CLINICS 2010;65(12):1247-1251 Table 1 - Subject characteristics of 30 lung cancer patients. Variables Age (years) mean¡SD Male n (%) Smoking history Former smokers n (%) Never smokers n (%) Pack–year mean¡DP Spirometry mean¡DP FEV1 % prev FVC % prev FEV1 / FVC % Histological types n (%) Adenocarcinoma Squamous cells SCLC Others KPS mean¡SD Staging status n (%) I and II III IV Mini Mental mean¡SD Scales Physical well-being Social/family well-being Emotional well-being Functional well-being FACT-G LCS FACT-L FACT-L TOI FLSI SD, standard deviation; FEV1, forced expiratory volume in the first second; FVC, forced vital capacity; SCLC, small cell lung cancer; KPS, Karnofsky Performance Status. Table 2 - Mean for the two visits (15-day interval) and intraclass correlation coefficient (ICC) for FACT-L scales and FLSI. 1st visit 2nd visit 22.9 19.5 18.4 18.1 78.9 20.0 98.9 61.0 19.0 22.7 18.6 19.0 17.0 76.3 19.8 97.1 59.6 18.1 62.0¡10.4 23 (73.7) 27 (90) 3 (10) 52.5¡33.4 75.0¡19.1 86.7¡13.1 71.8¡12.2 14 (46.7) 9 (30) 2 (6.7) 5 (16.7) 93.2¡9.9 14 (46.7) 13 (43.3) 3 (10) 27.9¡1.9 ICC 0.90 0.78 0.92 0.89 0.93 0.94 0.95 0.96 0.87 EWB 18.4 18.7 14.2 16.3 – 15.5 16.4 13.5 15.5 FWB 16.6 18.9 13.8 12.2 – 17.4 16.1 16.0 17.4 1249 Table 4 - Response time of the FACT-L and FLSI and p value of the comparison between the two visits (Student’s t test). Mean Median SD 3.8 2.9 Range 5–20 4–15 p 0.001 1st FACT-L + FLSI 2nd FACT-L + FLSI 9.6 9.0 8 9 FACT-L, Functional Assessment of Cancer Therapy-Lung; FLSI, Functional Assessment of Cancer Therapy-Lung Symptom Index. The mean score of the FACT-G scales was similar to the reference values for all scales that have these values established.22 Table 3 shows the mean values for the scales of FACT-G and FACT-L described in several studies of reliability and cultural adaptation into other languages. The time spent by patients in answering the questionnaire was measured at both visits (Table 4). The response time on the second application was significantly lower (p = 0.001). DISCUSSION The focus of this study was to analyze the reliability of the FACT-L and the FLSI, a specific instrument for assessing the quality of life of lung cancer patients in the Brazilian population. It was observed that the Brazilian version shows excellent reliability for this population. The FACT-L is an instrument that has been widely used in phase I, II, and III clinical trials. It has been translated and adapted into several languages and cultures.2,3,7,22,24–27 A feature of this instrument is the nonlinearity of the scores of its scales, a factor that complicates the interpretation of isolated study data. To facilitate the explanation of the results, the authors of the general questionnaire (FACT-G) have developed normative values from two reference groups, one from normal adults and another from adults with cancer in general.22 However, these normative values are only for the general questionnaire (FACT-G) and its scales. When comparing the results obtained in our study with the reference values, we observe that the score was similar in all scales and for the total value. A possible explanation for the fact that our patients have quality of life similar to patients with other cancer types is that, in the study for the establishment of benchmarks, besides includ- ing patients with various types of cancer, such as breast cancer, colon and rectum cancer, and cancer of the head and neck, they also included patients with lung cancer. Furthermore, 76.7% of the sample comprised patients treated and in remission from the underlying disease and, FACT-G 76.5 80.9 – 65.9 – 84.1 73.7 63.7 84.1 LCS 19.3 – 16.2 16.7 17.8 20.5 18.9 – 20.3 FACT-L FACT-L TOI 95.8 – 81.1 82.9 – – 94.6 – – 57.6 – 46.3 47.2 – 59.0 33.4 – 59.0 FACT-G, Functional Assessment of Cancer Therapy-General; LCS, Lung Cancer Scale; FACT-L, Functional Assessment of Cancer Therapy-Lung; FACT-L TOI, Functional Assessment of Cancer Therapy-Lung Trial Outcome Index; FLSI, Functional Assessment of Cancer Therapy-Lung Symptom Index. question B1. In the other questions, the kappa coefficient was less than 0.4. There was no correlation between spirometry and any of the questionnaire scales. Source Current study Brucker et al 2005 Browning et al 2009 Wan et al 2007 Saitoh et al 2007 Yoo et al 2006 Cella et al 2003 Dapueto et al 2003 Cella et al 1995 PWB 21.7 21.3 16.5 18.3 – 20.7 20.2 15.7 20.7 S/FWB 19.8 22.1 20.4 18.2 – 23.2 22.7 18.6 23.2 Table 3 - Mean values for the FACT-L scales in different reliability and validity trials with cancer patients. PWB, physical well-being; S/FWB, social/family well-being; EWB, emotional well-being; FWB, functional well-being; FACT-G, Functional Assessment of Cancer Therapy-General; LCS, Lung Cancer Scale; FACT-L, Functional Assessment of Cancer Therapy-Lung; FACT-L TOI, Functional Assessment of Cancer Therapy-Lung Trial Outcome Index.