治疗前生活质量和功能状态评估能显著预测接受化疗的老年晚期非小细胞肺癌患者的生存期：意大利老年肺癌多中心研究的预后分析

Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: a prognostic analysis of the multicenter Italian lung cancer in the elderly study.

作者信息

Maione Paolo, Perrone Francesco, Gallo Ciro, Manzione Luigi, Piantedosi FrancoVito, Barbera Santi, Cigolari Silvio, Rosetti Francesco, Piazza Elena, Robbiati Sergio Federico, Bertetto Oscar, Novello Silvia, Migliorino Maria Rita, Favaretto Adolfo, Spatafora Mario, Ferraù Francesco, Frontini Luciano, Bearz Alessandra, Repetto Lazzaro, Gridelli Cesare, Barletta Emiddio, Barzelloni Maria Luisa, Iaffaioli Rosario Vincenzo, De Maio Ermelinda, Di Maio Massimo, De Feo Gianfranco, Sigoriello Giuseppe, Chiodini Paolo, Cioffi Angela, Guardasole Vincenzo, Angelini Valentina, Rossi Antonio, Bilancia Domenico, Germano Domenico, Lamberti Alfredo, Pontillo Vittorio, Brancaccio Luigi, Renda Francesco, Romano Francesco, Esani Gabriella, Gambaro Anna, Vinante Orazio, Azzarello Giuseppe, Clerici Maurizia, Bollina Roberto, Belloni Paolo, Sannicolò Mirella, Ciuffreda Libero, Parello Giuseppe, Cabiddu Mary, Sacco Cosimo, Sibau Angela, Porcile Gianfranco, Castiglione Federico, Ostellino Oliviero, Monfardini Silvio, Stefani Micaela, Scagliotti Giorgio, Selvaggi Giovanni, De Marinis Filippo, Martelli Olga, Gasparini Giampietro, Morabito Alessandro, Gattuso Domenico, Colucci Giuseppe, Galetta Domenico, Giotta Francesco, Gebbia Vittorio, Borsellino Nicola, Testa Antonio, Malaponte Emilia, Capuano Matteo A, Angiolillo Michele, Sollitto Francesco, Tirelli Umberto, Spazzapan Simona, Adamo Vincenzo, Altavilla Giuseppe, Scimone Antonio, Hopps Maria Raffaella, Tartamella Francesco, Ianniello Giovanni Pietro, Tinessa Vincenza, Failla Giuseppe, Bordonaro Roberto, Gebbia Nicola, Valerio Maria Rosaria, D'Aprile Modesto, Veltri Enzo, Tonato Maurizio, Darwish Samir, Romito Sante, Carrozza Francesco, Barni Sandro, Ardizzoia Antonio, Corradini Giuliana Mara, Pavia Gianfranco, Belli Mario, Colantuoni Giuseppe, Galligioni Enzo, Caffo Orazio, Labianca Roberto, Quadri Antonello, Cortesi Enrico, D'Auria Giuliana, Fava Sergio, Calcagno Anna, Luporini Gino, Locatelli M Cristina, Di Costanzo Francesco, Gasperoni Silvia, Isa Luciano, Candido Paola, Gaion Fernando, Palazzolo Giovanni, Nettis Giuseppe, Annamaria Anselmo, Rinaldi Massimo, Lopez Massimo, Felletti Raffaella, Di Negro Giorgio Bernabò, Rossi Nestore, Calandriello Antonio, Maiorino Luigi, Mattioli Rodolfo, Celano Alfredo, Schiavon Stefania, Illiano Alfonso, Raucci Carlo Alberto, Caruso Michele, Foa Paolo, Tonini Giuseppe, Curcio Carlo, Cazzaniga Marina

机构信息

S Giuseppe Moscati Hospital, Avellino, Italy.

出版信息

J Clin Oncol. 2005 Oct 1;23(28):6865-72. doi: 10.1200/JCO.2005.02.527.

DOI:10.1200/JCO.2005.02.527

PMID:16192578

Abstract

PURPOSE

To study the prognostic value for overall survival of baseline assessment of functional status, comorbidity, and quality of life (QoL) in elderly patients with advanced non-small-cell lung cancer treated with chemotherapy.

PATIENTS AND METHODS

Data from 566 patients enrolled onto the phase III randomized Multicenter Italian Lung Cancer in the Elderly Study (MILES) study were analyzed. Functional status was measured as activities of daily living (ADL) and instrumental ADL (IADL). The presence of comorbidity was assessed with a checklist of 33 items; items 29 and 30 of the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire QLQ-C30 (EORTC QLQ-C30) were used to estimate QoL. ADL was dichotomized as none versus one or more dependency. For IADL and QoL, three categories were defined using first and third quartiles as cut points. Comorbidity was summarized using the Charlson scale. Analysis was performed by Cox model, and stratified by treatment arm.

RESULTS

Better values of baseline QoL (P = .0003) and IADL (P = .04) were significantly associated with better prognosis, whereas ADL (P = .44) and Charlson score (P = .66) had no prognostic value. Performance status 2 (P = .006) and a higher number of metastatic sites (P = .02) also predicted shorter overall survival.

CONCLUSIONS

Pretreatment global QoL and IADL scores, but not ADL and comorbidity, have significant prognostic value for survival of elderly patients with advanced non-small-cell lung cancer who were treated with chemotherapy. Using these scores in clinical practice might improve prognostic prediction for treatment planning.

摘要

目的

研究在接受化疗的老年晚期非小细胞肺癌患者中，功能状态、合并症及生活质量（QoL）的基线评估对总生存期的预后价值。

患者与方法

分析了纳入III期随机多中心意大利老年肺癌研究（MILES）的566例患者的数据。功能状态通过日常生活活动能力（ADL）和工具性日常生活活动能力（IADL）来衡量。采用包含33项内容的检查表评估合并症的存在情况；使用欧洲癌症研究与治疗组织（EORTC）核心问卷QLQ-C30（EORTC QLQ-C30）的第29项和第30项来评估QoL。ADL分为无依赖与有一项或多项依赖。对于IADL和QoL，使用第一和第三四分位数作为切点定义了三个类别。合并症采用Charlson量表进行总结。通过Cox模型进行分析，并按治疗组进行分层。