Cui Yong, Shu Xiao-Ou, Gao Yutang, Cai Hui, Wen Wanqing, Ruan Zhi-Xian, Jin Fan, Zheng Wei
Department of Medicine, Center for Health Services Research and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN 37232-8300, USA.
Breast Cancer Res Treat. 2004 Sep;87(2):135-47. doi: 10.1023/B:BREA.0000041620.76871.97.
Quality of life (QOL) has become an integral part of the modern assessment of cancer treatment in Western society. However, little is known about the QOL of Chinese breast cancer survivors. To evaluate the long-term impact of medical and socio-demographic factors on survivors' QOL, we conducted a population-based study of 1065 breast cancer survivors in Shanghai, China. The mean age at diagnosis was 48.1 years and the median survival time was 4.3 years for the study participants. The Generic Quality of Life Inventory was used to assess survivors' QOL. Multiple linear regression models were employed to analyze the associations of QOL outcomes with socio-demographic and medical factors. The results revealed that recurrence status, time since diagnosis, marital status, income and education all had an independent, significant association with overall QOL and differential domains of QOL. Age at diagnosis exhibited a dual effect on QOL, positively associated with material well-being and negatively associated with physical well-being. Stage of disease was only associated with social well-being, while the type of surgery was related to material well-being alone. No associations between QOL and chemotherapy or radiotherapy were found. Further, analyses by survival intervals suggested a domain-specific order of recovery of QOL after cancer treatment. These results fill gaps in the limited literature, and provide valuable information for physicians to target the specific needs of Chinese women with breast cancer, choose appropriate interventions at the optimal time, and develop strategies accordingly in terms of improvement of patient's QOL.
在西方社会,生活质量(QOL)已成为现代癌症治疗评估中不可或缺的一部分。然而,对于中国乳腺癌幸存者的生活质量却知之甚少。为了评估医疗和社会人口学因素对幸存者生活质量的长期影响,我们在中国上海对1065名乳腺癌幸存者进行了一项基于人群的研究。研究参与者的诊断时平均年龄为48.1岁,中位生存时间为4.3年。使用通用生活质量量表来评估幸存者的生活质量。采用多元线性回归模型分析生活质量结果与社会人口学和医疗因素之间的关联。结果显示,复发状态、诊断后的时间、婚姻状况、收入和教育程度均与总体生活质量以及生活质量的不同领域存在独立且显著的关联。诊断时的年龄对生活质量有双重影响,与物质幸福感呈正相关,与身体幸福感呈负相关。疾病分期仅与社会幸福感相关,而手术类型仅与物质幸福感相关。未发现生活质量与化疗或放疗之间存在关联。此外,按生存间隔进行的分析表明,癌症治疗后生活质量恢复存在特定领域的顺序。这些结果填补了有限文献中的空白,并为医生提供了有价值的信息,以便针对中国乳腺癌女性的特定需求,在最佳时机选择合适的干预措施,并相应地制定改善患者生活质量的策略。