The effect of chemotherapy on health-related quality of life in mesothelioma: results from the SWAMP trial

D T Arnold, C E Hooper, A Morley, P White, I D Lyburn, J Searle, M Darby, T Hall, D Hall, N M Rahman, E De Winton, A Clive, V Masani, A Dangoor, S Guglani, P Jankowska, S A Lowndes, J E Harvey, J P Braybrooke, N A Maskell

Research output: Contribution to journalArticle (Academic Journal)peer-review

15 Citations (Scopus)

Abstract

BACKGROUND: The effect of chemotherapy on health-related quality of life (HRQoL) in malignant pleural mesothelioma (MPM) is poorly understood. Patient-individualised prognostication and prediction of treatment response from chemotherapy is useful but little evidence exists to guide practice.

METHOD: Consecutive patients with MPM who were fit for first-line chemotherapy with pemetrexed and cisplatin\carboplatin were recruited and followed up for a minimum of 12 months. This study focussed on the HRQoL outcomes of these patients using the EQ-5D, EORTC QLQ-C30 and LC13.

RESULTS: Seventy-three patients were recruited of which 58 received chemotherapy and 15 opted for best supportive care (BSC). Compliance with HRQoL questionnaires was 98% at baseline. The chemotherapy group maintained HRQoL compared with the BSC group whose overall HRQoL fell (P=0.006) with worsening dyspnoea and pain. The impact of chemotherapy was irrespective of histological subtype although those with non-epithelioid disease had worse HRQoL at later time points (P=0.012). Additionally, those with a falling mesothelin or improvement on modified-RECIST CT at early follow-up had a better HRQoL at 16 weeks.

CONCLUSIONS: HRQoL was maintained following chemotherapy compared with a self-selected BSC group. Once chemotherapy is initiated, a falling mesothelin or improved RECIST CT findings infer a quality-of-life advantage.

Original languageEnglish
Pages (from-to)1183-9
Number of pages7
JournalBritish Journal of Cancer
Volume112
Issue number7
DOIs
Publication statusPublished - 31 Mar 2015

Structured keywords

  • Memory

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols
  • Biomarkers, Tumor
  • Carboplatin
  • Cisplatin
  • Female
  • Glutamates
  • Guanine
  • Humans
  • Lung Neoplasms
  • Male
  • Mesothelioma
  • Middle Aged
  • Palliative Care
  • Pemetrexed
  • Prospective Studies
  • Quality of Life
  • Clinical Trial
  • Journal Article
  • Multicenter Study
  • Observational Study

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