Lu Wei, Cui Yong, Chen Xiaoli, Zheng Ying, Gu Kai, Cai Hui, Zheng Wei, Shu Xiao-Ou
Shanghai Center for Disease Control and Prevention, Shanghai, China.
Breast Cancer Res Treat. 2009 Mar;114(2):357-69. doi: 10.1007/s10549-008-0008-3. Epub 2008 Apr 14.
To evaluate changes in quality of life (QOL) and identify medical and socio-demographic predictors of QOL among breast cancer survivors 3 years after diagnosis.
Between April 2002 and March 2004 2,232 women with breast cancer were recruited into the Shanghai Breast Cancer Survival Study, a population-based cohort study, approximately 6 months after cancer diagnosis. QOL was evaluated at 6 and 36 months post-diagnosis using the General Quality of Life Inventory. Multiple linear regression models were used to evaluate changes in QOL and their associations with socio-demographic and medical factors.
In general, breast cancer patients showed significant improvement over time in the physical, psychological, and social well-being domains, as well as overall QOL. However, QOL scores in several facets did not improve or even deteriorated, including increased negative feelings, reduced social support and interpersonal relationships, and worsened financial situation and living environment. Age at diagnosis was inversely associated with QOL changes in physical and psychological well-being and overall QOL scores. Compared with those who were disease-free, patients with a recurrence of disease had significantly poorer QOL scores across all well-being domains and almost all facets. Patients who received radiotherapy experienced significant improvements in physical and social well-being and overall QOL. Mixed ER/PR status was associated with improved scores in physical and psychological well-being and overall QOL. Education, body mass index, Charlson comorbidity score, TNM stage, type of surgery, chemotherapy, and immunotherapy were only associated with changes in certain well-being domains and/or facets, but not overall QOL. Tamoxifen use was not associated with changes in QOL outcomes.
Our study provides valuable information for developing strategies/interventions for improving the QOL of breast cancer patients.
评估生活质量（QOL）的变化，并确定乳腺癌幸存者确诊3年后生活质量的医学及社会人口学预测因素。
2002年4月至2004年3月期间，2232名乳腺癌女性患者被纳入上海乳腺癌生存研究，这是一项基于人群的队列研究，在癌症确诊后约6个月进行。使用一般生活质量量表在确诊后6个月和36个月评估生活质量。采用多元线性回归模型评估生活质量的变化及其与社会人口学和医学因素的关联。
总体而言，乳腺癌患者在身体、心理和社会幸福感领域以及总体生活质量方面随时间有显著改善。然而，几个方面的生活质量得分没有改善甚至恶化，包括负面情绪增加、社会支持和人际关系减少、财务状况和生活环境恶化。确诊年龄与身体和心理幸福感以及总体生活质量得分的变化呈负相关。与无疾病复发者相比，疾病复发患者在所有幸福感领域和几乎所有方面的生活质量得分显著更低。接受放疗的患者在身体和社会幸福感以及总体生活质量方面有显著改善。雌激素受体/孕激素受体（ER/PR）混合状态与身体和心理幸福感以及总体生活质量得分的改善有关。教育程度、体重指数、查尔森合并症评分、TNM分期、手术类型、化疗和免疫治疗仅与某些幸福感领域和/或方面的变化有关，而与总体生活质量无关。使用他莫昔芬与生活质量结果的变化无关。
我们的研究为制定改善乳腺癌患者生活质量的策略/干预措施提供了有价值的信息。
