Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.
Health Qual Life Outcomes. 2009 Dec 23;7:102. doi: 10.1186/1477-7525-7-102.
Health-related quality of life and survival are two important outcome measures in cancer research and practice. The aim of this paper is to examine the relationship between quality of life data and survival time in cancer patients.
A review was undertaken of all the full publications in the English language biomedical journals between 1982 and 2008. The search was limited to cancer, and included the combination of keywords 'quality of life', 'patient reported-outcomes' 'prognostic', 'predictor', 'predictive' and 'survival' that appeared in the titles of the publications. In addition, each study was examined to ensure that it used multivariate analysis. Purely psychological studies were excluded. A manual search was also performed to include additional papers of potential interest.
A total of 451 citations were identified in this rapid and systematic review of the literature. Of these, 104 citations on the relationship between quality of life and survival were found to be relevant and were further examined. The findings are summarized under different headings: heterogeneous samples of cancer patients, lung cancer, breast cancer, gastro-oesophageal cancers, colorectal cancer, head and neck cancer, melanoma and other cancers. With few exceptions, the findings showed that quality of life data or some aspects of quality of life measures were significant independent predictors of survival duration. Global quality of life, functioning domains and symptom scores - such as appetite loss, fatigue and pain - were the most important indicators, individually or in combination, for predicting survival times in cancer patients after adjusting for one or more demographic and known clinical prognostic factors.
This review provides evidence for a positive relationship between quality of life data or some quality of life measures and the survival duration of cancer patients. Pre-treatment (baseline) quality of life data appeared to provide the most reliable information for helping clinicians to establish prognostic criteria for treating their cancer patients. It is recommended that future studies should use valid instruments, apply sound methodological approaches and adequate multivariate statistical analyses adjusted for socio-demographic characteristics and known clinical prognostic factors with a satisfactory validation strategy. This strategy is likely to yield more accurate and specific quality of life-related prognostic variables for specific cancers.
健康相关的生活质量和生存是癌症研究和实践中的两个重要结果衡量指标。本文旨在研究癌症患者生活质量数据与生存时间之间的关系。
对 1982 年至 2008 年期间所有英文生物医学期刊的全文出版物进行了综述。检索仅限于癌症，并结合了关键词“生活质量”、“患者报告结果”、“预后”、“预测”、“预测性”和“生存”，这些词出现在出版物的标题中。此外，还对每项研究进行了检查，以确保其使用了多变量分析。排除了纯粹的心理学研究。还进行了手动搜索，以纳入其他潜在感兴趣的论文。
在对文献进行快速系统的综述中，共确定了 451 篇引文。其中，有 104 篇关于生活质量与生存之间关系的引文被认为是相关的，并进一步进行了研究。研究结果根据不同的标题进行了总结：癌症患者的异质样本、肺癌、乳腺癌、胃食管癌、结直肠癌、头颈部癌、黑色素瘤和其他癌症。除了少数例外，研究结果表明，生活质量数据或某些生活质量测量指标是生存时间的重要独立预测因素。总体生活质量、功能领域和症状评分（如食欲丧失、疲劳和疼痛）是预测癌症患者生存时间的最重要指标，无论是单独使用还是组合使用，在调整一个或多个人口统计学和已知临床预后因素后。
本综述提供了生活质量数据或某些生活质量测量指标与癌症患者生存时间之间存在正相关关系的证据。治疗前（基线）生活质量数据似乎为临床医生为癌症患者制定预后标准提供了最可靠的信息。建议未来的研究应使用有效的工具，采用稳健的方法学方法，并使用适当的多变量统计分析，调整社会人口统计学特征和已知的临床预后因素，并采用令人满意的验证策略。这种策略可能会为特定癌症产生更准确和具体的与生活质量相关的预后变量。
