Education
Primary	14 (19.44%)	15 (8.11%)	29 (11.28%)	0.054
Vocational	28 (38.89%)	90 (48.65%)	118 (45.91%)
Secondary	25 (34.72%)	61 (32.97%)	86 (33.46%)
Higher	5 (6.94%)	19 (10.27%)	24 (9.34%)
Employment status
Employed	14 (19.44%)	54 (29.19%)	68 (26.46%)
Pensioner	56 (77.78%)	125 (67.57%)	181 (70.43%)	0.279
Supported by relatives	2 (2.78%)	6 (3.24%)	8 (3.11%)
Comorbidities
No comorbidities	12 (16.67%)	62 (33.51%)	74 (28.79%)
One disease	28 (38.89%)	82 (44.32%)	110 (42.80%)	<0.001
Two diseases	25 (34.72%)	39 (21.08%)	64 (24.90%)
Three diseases	7 (9.72%)	2 (1.08%)	9 (3.50%)
Metastases
No metastases	35 (48.61%)	121 (65.41%)	156 (60.70%)	0.036
To one organ	23 (31.94%)	44 (23.78%)	67 (26.07%)
Multiorgan	14 (19.44%)	20 (10.81%)	34 (13.23%)
Treatment
Surgery alone	5 (6.94%)	75 (40.54%)	80 (31.13%)	<0.001
Other	67 (93.06%)	110 (59.46%)	177 (68.87%)
WHO performance status
Grade 0	13 (18.06%)	34 (18.38%)	47 (18.29%)	0.325
Grade 1	27 (37.50%)	80 (43.24%)	107 (41.63%)
Grade 2	26 (36.11%)	61 (32.97%)	87 (33.85%)
Grade 3	3 (4.17%)	9 (4.86%)	12 (4.67%)
Grade 4	3 (4.17%)	1 (0.54%)	4 (1.56%)

Note: Significant differences are marked in bold.

Abbreviations: NSCLC, nonsmall-cell lung cancer; SCLC, small-cell lung cancer; WHO, World Health Organization.

Table 2 Comparison of QoL between patients with NSCLC and SCLC

Variables	NSCLC	SCLC	p-value	Reference values NSCLCa	Reference values SCLCa
QLQ-C30 functioning area
Global	47.12±23.21	38.31±20.25	0.009	58.8±22.5	67.1±20.4
Physical	72.32±17.96	61.02±21.13	<0.001	78.4±19.3	78.7±18.7
Role	65.95±27.41	51.62±28.96	<0.001	60.7±33.1	73.9±29.8
Emotional	57.97±28.76	52.43±25.46	0.171	68.1±24.2	75.9±21.7
Cognitive	76.13±21.12	68.06±24.35	0.018	84.0±21.1	85.7±19.7
Social	65.77±32.4	59.49±23.21	0.038	73.6±28.9	76.0±26.1
QLQ-C30 symptom area
Fatigue	42.64±26.51	51.23±25.4	0.016	40.4±27	36.4±25.3
Nausea/vomiting	12.61±18.23	30.32±26.88	<0.001	9.7±18.3	9.9±17.6
Pain	36.94±23.8	44.44±27.69	0.033	29.7±30.3	18.4±24.8
Dyspnea	41.62±24.4	48.61±27.37	0.057	38.5±31.7	31.8±29.8
Sleep disturbance	41.98±31.43	50.46±29.6	0.054	32.4±32.7	23.1±27.8
Appetite loss	31.17±28.36	43.52±31.47	0.004	27.9±33.5	24.3±30.4
Constipation	17.48±26.25	27.78±28.53	0.002	17.4±27.9	15.6±26.1
Diarrhea	9.19±22.65	11.57±19.51	0.065	6.8±17.4	7.3±16
Financial problems	33.33±31.85	53.7±28.83	<0.001	12.8±25.8	17.0±28.8
QLQ-LC13
Dyspnea	34.17±22.83	47.99±23.58	<0.001
Coughing	50.09±24.11	54.63±27.01	0.256
Hemoptysis	14.59±20.78	19.91±24.17	0.105
Sore mouth and tongue	7.57±15.63	23.15±27.2	<0.001
Dysphagia	12.79±19.93	25.93±29.19	<0.001
Peripheral neuropathy	11.89±18.79	29.63±28.28	<0.001
Hair loss	12.07±23.92	30.56±37.42	<0.001
Chest pain	23.24±25.19	41.2±29.86	<0.001
Pain in arm or shoulder	12.79±22.49	21.76±28.61	0.009
Other pain sites	23.78±27.56	29.17±34.46	0.451
Taking analgesics	50.41±37	49.31±31.67	0.477

Notes: Significant differences are marked in bold.

a According to the EORTC QLQ-C30 reference values.¹⁶

Abbreviations: NSCLC, nonsmall-cell lung cancer; SCLC, small-cell lung cancer; QoL, quality of life; QLQ-C30, European Organization for Research and Treatment of Cancer 30-item Core Quality of Life Questionnaire; QLQ-LC13, European Organization for Research and Treatment of Cancer 13-item Lung Cancer specific Quality of Life Questionnaire.

Table 3 Correlations between acceptance of illness and dimensions of QoL in patients with NSCLC and SCLC

Variables	AIS score in NSCLC patients		AIS score in SCLC patients
	Correlation coefficient	p-value	Correlation coefficient	p-value
QLQ-C30 functioning area
Global	0.754	<0.001	0.577	<0.001
Physical	0.495	<0.001	0.62	<0.001
Role	0.629	<0.001	0.666	<0.001
Emotional	0.742	<0.001	0.593	<0.001
Cognitive	0.595	<0.001	0.537	<0.001
Social	0.723	<0.001	0.642	<0.001
QLQ-C30 symptom area
Fatigue	0.723	<0.001	–0.658	<0.001
Nausea/vomiting	–0.648	<0.001	–0.229	0.053
Pain	–0.396	<0.001	–0.617	<0.001
Dyspnea	–0.648	<0.001	–0.525	<0.001
Sleep disturbance	–0.324	<0.001	–0.453	<0.001
Appetite loss	–0.47	<0.001	–0.366	0.002
Constipation	–0.443	<0.001	–0.09	0.453
Diarrhea	–0.154	0.037	–0.069	0.565
Financial problems	–0.187	0.011	–0.182	0.125
QLQ-LC13
Dyspnea	–0.598	<0.001	–0.554	<0.001
Coughing	–0.409	<0.001	–0.336	0.004
Hemoptysis	0.158	0.032	–0.173	0.147
Sore mouth and tongue	–0.205	0.005	–0.357	0.002
Dysphagia	–0.394	<0.001	–0.048	0.687
Peripheral neuropathy	–0.328	<0.001	–0.206	0.083
Hair loss	–0.022	0.765	–0.125	0.294
Chest pain	–0.339	<0.001	–0.254	0.031
Pain in arm or shoulder	–0.251	0.001	–0.225	0.057
Other pain sites	–0.441	<0.001	–0.339	0.004
Taking analgesics	–0.049	0.509	–0.123	0.302

Note: Bold text represents a statistically significant value of p<0.05.

Abbreviations: AIS, Acceptance of Illness Scale; NSCLC, nonsmall-cell lung cancer; SCLC, small-cell lung cancer; QoL, quality of life; QLQ-C30, Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30; QLQ-LC13, Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 13.

ScottNWFayersPMAaronsonNKEORTC QLQ-C30 Reference ValuesBrusselsEORTC Quality of Life Group2008 Available from: http://groups.eortc.be/qol/sites/default/files/img/newsletter/reference_values_manual2008.pdfAccessed September 9, 2017

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