Quality of life in patients with lung cancer: a review of literature from 1970 to 1995

Chest. 1998 Feb;113(2):467-81. doi: 10.1378/chest.113.2.467.


A review of the literature was carried out covering the last 25 years (1970 to 1995) by searching through the MEDLINE and manually. The review consists of two companion parts. The first includes studies of quality of life in lung cancer patients in general, while the second part is restricted to defined samples of small and non-small cell lung cancer patients. Excluding non-English and review articles, in total 151 citations were identified and all have been reviewed. Over 50 instruments were used to measure quality of life in lung cancer studies. Of these, the European Organisation for Research and Treatment of Cancer Quality of Life Lung Cancer Questionnaire (EORTC QLQ-LC13) in conjunction with the core cancer questionnaire (QLQ-C30) was found to be the best developed instrument, although there were two other lung cancer-specific measures with good reliability and validity. Several topics in this chapter have been highlighted, including the importance of regularly measuring quality of life in lung cancer patients. Progress and achievements in areas such as performance status as a proxy of quality of life measure, psychological morbidity and symptom distress as predictive factors of quality of survival, and communication problems in quality of life studies of lung cancer patients have been emphasized and their implications in lung cancer care discussed. It is argued that palliation of symptoms, psychosocial interventions, and understanding patients' feelings and concerns all contribute to improving quality of life in lung cancer patients. It is concluded that the future challenge in treatment of lung cancer lies not only in improving the survival, but mainly the patients' quality of life regardless of cell type. Clinical trial and epidemiologic population-based outcome studies are recommended to provide this and to allow a better understanding of the contribution of the socioeconomic characteristics of the patients to their pretreatment and posttreatment quality of life.

Publication types

  • Meta-Analysis

MeSH terms

  • Activities of Daily Living
  • Carcinoma, Non-Small-Cell Lung / psychology
  • Carcinoma, Non-Small-Cell Lung / therapy
  • Carcinoma, Small Cell / psychology
  • Carcinoma, Small Cell / therapy
  • Clinical Trials as Topic
  • Communication
  • Emotions
  • Epidemiologic Studies
  • Follow-Up Studies
  • Forecasting
  • Humans
  • Karnofsky Performance Status
  • Lung Neoplasms / psychology*
  • Lung Neoplasms / therapy
  • Outcome Assessment, Health Care
  • Palliative Care
  • Patient Care
  • Physician-Patient Relations
  • Population Surveillance
  • Prognosis
  • Psychometrics
  • Quality of Life*
  • Reproducibility of Results
  • Social Support
  • Socioeconomic Factors
  • Stress, Psychological / psychology
  • Surveys and Questionnaires
  • Survival Rate