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Table 2 EORTC QLQ-C30

From: A multicenter randomized controlled open-label trial to assess the efficacy of compound kushen injection in combination with single-agent chemotherapy in treatment of elderly patients with advanced non-small cell lung cancer: study protocol for a randomized controlled trial

Questions Not at all A little Quite a bit Very much
1. Do you have any trouble doing strenuous activities, like carrying a heavy shopping bag or a suitcase? 1 2 3 4
2. Do you have any trouble taking a long walk? 1 2 3 4
3. Do you have any trouble taking a short walk outside of the house? 1 2 3 4
4. Do you need to stay in bed or a chair during the day? 1 2 3 4
5. Do you need help with eating, dressing, washing yourself, or using the toilet? 1 2 3 4
During the past week:     
6. Were you limited in doing either your work or other daily activities? 1 2 3 4
7. Were you limited in pursuing your hobbies or other leisure time activities? 1 2 3 4
8. Were you short of breath? 1 2 3 4
9. Have you had pain? 1 2 3 4
10. Did you need to rest? 1 2 3 4
11. Have you had trouble sleeping? 1 2 3 4
12. Have you felt weak? 1 2 3 4
13. Have you lacked appetite? 1 2 3 4
14. Have you felt nauseated? 1 2 3 4
15. Have you vomited? 1 2 3 4
16. Have you been constipated? 1 2 3 4
During the past week:     
17. Have you had diarrhea? 1 2 3 4
18. Were you tired? 1 2 3 4
19. Did pain interfere with your daily activities? 1 2 3 4
20. Have you had difficulty in concentrating on things, like reading a newspaper or watching television? 1 2 3 4
21. Did you feel tense? 1 2 3 4
22. Did you worry? 1 2 3 4
23. Did you feel irritable? 1 2 3 4
24. Did you feel depressed? 1 2 3 4
25. Have you had difficulty remembering things? 1 2 3 4
26. Has your physical condition or medical treatment interfered with your family life? 1 2 3 4
27. Has your physical condition or medical treatment interfered with your social activities? 1 2 3 4
28. Has your physical condition or medical treatment caused you financial difficulties? 1 2 3 4
For the following questions please circle the number between 1 and 7 that best applies to you.
29. How would you rate your overall health during the past week?
               1          2          3          4          5          6          7
Very poor                                               Excellent
30. How would you rate your overall quality of life during the past week?
               1          2          3          4          5          6          7
Very poor                                                   Excellent