First Department of Internal Medicine, German Hodgkin Study Group (GHSG), University of Cologne, Kerpener Street 62, D-50924 Cologne, Germany.
Br J Cancer. 2013 Jan 15;108(1):49-57. doi: 10.1038/bjc.2012.550.
Health-related quality of life (HRQoL) comprises different domains of physical, mental, and social well-being. In this analysis, we focus on sexual quality of life in Hodgkin Lymphoma (HL) patients.
Four-thousand one-hundred and sixty patients enroled in the HD10-HD12 trials underwent HRQoL assessment. Instruments included the Quality of Life Questionnaire for survivors (QLQ-S), combining the European Organisation for Research and Treatment of Cancer QLQ-C30, Multidimensional fatigue (FA) inventory (MFI-20) and an additional sexual functioning (SX) scale. We describe SX up to 27 months after therapy and analyse relationship to stage, age, gender, FA, social functioning, and therapy. Statistical methods range from descriptive statistics to a classification of SX courses, and a longitudinal structural equations model with full information maximum likelihood estimation of missing data. In the analysis, a score below 50 was used to describe severe sexual dysfunction.
Three-thousand two-hundred and eight patients provided data on SX. Patients in advanced stages reported lower SX than patients in early stages both, before and after the treatment. During follow-up, an improvement of SX compared with baseline was detected, except for those ≥50 years. Patients in early stages reached normal SX, whereas advanced-stage patients remained below the reference value for healthy controls. Sexual functioning during follow-up was significantly and strongly related to previous SX, other HRQoL measures, age, and stage, and to lesser degree with gender and chemotherapy.
Overall, HL patients have a decreased sexual quality of life at baseline, which improves after therapy and normalises in early-stage patients. Importantly, long-term SX is more closely related to patient characteristics and SX at baseline than to the intensity of treatment.
健康相关生活质量（HRQoL）包括身体、心理和社会福祉的不同领域。在本分析中，我们专注于霍奇金淋巴瘤（HL）患者的性健康质量。
在 HD10-HD12 试验中，有 4160 名患者接受了 HRQoL 评估。评估工具包括生存质量问卷（QLQ-S），它结合了欧洲癌症研究与治疗组织的 QLQ-C30、多维疲劳（FA）量表（MFI-20）和额外的性功能（SX）量表。我们描述了治疗后 27 个月内的 SX，并分析了与分期、年龄、性别、FA、社会功能和治疗的关系。统计方法包括描述性统计、SX 课程分类以及包含完全信息极大似然估计缺失数据的纵向结构方程模型。在分析中，使用低于 50 分来描述严重的性功能障碍。
3208 名患者提供了 SX 数据。晚期患者在治疗前后报告的 SX 均低于早期患者。在随访期间，除了≥50 岁的患者外，与基线相比，SX 有所改善。早期患者达到了正常的 SX，而晚期患者仍低于健康对照组的参考值。随访期间的性功能与之前的 SX、其他 HRQoL 指标、年龄和分期显著且强烈相关，与性别和化疗的相关性较小。
总体而言，HL 患者在基线时的性健康质量下降，治疗后有所改善，早期患者恢复正常。重要的是，长期的 SX 与患者特征和基线时的 SX 比与治疗强度更密切相关。
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