Summary of evidence of effect of docetaxel, gemcitabine, paclitaxel and vinorelbine on quality of life
| Study details | Quality of life |
|---|---|
| BSC=best supportive care; CDDP=cisplatin; DOC=docetaxel; EPI=epirubicin; GEM=gemcitabine; LON=lonidamine; PAX=Paclitaxel; QoL=quality of life; SS14=subset of commonly reported symptoms from the European Organisation for Research and Treatment (EORTC) Quality of Life instrument (LQ-C30 and LC13 scales); TriComb=combination of MITO, IFOS and CDDP; VDS=vindesine; VNB=vinorelbine; VP-16=etoposide. | |
| Docetaxel | |
| Shepherd et al19 | QoL parameters favoured DOC patients, significant differences for pain (p=0.006), fatigue (p=0.06) and tumour related medications used (p=0.02). |
| Roszkowski et al18 | DOC had significantly favourable effects on emotional functioning (p<0.05), nausea/vomiting (p=0.04), pain (p<0.0001) and dyspnea (p=0.02). No difference between global health status and physical functioning scores (p=NS). |
| Gemcitabine | |
| Anderson et al13 | On SS14 symptom scale GEM+BSC patients improved (–10%) from baseline to 2 months compared with deterioration in BSC patients (+1%) (p=0.113). Sustained (≥4 weeks) improvement (≥25%) in SS14 score was significantly higher for patients on GEM+BSC (22%) compared with BSC (9%) (p<0.005) |
| Bokkel Huinink et al2057 | No significant difference in change from baseline on global, physical, role, cognitive, emotional and social aspects of QoL (p>0.05). |
| Cardenal et al21 | No clinically significant differences in change from baseline within treatment arm or between treatment arms in functional domains or global QoL. Statistically significant difference between treatment arms in change from baseline for alopecia, worse for the VP-16 arm. Pain, insomnia, cough, hemoptysis, chest pain and shoulder pain by GEM and VP-16. |
| Crino et al22 | Global QoL did not change significantly in either arm. Comparisons of change from baseline showed a worsening of alopecia in the TriComb arm and a greater improvement in chest pain in the GEM+CDDP arm (p<0.05). |
| Sandler et al24 | No significant differences in QoL between treatment arms in change from baseline. |
| Paclitaxel | |
| Bonomi et al28 | No significant difference between treatment arms in change from baseline. |
| Ranson et al33 | No statistically significant difference between arms in change from baseline. |
| Gatzemier et al30 | On symptom scales CDDP patients had significant worsening of nausea and vomiting (p<0.0003), appetite loss (p<0.02) and constipation (p<0.032), while PAX+CDDP patients had significant worsening of hair loss and peripheral neuropathy (p<0.0001). |
| Giaccone et al31 | Patients on PAX+CDDP had significant beneficial effects on functional scales and some symptom scales at 6 weeks (fatigue (p=0.006) and appetite loss (p<0.001)), which disappeared at 12 weeks. |
| Vinorelbine | |
| Crawford et al38 | No significant difference between treatment arms in change from baseline (no data presented). |
| Martoni et al43 | No significant difference in change from baseline between treatment arms. |
| ELVIS45 | On EORTC functional and symptom scales and on LC-13, VNB had significant improvement in cognitive function (p=0.02), pain (p=0.02), dyspnea (p=0.05), and pain medication (p=0.01), but significantly worse on constipation (p=0.002), nausea and vomiting (p=0.07) peripheral neuropathy (p=0.04) and hair loss (p=0.0001). |
| Combined treatments | |
| Comella et al47 | Improved QoL score CDDP+GEM+VNB=59%, CDDP+EPI+VDS+ LON=39% (p not stated) |
| Frasci et al49 | Almost 60% of GEM+VNB patients did not show impairment of QoL during treatment, compared to approximately 40% in the VNB arm. Insufficient reporting of QoL measures (p not stated). |