Office of Clinical Research, Cancer Treatment Centers of America at Midwestern Regional Medical Center, 2520 Elisha Avenue, Zion, IL 60099, USA.
Eur J Cancer Care (Engl). 2012 Sep;21(5):614-22. doi: 10.1111/j.1365-2354.2012.01332.x. Epub 2012 Feb 6.
In patients with advanced cancer, quality of life is as meaningful to patients as the actual length of life. We investigated whether changes in quality of life could predict survival in non-small cell lung cancer. Quality of life was evaluated using EORTC QLQ-C30 (European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire). Cox regression evaluated the prognostic significance of baseline, 3-month and changes in quality of life scores after adjusting for age, gender, treatment history and stage. Two hundred and seventeen patients were men and 213 women. One hundred and fifty-nine patients had stage III while 271 had stage IV disease. Baseline quality of life scales predictive of survival upon multivariate analysis were physical (hazard ratio, 0.90; 95% confidence interval, 0.81-0.98; P= 0.02) and global (hazard ratio, 0.92; 95% confidence interval, 0.87-0.96; P < 0.001). On multivariate analysis, no change variables were significantly predictive of survival. However, in stage IV patients, change in physical function over a period of 3 months showed marginal significance such that every 10-point increase in physical function change score was associated with an 8% decreased risk of death. These findings should be used in clinical practice to systematically address quality of life-related problems of lung cancer patients throughout their treatment course.
在晚期癌症患者中，生活质量与实际寿命一样对患者有意义。我们研究了生活质量的变化是否可以预测非小细胞肺癌患者的生存情况。使用 EORTC QLQ-C30（欧洲癌症研究与治疗组织生活质量问卷）评估生活质量。Cox 回归在调整年龄、性别、治疗史和分期后，评估了基线、3 个月时以及生活质量评分变化对生存的预后意义。217 名患者为男性，213 名患者为女性。159 名患者为 III 期，271 名患者为 IV 期疾病。多变量分析中，预测生存的基线生活质量量表包括身体功能（危险比，0.90；95%置信区间，0.81-0.98；P=0.02）和总体健康状况（危险比，0.92；95%置信区间，0.87-0.96；P<0.001）。多变量分析显示，无变化变量对生存没有显著预测意义。然而，在 IV 期患者中，3 个月期间身体功能的变化具有边缘意义，即身体功能变化评分每增加 10 分，死亡风险降低 8%。这些发现应在临床实践中使用，以系统地解决肺癌患者在整个治疗过程中与生活质量相关的问题。
