The first systematic assessment of performance status was introduced by Karnofsky and Burchenal in 1949. They developed a single-item scale, rated by physicians, as an additional descriptive measure for chemotherapy treatment trials. The scale has been found to be an important independent predictor of prognosis and survival in lung cancer patients. Performance status is a standard stratification variable in clinical trials of lung cancer treatment, mostly assessed by short forms—four- or five-point grading scales® adapted from the original ten-point scale. Both types of instruments have been criticized for being crude measures with only modest interrater reliability, and modifications have been proposed. Nevertheless, the patients performance status or functional ability has important biologic and psychosocial consequences. buy flovent inhaler
There is only limited information about the psychosocial impact of lung cancer surgery, and this may relate to the fact that surgery is usually performed with curative intent. Some investigators assessed the functional status of surgically treated lung cancer patients longitudinally by using simple physician-rated measures.’ This approach gives only a rough picture of the patients physical well-being and neglects the patients subjective experience. Similarly, there have been only limited evaluations of the psychosocial effects of radiotherapy in lung cancer patients. Surgery and radiotherapy are commonly employed treatments for lung cancer and thus warrant more extensive study of their psychosocial effects.