Quality of Life Department, European Organization for Research and Treatment of Cancer Headquarters, Brussels, Belgium.
Cancer. 2014 Jan 15;120(2):302-11. doi: 10.1002/cncr.28382. Epub 2013 Oct 11.
BACKGROUND: The objective of this study was to examine the prognostic value of baseline health-related quality of life (HRQOL) for survival with regard to different cancer sites using 1 standardized and validated patient self-assessment tool. METHODS: In total, 11 different cancer sites pooled from 30 European Organization for Research and Treatment of Cancer (EORTC) randomized controlled trials were selected for this study. For each cancer site, univariate and multivariate Cox proportional hazards modeling was used to assess the prognostic value (P< .05) of 15 HRQOL parameters using the EORTC Core Quality of Life Questionnaire (QLQ-C30). Models were adjusted for age, sex, and World Health Organization performance status and were stratified by distant metastasis. RESULTS: In total, 7417 patients completed the EORTC QLQ-C30 before randomization. In brain cancer, cognitive functioning was predictive for survival; in breast cancer, physical functioning, emotional functioning, global health status, and nausea and vomiting were predictive for survival; in colorectal cancer, physical functioning, nausea and vomiting, pain, and appetite loss were predictive for survival; in esophageal cancer, physical functioning and social functioning were predictive for survival; in head and neck cancer, emotional functioning, nausea and vomiting, and dyspnea were predictive for survival; in lung cancer, physical functioning and pain were predictive for survival; in melanoma, physical functioning was predictive for survival; in ovarian cancer, nausea and vomiting were predictive for survival; in pancreatic cancer, global health status was predictive for survival; in prostate cancer, role functioning and appetite loss were predictive for survival; and, in testis cancer, role functioning was predictive for survival. CONCLUSIONS: The current results demonstrated that, for each cancer site, at least 1 HRQOL domain provided prognostic information that was additive over and above clinical and sociodemographic variables.
背景:本研究旨在使用 1 种标准化和经过验证的患者自我评估工具,通过 11 个不同的癌症部位,从 30 项欧洲癌症研究与治疗组织(EORTC)随机对照试验中,检验基线健康相关生活质量(HRQOL)对生存的预后价值。
方法:为了这项研究,从 30 项欧洲癌症研究与治疗组织(EORTC)随机对照试验中选择了 11 个不同的癌症部位。对于每个癌症部位,使用 EORTC 核心生活质量问卷(QLQ-C30)的单变量和多变量 Cox 比例风险模型来评估 15 个 HRQOL 参数的预后价值(P<0.05)。模型调整了年龄、性别和世界卫生组织表现状态,并按远处转移进行分层。
结果:共有 7417 名患者在随机分组前完成了 EORTC QLQ-C30。在脑癌中,认知功能对生存有预测作用;在乳腺癌中,身体功能、情绪功能、整体健康状况、恶心和呕吐对生存有预测作用;在结直肠癌中,身体功能、恶心和呕吐、疼痛和食欲减退对生存有预测作用;在食道癌中,身体功能和社会功能对生存有预测作用;在头颈部癌症中,情绪功能、恶心和呕吐、呼吸困难对生存有预测作用;在肺癌中,身体功能和疼痛对生存有预测作用;在黑色素瘤中,身体功能对生存有预测作用;在卵巢癌中,恶心和呕吐对生存有预测作用;在胰腺癌中,整体健康状况对生存有预测作用;在前列腺癌中,角色功能和食欲减退对生存有预测作用;在睾丸癌中,角色功能对生存有预测作用。
结论:目前的结果表明,对于每个癌症部位,至少有 1 个 HRQOL 领域提供了预后信息,这些信息在临床和社会人口统计学变量之外具有附加价值。
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