356 Abstracts /Lmg Cancer 13 (1995) 323-356

recommended radiotherapy, 1% recommended chemotherapy, and 3% recommended both radiotherapy and chemotherapy, For an asymptomatic patient with stage IIlb NSCLC, 17% recommended no active treatment, 65% recommended radiotherapy alone, 16% recommended radiation and chemotherapy, and 2% recommended chemotherapy alone. For an asymptomatic patient with a stage IV NSCLC, 80% recommended no active treatment and 200/o recommended chemotherapy. Doctors’ beliefs about the natural history of NSCLC and its response to treatment varied widely. Seventy-five percent of respondents believed that adjuvant radiotherapy did not increase mwival in stage II disease+ but 25% believed that it did. Thirty percent believed that the addition of chemotherapy to radiotherapy in stage III increased sutvivd, but 70% believed that it did not. Fii-five percent believed that chemotherapy increased the median survival in stage IV, but 45% believed that it did not. Doctors’ beliefs about the efficacy of treatment were strongly associated with their treatment recommendations. Conchian: Personal beliefs, rather than universal knowledge, currently guide the management of NSCLC in Canada.

Development of quality of life (QOL) questionnaire for use of lung cancer patients in palliative therapy - Study of validity and reliability no. 2, the effects of chemotherapeutics in QOL Ishihara Y, Sakai H, Nukariya N, Kobayashi K, Yoneda S, Matsuoka R et al. Department of Hygiene/Public Health, TO&I Women b Medical CoNege, Tokyo. Jpn J Cancer Chemother 1995;22: 1087-93.

The effects of cisplatin and carboplatin in QGL were studied using a QGL questionnaire seeking to conform their validity and reliability in lung cancer patients. The questionnaire was composed of eleven items; appetite, feeling, sleep, mental fatigue, pain, anxiety, daily activity, abdominal and respiratory conditions, linear analog and face scale as global scale. The data were collected from 21 patients treated with cisplatin (Cis group) and 9 patients administered carboplatin (Garbo group). Chronological changes of QGL were measured by AUC (area under the curve) method. I) The total score of 9 items, linear analog and face scales rose immediately to the highest levels (worse) after treatment and maintained this level for 1 week in the Cis group. The Carbo group levels rose from 3 days and returned to the control level at 9 days after treatment. 2) AUC of the. total score, linear analog and face scales in the Cis group increased signilIcantly when compared with those of the Garbo group. 3) When compared with the Cis and Garbo groups the physiological and active scales were not different, but the

psychological scale showed a signiticant difference between the two groups. 4) The total score of the psychological scale correlated the abdominal score in the Cis group, but not in the Garbo group. 5) Sleep and mental fatigue were related to the aggravation of QGL at 56 days after Carboplatin treatment. These results suggested that this QOL questionnaire had suRicient sensitivity to reflect any chemotherapeutic side effects. 6) AUC is useful method in chronological evaluation of QOL.

Assessment of ‘quality of life’ using a daily diary card in a randomised trial of chemotherapy in small-cell lung cancer Gower NH, Rudd RM, Ruiz de Elvira MC, Spiro SG, James LE. Harper PG et al. Department of Oncology, Univ College London Medical School, Middlesex Hospital, London WIN &IA. Ann Oncol 1995;6:575- 80.

Background: Quality of life (QGL) was assessed using a daily diary card within a multicentre randomised trial of treatment of small-ceil lung cancer. The trial compared a weekly dose-intensive regimen with a 5-weekly conventional treatment in good prognosis patients, that is patients with limited disease or extensive disease with a good performance status (ECOG 0 or 1) and alkaline phosphatase of less than one and a half times the upper limit of normal. The trial which has been previously reported detected no difference in response or survival. Patients and methods: Daily diary cards (DDCs) were wllected for up to eight months from the first day of chemotherapy in a cohort of 75 patients at one centre. Percentages of scores over a specified lever were calculated for each of the eight diary card questions and comparisons were made between treatment arms. Results: During the period of chemotherapy wmpliance in completing DDCs was 72.5% hi the weekly arm and 77.2% in the 3 weekly. Significantly worse scores were reported with weekly chemotherapy during this period for six of the eight parameters,namely: nausea, vomiting, happiness, appetite, general well- being and sleep. Recognised problems of QGL data collection, in particular, compliance, attrition and generahsability are highlighted by this study and are discussed in the paper. Conclusions: The QGL measurements indicate that 3 weekly chemotherapy is the preferred treatment. This study demonstrates that: QGL measurements may be helpful in choosing between treatment alternatives where no difference in outcome is observed.