The Evaluations And Applications Of Quality Of Life Scales For Patients With Lung Cancer

Objective:To evaluate the validity, reliability and clinic response of the standard Chinese version of the Functional Assessment of Cancer Therapy-Lung Cancer (FACT-L) questionnaire and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire version3.0 (EORTC QLQ-LC43). To assess the quality of life (QOL) of Chinese patients with non-small cell lung cancer and it's influencing factors with FACT-L, and then evaluate the efficacy of the two commonly used chemotherapy regimens (navelbine plus cisplatin (NP) and gecitabine plus cisplatin (GP))Methods:(1) The QOL data of the FACT-L Chinese version 4.0 and QLQ-LC43 Chinese version 3.0 was collected three times from 28 in-patients with lung cancer. The structural validity of the scale was evaluated through the Correlation analysis, factor analysis and cluster analysis. The correlation coefficient was used to evaluate the content validity. The Cronbach's a coefficient and intraclass correlation coefficients (ICC) were used as indexs to reflect the reliability of the scales. The paired t-test was used to evaluate the responsiveness. (2) 154 non-small cell lung cancer patients completed FACT-L Chinese version 4.0 questionnaire. The influencing factors of QOL were studied with Kruskal Wallis Test. (3) Total 89 inpatients had completed the NP or GP chemotherapy twice,50 in NP group,39 in GP group. In order to evaluate effects of the two chemotherapy regimens, the clinical efficacy, adverse effects and quality of life scores were compared.Results:(1) Based on the above analysis of FACT-L, the principle component and factors analysis showed the scales had a better construct validity, for the total Cumulative % was 77.219%. The Cronbach's a coefficient was above 0.7 and the ICC was above 0.6. The t-test showed there were siginificent differences in PWB, LCS domins and total QOL score during the chemotherapy. The EORTC QLQ-LC43 had better construct validity, reliability and responsiveness. Seven components were extracted by the principle component and factors analysis, the total Cumulative% was 79.205%. The Cronbach's a coefficient and ICC were above 0.7 and 0.6, respectively. The paired t-test showed siginificent differences in five domains(PF,SF,FA,NV,AP) during the chemotherapy. (2) The old male patients had more severe lung cancer symptoms. Patients with moderate education level got higher QOL scores. The QOL of patients with lower income was worse than patients with higher income. The quality of life before and after the chemotherapy were significantly different.The chemotherapy and smoking would worsen the QOL of patients with lung cancer. (3) The clinical efficacy and adverse effects of NP group and GP group were slightly different. The QOL scores of patients of NP group were apparently lower than GP group. There were siginificent difficences in SWB, LCS and the total QOL scores.Conclusions:The Chinese version of FACT-L and EORTC QLQ-LC43 had better reliability, validity and responsiveness and could be used to assess the QOL of Chinese patients with lung cancer. The education level, income, chemotherapy and smoking affected the quality of life of lung cancer patients mostly.It might be an effective and viable method to evaluate the efficacy of therapeutic drugs with the Quality of life scores.