European Journal of Cancer: Highlights of Issue 37:09

Derivation of an integrated linear QoL measure for use in economic evaluations

The use of quality of life data in economic evaluations is an area of increasing importance. In this issue, Bagust and colleagues have reanalysed quality of life (QoL) data collected using the European Organization for Research and Treatment of Cancer-Quality of Life-Core30 (EORTC-QLQ-C30/LC13) instrument from small cell lung cancer (SCLC) patients treated in the MRC LU-16 trial and have shown that the QoL data was inherently non-linear. In order to use this data for economic evaluations, they derived an integrated QoL measure which was subsequently validated using data from non-small cell lung cancer (NSCLC) patients treated in the EORTC JHDN trial. The authors propose that this study, although designed for lung cancer patients, should stimulate the development of similar measures for other cancers.

c-erbB2 is a marker of tumour progression in NSCLC

Kristiansen and colleagues have studied the expression of c-erbB2 in n= 89 cases of non-small cell lung cancer (NSCLC). Using both immunohistochemistry (IHC) and comparative genomic hybridisation (CGH) (in a proportion of cases), they were able to show a significant correlation between chromosomal gains at the c-erbB2 locus, 17q21, and overexpression of the gene (P=0.009). The overexpression was also associated with a more advanced stage of disease and positive nodal status. The authors conclude 'that c-erbB2 is a marker of tumour progression in NSCLC'.

'Best practice' for the management of terminally-ill cancer patients

Stone and colleagues provide a thought-provoking review in this issue discussing the 'end of life' care of cancer patients. They outline the various problems in identifying when the terminal phase of disease is entered. These problems result in the majority of patients dying in hospital rather than under the auspices of hospices or specialised palliative teams. Patients are therefore denied the expertise and training of these specialist teams and the goals of their care are often inappropriate. Symptom management and care pathways should be confirmed for decisions such as whether the patient should be resuscitated. The authors also discuss the importance of communication with all those involved as an essential part of managing the terminal phase of a patient's life. They conclude that 'the keys to improving patient care in this area will be better education of medical and nursing staff and the introduction of care pathways'.

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