Quality of life in patients with advanced lung cancer at home palliative care and at the in-patient palliative care unit

Background: Quality of life (QL) in patients with advanced lung cancer (ALC) is an important issue in palliative care. The aim of the study was to assess QL and performance status changes during the course of ALC in patients at the in-patient and home palliative care.
Material and methods: A prospective study of 50 consecutive patients cared at home hospice (HH, 25 patients) and at the in-patient palliative care unit (IPCU, 25 patients). The following instruments were used: EORTC QLQ-C30 for QL evaluation and Karnofsky scale for performance status (KPS) assessment. Measurements were performed in each group twice with 10 day inter-val. In both patient groups NSCLC and SCLC was diagnosed.
Results: No differences in physical functioning and finances in both groups were observed. In both groups role functioning deterioration (hobby) was observed. Social functioning deteriorated in HH (family life) with no change at IPCU. Emotional functioning deteriorated in HH (worry) with no change at IPCU. Cognitive functioning deteriorated only in IPCU patients (concentration and memory). Global quality of life (GQL) and global health status (GHS) deteriorated at IPCU with no change at HH. KPS deteriorated in HH and did not change at IPCU.
Conclusions: Low GQL (1.5–2), GHS (2–2.5) and PS (3–4) values were observed in both patient groups. In most QL functional scales and KPS deteriorated in the second measurement, at least in one patients group. The deterioration was probably associated with more intense somatic symptoms due to the disease progression.