Dirven Linda, Aaronson Neil K, Heimans Jan J, Taphoorn Martin J B
Department of Neurology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, Netherlands.
Chin J Cancer. 2014 Jan;33(1):40-5. doi: 10.5732/cjc.013.10214.
Gliomas are malignant primary brain tumors and yet incurable. Palliation and the maintenance or improvement of the patient's quality of life is therefore of main importance. For that reason, health-related quality of life (HRQoL) has become an important outcome measure in clinical trials, next to traditional outcome measures such as overall and progression-free survivals, and radiological response to treatment. HRQoL is a multidimensional concept covering physical, psychological, and social domains, as well as symptoms induced by the disease and its treatment. HRQoL is assessed by using self-reported, validated questionnaires. Various generic HRQoL questionnaires, which can be supplemented with a brain tumor- specific module, are available. Both the tumor and its treatment can have a negative effect on HRQoL. However, treatment with surgery, radiotherapy, chemotherapy, and supportive treatment may also improve patients' HRQoL, in addition to extending survival. It is expected that the impact of HRQoL measurements in both clinical trials and clinical practice will increase. Hence, it is important that HRQoL data are collected, analyzed, and interpreted correctly. Methodological issues such as selection bias and missing data may hamper the interpretation of HRQoL data and should therefore be accounted. In clinical trials, HRQoL can be used to assess the benefits of a new treatment strategy, which should be weighed carefully against the adverse effects of that treatment. In daily clinical practice, HRQoL assessments of an individual patient can be used to inform physicians about the impact of a specific treatment strategy, and it may facilitate the communication between the physicians and the patients.
胶质瘤是恶性原发性脑肿瘤，且无法治愈。因此，缓解症状以及维持或改善患者的生活质量至关重要。出于这个原因，除了传统的疗效指标，如总生存期、无进展生存期以及对治疗的放射学反应外，健康相关生活质量（HRQoL）已成为临床试验中的一项重要疗效指标。HRQoL是一个多维概念，涵盖身体、心理和社会领域，以及疾病及其治疗引发的症状。HRQoL通过使用经过验证的自我报告问卷进行评估。有各种通用的HRQoL问卷可供使用，还可辅以特定于脑肿瘤的模块。肿瘤及其治疗均可对HRQoL产生负面影响。然而，手术、放疗、化疗和支持性治疗除了能延长生存期外，也可能改善患者的HRQoL。预计HRQoL测量在临床试验和临床实践中的影响将会增加。因此，正确收集、分析和解释HRQoL数据非常重要。诸如选择偏倚和数据缺失等方法学问题可能会妨碍对HRQoL数据的解释，因此应予以考虑。在临床试验中，HRQoL可用于评估新治疗策略的益处，这需要与该治疗的不良反应仔细权衡。在日常临床实践中，对个体患者的HRQoL评估可用于让医生了解特定治疗策略的影响，并且可能促进医生与患者之间的沟通。
