Quality of life (QOL) assessment of MIP (mitomycin, ifosfamide and cisplatin) chemotherapy in advanced non-small cell lung cancers (NSCLC)

BACKGROUND: Quality of life (QOL) assessment has emerged to measure andquantify the balance between treatment benefit and toxicity, and has avalue in predicting response and overall survival in cancer patients.METHODS: From July 1995 to February 1997, 38 symptomatic patients withadvanced non-small cell lung cancer (NSCLC) were treated with MIPchemotherapy (mitomycin 6 mg/m2, ifosfamide 3000 mg/m2 and cisplatin 50mg/m2 on day 1 every 3 weeks). Patients were assessed for QOL includingphysical well-being, general symptoms and lung cancer-specific symptoms, aswell as objective response. RESULTS: The overall response rate was 38.9%(14/36, all were partial response) and the median duration of response was3.5 months [95% confidence interval (CI) 2.0-4.0]. The median duration ofoverall survival was 7 months (95% CI 5.9-8.5). The overall improvement ofQOL was 58.3% with 21 patients feeling better on treatment. The toxicity ofchemotherapy was mild, mainly nausea/vomiting and minimal alopecia. Usingmultiple clinical predictors of survival (age, histology, stage,performance status), only change of QOL emerged significantly (P = 0.0007).CONCLUSIONS: MIP had an endurable response and low toxicity profile, andprovided good QOL. Integral QOL data in our study provided the strongprediction of survival in advanced NSCLC. Further experienced QOL studywill provide greatly enhanced outcome data in clinical trials.