Professional-patient discrepancies in assessing lung cancer radiotherapy symptoms: An international multicentre study Journal Article


Authors: Aguado-Barrera, M. E.; Lopez-Pleguezuelos, C.; Gómez-Caamaño, A.; Calvo-Crespo, P.; Taboada-Valladares, B.; Azria, D.; Boisselier, P.; Briers, E.; Chan, C.; Chang-Claude, J.; Coedo-Costa, C.; Crujeiras-González, A.; Cuaron, J. J.; Defraene, G.; Elliott, R. M.; Faivre-Finn, C.; Franceschini, M.; Fuentes-Rios, O.; Galego-Carro, J.; Gutiérrez-Enríquez, S.; Heumann, P.; Higginson, D. S.; Johnson, K.; Lambrecht, M.; Lang, P.; Lievens, Y.; Mollà, M.; Ramos, M.; Rancati, T.; Rattay, T.; Rimner, A.; Rosenstein, B. S.; Sangalli, C.; Seibold, P.; Sperk, E.; Stobart, H.; Symonds, P.; Talbot, C. J.; Vandecasteele, K.; Veldeman, L.; Ward, T.; Webb, A.; Woolf, D.; de Ruysscher, D.; West, C. M. L.; Vega, A.; REQUITE Consortium
Article Title: Professional-patient discrepancies in assessing lung cancer radiotherapy symptoms: An international multicentre study
Abstract: Background and purpose: We investigate discrepancies in the assessment of treatment-related symptoms in lung cancer between healthcare professionals and patients, and factors contributing to these discrepancies. Materials and methods: Data from 515 participants in the REQUITE study were analysed. Five symptoms (cough, dyspnoea, bronchopulmonary haemorrhage, chest wall pain, dysphagia) were evaluated both before and after radiotherapy. Agreement between healthcare professionals and people with lung cancer was quantified using Gwet's-AC2 coefficient. The influence of clinical variables, comorbidities, and quality-of-life outcomes on agreement was examined through stratified analyses. Results: We found varying levels of agreement between healthcare professionals and people with lung cancer. Bronchopulmonary haemorrhage and dysphagia exhibited very good agreement (meanAC2 > 0.81), while cough and chest wall pain showed substantial agreement (meanAC2 = 0.64 and 0.76, respectively). Dyspnoea had the lowest agreement (meanAC2 = 0.59), with prior chemotherapy significantly reducing agreement levels. Chronic obstructive pulmonary disease (COPD) and early cancer stages also contributed to discrepancies in dyspnoea assessments. Regarding quality-of-life, the most relevant factor was fatigue, which reduced agreement in the assessment of dyspnoea (AC2 = 0.55 vs 0.70), dysphagia (AC2 = 0.48 vs 0.69), cough (AC2 = 0.58 vs 0.82), and chest wall pain (AC2 = 0.77 vs 0.91). Conclusions: Our findings indicate strong alignment between healthcare professionals’ and people with lung cancer evaluations of observable treatment-related symptoms, but less consistency for subjective symptoms such as dyspnoea. Factors such as prior chemotherapy, COPD, and cancer stage should be considered when interpreting symptom assessments. Furthermore, our study underscores the importance of integrating quality-of-life considerations, particularly fatigue, into symptom evaluations to mitigate potential biases in symptom perception. © 2024 Elsevier B.V.
Keywords: adult; cancer chemotherapy; controlled study; treatment outcome; aged; middle aged; major clinical study; clinical feature; fatigue; cancer radiotherapy; cancer staging; quality of life; cohort analysis; lung cancer; retrospective study; coughing; dyspnea; dysphagia; patient participation; population research; thorax pain; radiation effects; multicenter study; clinical evaluation; comorbidity; health care personnel; patient reported outcome measures; chronic obstructive lung disease; lung hemorrhage; very elderly; human; male; female; article; symptom assessment; disease assessment; professional-patient relationship; correlation measures
Journal Title: Lung Cancer
Volume: 199
ISSN: 0169-5002
Publisher: Elsevier Ireland Ltd.  
Date Published: 2025-01-01
Start Page: 108072
Language: English
DOI: 10.1016/j.lungcan.2024.108072
PROVIDER: scopus
PUBMED: 39740425
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Andreas Rimner
    524 Rimner
  2. John Jacob Cuaron
    142 Cuaron