de Graeff A, de Leeuw J R, Ros W J, Hordijk G J, Blijham G H, Winnubst J A
Department of Internal Medicine, F.02.126, University Medical Center, Heidelberglaan 100, 3584 HM Utrecht, The Netherlands.
Eur J Cancer. 2001 Feb;37(3):332-9. doi: 10.1016/s0959-8049(00)00385-3.
Pre-treatment quality of life (QOL) has been found to be an independent prognostic factor for survival in cancer patients, in particular in patients with advanced cancer. Sociodemographic factors such as marital and socioeconomic status have also been recognised as prognostic factors. We studied the influence of QOL and mood (measured with the European Organization for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30) and the Head and Neck Cancer Questionnaire (EORTC QLQ-H&N35), and with the Center for Epidemiologic Studies-Depression Scale (CES-D)) as measured before treatment, the use of cigarettes and alcohol and sociodemographic factors (age, gender, marital status, income and occupation) on recurrence and survival in 208 patients with head and neck cancer prior to treatment with surgery and/or radiotherapy, using Kaplan-Meier and Cox regression analyses. Cognitive functioning and, to a lesser degree, marital status were independent predictors of recurrence and survival, along with medical factors (stage and radicality). Patients with less than optimal cognitive functioning and unmarried patients had a relative risk (RR) of recurrence of 1.72 (95% confidence interval (95% CI) 1.01-2.93) and 1.85 (95% CI 1.06-3.33), respectively, and a RR of dying of 1.90 (95% CI 1.10-3.26) and 1.82 (95% CI 1.03-3.23), respectively. Performance status, physical functioning, mood and global QOL and smoking and drinking did not predict for recurrence and survival. The influence of cognitive functioning might be related to the use of alcohol. Marital status may influence prognosis through mechanisms of health behaviour and/or social support mechanisms.
治疗前的生活质量（QOL）已被发现是癌症患者生存的独立预后因素，尤其是晚期癌症患者。婚姻和社会经济地位等社会人口学因素也被认为是预后因素。我们使用Kaplan-Meier和Cox回归分析，研究了治疗前测量的生活质量和情绪（用欧洲癌症研究与治疗组织核心问卷（EORTC QLQ-C30）和头颈癌问卷（EORTC QLQ-H&N35）以及流行病学研究中心抑郁量表（CES-D）测量）、烟酒使用情况以及社会人口学因素（年龄、性别、婚姻状况、收入和职业）对208例头颈癌患者在接受手术和/或放疗前的复发和生存的影响。认知功能以及在较小程度上的婚姻状况是复发和生存的独立预测因素，同时还有医学因素（分期和根治性）。认知功能未达最佳的患者和未婚患者的复发相对风险（RR）分别为1.72（95%置信区间（95%CI）1.01 - 2.93）和1.85（95%CI 1.06 - 3.33），死亡相对风险分别为1.90（95%CI 1.10 - 3.26）和1.82（95%CI 1.03 - 3.23）。体能状态、身体功能、情绪和总体生活质量以及吸烟和饮酒并不能预测复发和生存。认知功能的影响可能与酒精使用有关。婚姻状况可能通过健康行为机制和/或社会支持机制影响预后。
