6533b7d1fe1ef96bd125d5aa

RESEARCH PRODUCT

Qol and adherence to i.v. or oral chemotherapy treatment in elderly patients with advanced NSCLC.

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e18002 Background: In elderly patients with advanced stage NSCLC the identification of the best treatment-related quality of life becomes the main discriminating endpoint. Methods: In this multicentre study, 53 elderly (≥ 70 yrs) patients with advanced (IIIB-IV) NSCLC were randomly allocated to receive as first-line treatment either Gemcitabine intravenously (1000 mg/m2) or oral Vinorelbine (60 mg/m2) both on days 1 and 8, every 21 days. The primary objective was the evaluation of the QoL, while the secondary one was the assessment of treatment adherence. The EORTC QLQ-C30 v 2.0 and QLQ-LC13 questionnaires have been used to evaluate the quality of life and an “ad hoc” questionnaire for the estimate of adherence/compliance to treatment in patients receiving oral Vinorelbine. The questionnaires were filled in at baseline and every 3 cycles. Results: Forty-one patients (thirty-six males), median age of 75.7 years, have been considered suitable for evaluation. All patients filled in the QoL questionnaires at baseline, 18 of them after three cycles of treatment. Differences of mean score values of items recorded at each assessment were calculated. Referring to QLQ-C30, patients enrolled in the Vinorelbine arm displayed higher mean scores as compared to those of Gemcitabine. There was a gain of 5.6 points as regards Physical Function and 16.9 points for Social Function in the Vinorelbine arm as compared to 3 and 1.6 points in the Gemcitabine arm. A higher improvement of the symptoms Nausea and Vomiting and Sleep Disturbance in the Vinorelbine arm in comparison with Gemcitabine (- 7 vs. + 3.2 and – 21.3 vs. + 7.7, respectively) was also observed. Patients treated with oral Vinorelbine showed improvements of the majority of QLQ-LC13 scores and completed a higher number of cycles as compared to Gemcitabine. Most patients (93.5%) responded positively to the satisfaction questionnaire of oral Vinorelbine. Conclusions: Oral Vinorelbine may provide an advantage in terms of patient preference since, without reducing the effectiveness, is able to maintain an acceptable toxicity profile which results in a gain of the level of quality of life.