Penson Richard, Cella David, Wenzel Lari
Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.
J Reprod Med. 2005 Jun;50(6):407-16.
While there has not been a dramatic improvement in the cure rate of ovarian cancer, >40% of women survive longer than 5 years, with what is commonly considered a "chronic" cancer. In each phase of the illness (diagnosis, surgery and chemotherapy with curative intent, remission and survivorship, relapse and sequential chemotherapy, bowel obstruction and end of life), quality of life (QOL) is one of the most important considerations. There has recently been a large increase in studies reporting the assessment of QOL; that has changed the field from descriptive reporting to quantitative science. There are well-validated, standardized scales, and approximately 10% of randomized cancer trials include health-related QOL as one of the main end points. This article reviews the history and development of QOL evaluation and the 2 main approaches to QOL assessment (psychometric based and utility based) and describes strategies for meaningful interpretation of QOL profiles. While the humanities perhaps teach us much about the value of QOL, the science of the study of QOL will be the foundation and confirmation of many of the anticipated advances for patients.
虽然卵巢癌的治愈率并没有显著提高,但超过40%的女性存活时间超过5年,这通常被认为是一种“慢性”癌症。在疾病的每个阶段(诊断、根治性手术和化疗、缓解与生存、复发与序贯化疗、肠梗阻与生命终结),生活质量(QOL)都是最重要的考虑因素之一。最近,报告生活质量评估的研究大幅增加;这已将该领域从描述性报告转变为定量科学。有经过充分验证的标准化量表,约10%的随机癌症试验将与健康相关的生活质量作为主要终点之一。本文回顾了生活质量评估的历史和发展以及生活质量评估的两种主要方法(基于心理测量和基于效用),并描述了对生活质量概况进行有意义解读的策略。虽然人文学科或许能让我们对生活质量的价值有很多了解,但生活质量研究的科学将是许多预期的患者进展的基础和确证。