Movsas Benjamin
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
Semin Radiat Oncol. 2003 Jul;13(3):235-47. doi: 10.1016/S1053-4296(03)00029-8.
Over the last 2 decades, there has been an explosion of quality of life (QOL) studies in the oncology literature. The purpose of this review is to provide a basic guide regarding the state-of-the-art of QOL in oncology trials from a clinical perspective. This article aims to provide fundamental definitions, describe useful existing tools, and highlight the challenges in interpreting QOL studies. What exactly is QOL, and why is it important to measure in cancer trials? Key methodological issues will be addressed, including choosing the optimal instrument, basic psychometric properties, timing of QOL assessments, and statistical considerations, such as minimizing missing data. The critical issue of interpreting the clinical significance of QOL results will be explored, using both anchor- and distribution-based strategies. The Radiation Therapy Oncology Group (RTOG) model involving a triad of outcomes (clinical, humanistic/QOL, and economic) will also be described. The future challenge will be to translate QOL results into clinically meaningful interventions.
在过去20年里，肿瘤学文献中的生活质量（QOL）研究呈爆发式增长。本综述的目的是从临床角度提供一份关于肿瘤学试验中生活质量最新状况的基本指南。本文旨在给出基本定义，描述现有的有用工具，并突出解读生活质量研究中的挑战。生活质量究竟是什么，为何在癌症试验中进行测量很重要？将讨论关键的方法学问题，包括选择最佳工具、基本心理测量特性、生活质量评估的时间安排以及统计考量，比如尽量减少缺失数据。将使用基于锚定和分布的策略探讨解读生活质量结果临床意义的关键问题。还将描述涉及三联结局（临床、人文/生活质量和经济）的放射治疗肿瘤学组（RTOG）模型。未来的挑战将是把生活质量结果转化为具有临床意义的干预措施。
