Shields Lisa B E, Choucair Aliisha, Choucair Ali K
Norton Neuroscience Institute and Norton Cancer Institute, Norton Healthcare, Louisville, KY 40202, USA.
Surg Neurol Int. 2013 Apr 5;4:48. doi: 10.4103/2152-7806.110143. Print 2013.
The health-related quality of life (HRQOL) measures serve as valuable indicators of survival in patients with newly diagnosed primary brain tumors (PBTs). HRQOL outcomes may benefit clinical decision-making by individualizing patient treatment and improving communications between the doctor, patient, and families. Exploring the individual items of the European Organization and Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QOL) measures may be predictive of prognosis.
We prospectively collected the validated HRQOL and standard clinical and radiological measures from 48 patients with newly diagnosed PBT. The patients were followed every 3 months over 2 years. No proxies were allowed. Questionnaire responses were compared between two groups: Patients with recurrence and/or death (n = 26) and patients without a recurrence (n = 22). A total of 17 patients succumbed to a tumor-related death. Statistical analysis utilizing nonparametric t-tests and Wilcoxon sign tests assessed QOL responses.
Significant group differences were noted in the QOL measures with more negative responses in the recurrence group. EORTC QLQ-C30 questions revealed a poor global HRQOL scale (P < 0.005) and pain interfering with daily activities (P < 0.05). EORTC QLQ-BN20 questions revealed weakness of the legs (P < 0.05), coordination difficulties (P < 0.005), and unsteady gait (P < 0.05). Hospital Anxiety and Depression Scale (HADS) questions reflected a patient who is slowed down (P < 0.01) and "frightened" (P < 0.05).
Our analysis of longitudinal HRQOL measures may shed light on the prognostic significance of HRQOL measures in patients with newly diagnosed PBT. Further research is warranted to determine which selected individual measures of the EORTC QOL measures may be predictive of a patient's progression-free and overall survival and to test their validity and reliability in clinical trials.
健康相关生活质量（HRQOL）指标是新诊断原发性脑肿瘤（PBT）患者生存的重要指标。HRQOL结果可能通过个体化患者治疗以及改善医生、患者和家属之间的沟通，为临床决策提供帮助。探索欧洲癌症研究与治疗组织生活质量问卷（EORTC QOL）指标的各个项目可能对预后具有预测作用。
我们前瞻性收集了48例新诊断PBT患者经过验证的HRQOL以及标准临床和影像学指标。在2年时间里，每3个月对患者进行一次随访。不允许使用代理人。对两组患者的问卷回答进行比较：复发和/或死亡患者（n = 26）和未复发患者（n = 22）。共有17例患者死于肿瘤相关原因。利用非参数t检验和Wilcoxon符号检验进行统计分析，评估生活质量回答情况。
在生活质量指标方面发现了显著的组间差异，复发组的负面回答更多。EORTC QLQ-C30问题显示总体HRQOL量表较差（P < 0.005）以及疼痛干扰日常活动（P < 0.05）。EORTC QLQ-BN20问题显示腿部无力（P < 0.05）、协调困难（P < 0.005）和步态不稳（P < 0.05）。医院焦虑抑郁量表（HADS）问题反映出患者行动迟缓（P < 0.01）和“恐惧”（P < 0.05）。
我们对纵向HRQOL指标的分析可能有助于揭示HRQOL指标在新诊断PBT患者中的预后意义。有必要进行进一步研究，以确定EORTC QOL指标中哪些选定的个体指标可能预测患者的无进展生存期和总生存期，并在临床试验中检验其有效性和可靠性。
