Wu Eric, Robison Leslie L, Jenney Meriel E M, Rockwood Todd H, Feusner James, Friedman Debra, Kane Robert L, Bhatia Smita
Division of Population Sciences, City of Hope National Medical Center, Duarte, California, USA.
Pediatr Blood Cancer. 2007 Jun 15;48(7):678-86. doi: 10.1002/pbc.20874.
Improved survival after childhood cancer has shifted the focus to health-related quality of life (HRQL)-an understudied problem, especially among adolescents.
We assessed HRQL among adolescents utilizing a validated self-report tool, the Minneapolis-Manchester Quality of Life (MMQL) Adolescent Form, consisting of 46 items comprising seven domains: physical, cognitive, psychological and social functioning, body image, intimate relations, and outlook on life, and computed an overall QoL score. The MMQL Adolescent Form was administered to 226 adolescent survivors of childhood cancer a median of 7.8 years from diagnosis (off therapy-median age: 16.2 years), 136 adolescent cancer patients undergoing therapy (on therapy-median age: 16.4 years), and 134 healthy adolescents (controls-median age: 15.5 years). Primary diagnoses included leukemia (46%), lymphoma (26%), brain tumors (5%), and other solid tumors (23%).
Compared to healthy controls, on-therapy patients were at increased risk for reporting poor overall QoL [Odds Ratio (OR) = 3.3, P = 0.002)] and poor physical functioning (OR = 11.8, P < 0.001). Off-therapy survivors did not differ significantly from healthy controls for overall QoL (OR = 1.6, P = 0.5) or any HRQL domains. Female patients, both on- and off-therapy, were more likely to report poorer overall QoL, physical, psychological and cognitive functioning as well as poorer body image when compared with male patients.
While adolescent cancer patients undergoing active therapy report poor physical functioning, there is no evidence of long-term QoL sequelae.
儿童癌症患者生存率的提高使人们将关注点转向了与健康相关的生活质量（HRQL）——这是一个研究较少的问题，尤其是在青少年中。
我们使用经过验证的自我报告工具——明尼阿波利斯 - 曼彻斯特生活质量（MMQL）青少年版，对青少年的HRQL进行评估。该工具包含46个项目，涵盖七个领域：身体、认知、心理和社会功能、身体形象、亲密关系以及生活展望，并计算出总体生活质量得分。MMQL青少年版应用于226名儿童癌症青少年幸存者，自确诊起中位时间为7.8年（停止治疗——中位年龄：16.2岁），136名正在接受治疗的青少年癌症患者（正在治疗——中位年龄：16.4岁），以及134名健康青少年（对照组——中位年龄：15.5岁）。主要诊断包括白血病（46%）、淋巴瘤（26%）、脑肿瘤（5%）和其他实体瘤（23%）。
与健康对照组相比，正在接受治疗的患者报告总体生活质量差的风险增加[优势比（OR）= 3.3，P = 0.002]，身体功能差的风险增加（OR = 11.8，P < 0.001）。停止治疗的幸存者在总体生活质量（OR = 1.6，P = 0.5）或任何HRQL领域与健康对照组相比无显著差异。与男性患者相比，无论是正在接受治疗还是停止治疗的女性患者，更有可能报告总体生活质量、身体、心理和认知功能较差以及身体形象较差。
虽然正在接受积极治疗的青少年癌症患者报告身体功能较差，但没有证据表明存在长期生活质量后遗症。
