Prognostic Value of Functional Assessment of Cancer Therapy-General (FACT-G)‎ in Advanced Non-Small-Cell Lung Cancer Treated with Korean Medicine

Abstract EN

Objectives.

The impact of health-related quality of life (HRQoL) on survival has been investigated in patients with various cancers.

Here, we evaluated the prognostic value of HRQoL using the Functional Assessment of Cancer Therapy-General (FACT-G) in advanced non-small-cell lung cancer (NSCLC) patients treated with Korean medicine.

Methods.

A retrospective review of medical records and FACT-G scores of patients with advanced NSCLC who received treatment with Korean medicine was conducted.

The reliability of the FACT-G was determined using Cronbach’s alpha and calculating floor-and-ceiling effects.

Correlations between FACT-G scores were estimated using Pearson’s correlation analysis.

Overall survival was calculated using the Kaplan–Meier method, and the prognostic impact of FACT-G scores and patients’ characteristics was evaluated with Cox proportional hazards regression.

Results.

Of the 165 enrolled patients, 115 (70%) had extrathoracic metastasis and 139 (84%) had undergone prior anticancer treatment.

The median overall survival was 10.1 months.

The mean FACT-G score was 65.0, and Cronbach’s alpha for the FACT-G was 0.917.

Age ≥65 years, male sex, smoking history, squamous-cell carcinoma, Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≥2, and presence of extrathoracic metastasis were associated with an increased risk of mortality.

High FACT-G total scores, physical well-being (PWB), emotional well-being, and functional well-being were associated with prolonged survival.

After adjusting for age, sex, smoking history, ECOG-PS, histological type, and presence of extrathoracic metastasis, a high FACT-G total score (hazard ratio (HR): 0.99, p=0.032) and high PWB score (HR: 0.94, p<0.001) were associated with prolonged survival as independent prognostic factors in patients with advanced NSCLC.

Conclusion.

The FACT-G total score and PWB score as HRQoL measurements were significant prognostic factors for survival in advanced NSCLC patients treated with Korean medicine.

This finding implies that the FACT-G can be used in clinical practice as a predictor of survival in patients with advanced NSCLC.