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Title: Early stage non-small cell lung cancer's treatment journey : patients' perspectives
Author: Pompili, Cecilia
ISNI:       0000 0004 8506 1768
Awarding Body: University of Leeds
Current Institution: University of Leeds
Date of Award: 2019
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Background: Video assisted thoracoscopic surgery (VATS) is becoming the standard of care for earlystage non-small-cell lung cancer (NSCLC). Stereotactic Ablative Body Radiotherapy (SABR) is an accepted alternative for medically inoperable patients. Aims: The primary objectives of this thesis were to assess the role of Patients Reported Outcomes Measures (PROMs) during the first year following VATS or SABR treatment for early-stage NSCLC and the potential of Quality of Life (QOL) in predicting postoperative outcomes. Mixed method: Preliminary studies. Prior to delivering a prospective longitudinal observational study, important practical and methodological issues were addressed. Analysis from a systematic review, found there is no sufficient standardized data describing the evolution of QOL after VATS or SABR. Analysis from a service evaluation project of 330 patients demonstrated it was feasible to collect PROMS data in surgical patients in clinical practice and that preoperative QOL information is associated with postoperative clinical outcomes. The EORTC SumSc was evaluated and found to be sensitive to detecting changes in the perioperative period. Electronic methods for the collection and presentation of PROMS data were implemented to improve clinical data capture from electronic health records (EHR). Prospective study (Lilac study). Interim analysis (n=225) from this prospective evaluation of QOL demonstrated that QOL did not change significantly for SABR patients although baseline scores were significantly worse. The surgical population experienced a worsening in respiratory symptoms by six-months. Qualitative analysis of patient interviews found the Lilac study was acceptable to patients and revealed low electronic PROMS completion rate might be due to inherent demographic differences in the patient population. Conclusions: QOL has the potential to add important information in the decision-making process of early-stage NSCLC patients not otherwise captured by traditional objective parameters. Further analysis of the 12-month results and staff involvement using qualitative and quantitative assessments will provide insights into motivators and barriers of adoption in clinical practice.
Supervisor: Velikova, Galina ; Franks, Kevin ; Absolom, Kate Sponsor: YCR
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available