Table 4.
Multivariate Analysis: Stepwise Cox Regression of Moderate to Severe Baseline Symptoms,* Symptom Increase,† and Patient Characteristicsas Predictors of Overall Survival
| Participants/Events | HR | 95% CL | P | ||
|---|---|---|---|---|---|
| Model 1a. Baseline symptom component score and patient characteristics‡ as predictors | |||||
| Entire sample with all ethnicities | 91/73 | ||||
| 5 baseline symptoms§ (moderate to severe*) | 2.66 | 1.48 | 4.80 | .001 | |
| PS = 2 | 2.08 | 1.22 | 3.55 | .007 | |
| Race = white non-Hispanic | 0.36 | 0.15 | 0.87 | .023 | |
| White non-Hispanic sample | 84/66 | ||||
| 5 baseline symptoms§ (moderate to severe*) | 2.92 | 1.59 | 5.36 | .0006 | |
| Model 1b. Individual baseline symptoms and patient characteristics|| as predictors | |||||
| Entire sample with all ethnicities | 90/72 | ||||
| Coughing (moderate to severe*) | 8.69 | 3.53 | 21.38 | < .0001 | |
| PS = 2 | 2.01 | 1.15 | 3.01 | .014 | |
| Race = white non-Hispanic | 0.16 | 0.01 | 0.39 | < .0001 | |
| White non-Hispanic sample | 83/65 | ||||
| Coughing (moderate to severe*) | 7.83 | 3.05 | 20.12 | <.0001 | |
| Model 2a. Symptom increase† component score and patient characteristics‡ as predictors | |||||
| Entire sample with all ethnicities | 56/47 | ||||
| Symptom increase† in any 1 of 6 symptoms¶ | 4.16 | 1.71 | 10.16 | .002 | |
| 5 baseline symptoms§ | 2.47 | 1.19 | 5.10 | .015 | |
| PS = 2 | 2.34 | 1.08 | 5.08 | .032 | |
| White non-Hispanic sample | 52/43 | ||||
| 5 baseline symptoms§ | 2.36 | 1.15 | 4.85 | .019 | |
| Symptom increase† in any 1 of 6 symptoms¶ | 4.32 | 1.76 | 10.64 | .001 | |
| Model 2b. Symptom increase† in individual symptoms and patient characteristics|| as predictors | |||||
| Entire sample with all ethnicities | 53/44 | ||||
| Fatigue | 3.54 | 1.21 | 10.36 | 0.021 | |
| Shortness of breath | 4.07 | 1.28 | 12.95 | 0.018 | |
| Race = white non-Hispanic | 0.05 | 0.01 | 0.48 | 0.009 | |
| White non-Hispanic sample | 49/40 | ||||
| Fatigue | 4.17 | 1.28 | 13.55 | 0.018 | |
| Lack of appetite | 7.36 | 2.07 | 26.14 | 0.002 | |
HR indicates hazard ratio; CL, confidence limit; PS, Eastern Cooperative Oncology Group performance status.
A symptom rated 4 or higher on the MDASI’s 0–10 scale was considered to be moderate to severe.
“Symptom increase” was defined as a symptom-score increase of 1 or more points on the MDASI’s 0–10 scale between baseline and the end of the first chemotherapy cycle (21 days, on average).
Age, gender, race, PS, previous chemotherapy, and level of comorbidities were included as covariates in the Cox model.
Coughing, nausea, lack of appetite, distress, and fatigue.
All baseline symptoms, age, gender, race, PS, previous chemotherapy, and level of comorbidities were included as covariates in the multivariate Cox model.
Fatigue, shortness of breath, vomiting, difficulty remembering, numbness, and lack of appetite.