Rapid Response Radiotherapy Program, Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.
Support Care Cancer. 2013 Jun;21(6):1709-16. doi: 10.1007/s00520-013-1717-7. Epub 2013 Jan 22.
This study examined which domains/symptoms from the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 15 Palliative (QLQ-C15-PAL), an abbreviated version of the health-related EORTC QLQ-C30 questionnaire designed for palliative cancer patients, were predictive of overall quality of life (QOL) in advanced cancer patients.
Patients with advanced cancer from six countries completed the QLQ-C15-PAL at consultation and at one follow-up point. Univariate and multivariate regression analyses were conducted to determine the predictive value of the EORTC QLQ-C15-PAL functional/symptom scores for global QOL (question 15).
Three hundred forty-nine patients completed the EORTC QLQ-C15-PAL at baseline. In the total patient sample, worse emotional functioning, pain, and appetite loss were the most significant predictive factors for worse QOL. In the subgroup of patients with bone metastases (n = 240), the domains mentioned above were also the most significant predictors, whereas in patients with brain metastases (n = 109), worse physical and emotional functioning most significantly predicted worse QOL. One-month follow-up in 267 patients revealed that the significant predictors changed somewhat over time. For example, in the total patient sample, physical functioning, fatigue, and appetite loss were significant predictors at the follow-up point. A sub-analysis of predictive factors affecting QOL by primary cancer (lung, breast, and prostate) was also conducted for the total patient sample.
Deterioration of certain EORTC QLQ-C15-PAL functional/symptom scores significantly contributes to worse overall QOL. Special attention should be directed to managing factors most influential on overall QOL to ensure optimal management of advanced cancer patients.
本研究旨在探讨欧洲癌症研究与治疗组织（EORTC）生活质量问卷核心 15 项（QLQ-C15-PAL）的哪些领域/症状，这是为晚期癌症患者设计的 EORTC QLQ-C30 健康相关问卷的缩写版本，能够预测晚期癌症患者的总体生活质量（QOL）。
来自六个国家的晚期癌症患者在就诊时和一个随访点完成了 QLQ-C15-PAL。进行了单变量和多变量回归分析，以确定 EORTC QLQ-C15-PAL 功能/症状评分对全球 QOL（问题 15）的预测价值。
349 名患者在基线时完成了 EORTC QLQ-C15-PAL。在总患者样本中，情绪功能障碍、疼痛和食欲丧失是 QOL 较差的最显著预测因素。在有骨转移的患者亚组（n=240）中，上述领域也是最显著的预测因素，而在有脑转移的患者亚组（n=109）中，身体和情绪功能障碍的恶化则是预测 QOL 较差的最重要因素。267 名患者的一个月随访结果显示，随着时间的推移，显著预测因素发生了一些变化。例如，在总患者样本中，身体功能、疲劳和食欲丧失在随访点是显著的预测因素。还对总患者样本中按原发性癌症（肺癌、乳腺癌和前列腺癌）进行的 QOL 影响预测因素的亚分析。
某些 EORTC QLQ-C15-PAL 功能/症状评分的恶化显著导致总体 QOL 下降。应特别注意管理对总体 QOL 影响最大的因素，以确保对晚期癌症患者的最佳管理。
