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脑肿瘤患儿的日常生活概况:与健康相关的生活质量评估

Profile of daily life in children with brain tumors: an assessment of health-related quality of life.

作者信息

Bhat Sundeep R, Goodwin Tress L, Burwinkle Tasha M, Lansdale Meagan F, Dahl Gary V, Huhn Stephen L, Gibbs Iris C, Donaldson Sarah S, Rosenblum Ruth K, Varni James W, Fisher Paul G

机构信息

Department of Neurology, Stanford University School of Medicine, Palo Alto, CA, USA.

出版信息

J Clin Oncol. 2005 Aug 20;23(24):5493-500. doi: 10.1200/JCO.2005.10.190.

Abstract

PURPOSE

The survival of children with CNS tumors approaches 70%, yet health-related quality of life (HRQOL) has not been investigated rigorously in this population. We aimed to show that universal assessment of HRQOL could be obtained easily by using the PedsQL 4.0 and to provide a composite profile of their daily lives.

PATIENTS AND METHODS

The PedsQL was administered to all patients seen in the neuro-oncology clinic at Lucile Packard Children's Hospital (Palo Alto, CA) from December 2001, to September 2002. Patients were compared with healthy controls by using two-sided t tests to evaluate statistically significant differences.

RESULTS

One hundred thirty-four patients (73 male; mean age +/- standard deviation, 11.8 +/- 5.4 years; 55 had low-grade glioma, 32 had medulloblastoma/primitive neuroectodermal tumor/embryonal tumor, 17 had malignant astrocytoma, nine had germ-cell tumor, and 21 had other types of tumors) were assessed, each in less than 20 minutes. Scores on both child and parent-proxy reports for the total HRQOL, psychosocial, physical, emotional, social, and school-functioning scales were all significantly lower than controls (P < .01). Patients with low-grade glioma were reported to have the highest total HRQOL. Children receiving radiation therapy (XRT) but no chemotherapy had significantly lower total, psychosocial, emotional, and social functioning than those receiving other treatments, including XRT plus chemotherapy.

CONCLUSION

The PedsQL can be used to assess HRQOL rapidly and easily in children with CNS tumors, who have significantly worse HRQOL than healthy children. Children receiving XRT fare worse overall; chemotherapy added to XRT does not seem to worsen HRQOL. Assessment of HRQOL should be included as an outcome in future clinical trials.

摘要

目的

中枢神经系统肿瘤患儿的生存率接近70%,然而该人群与健康相关的生活质量(HRQOL)尚未得到严格研究。我们旨在表明,使用儿童生活质量量表4.0(PedsQL 4.0)能够轻松获得HRQOL的全面评估,并提供他们日常生活的综合概况。

患者与方法

2001年12月至2002年9月期间,对在露西尔·帕卡德儿童医院(加利福尼亚州帕洛阿尔托)神经肿瘤门诊就诊的所有患者进行了PedsQL评估。通过双侧t检验将患者与健康对照进行比较,以评估统计学上的显著差异。

结果

共评估了134例患者(73例男性;平均年龄±标准差为11.8±5.4岁;55例患有低级别胶质瘤,32例患有髓母细胞瘤/原始神经外胚层肿瘤/胚胎性肿瘤,17例患有恶性星形细胞瘤,9例患有生殖细胞肿瘤,21例患有其他类型肿瘤),每位患者的评估时间均少于20分钟。儿童及家长代理报告在总HRQOL、心理社会、身体、情感、社交和学校功能量表上的得分均显著低于对照组(P <.01)。据报告,低级别胶质瘤患者的总HRQOL最高。接受放射治疗(XRT)但未接受化疗的儿童在总功能、心理社会、情感和社交功能方面显著低于接受其他治疗的儿童,包括XRT联合化疗。

结论

PedsQL可用于快速、轻松地评估中枢神经系统肿瘤患儿的HRQOL,这些患儿的HRQOL明显低于健康儿童。接受XRT的儿童总体情况更差;XRT联合化疗似乎不会使HRQOL恶化。HRQOL评估应作为未来临床试验的一项结果纳入其中。

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