Kumar Satwant, Rana Madhu Lata, Verma Khushboo, Singh Narayanjeet, Sharma Anil Kumar, Maria Arun Kumar, Dhaliwal Gobind Singh, Khaira Harkiran Kaur, Saini Sunil
Institute of Bioinformatics, Bangalore, Karnataka, India ; Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India.
Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India ; Himalayan Institute of Medical Sciences(HIMS), Dehradun, Uttarkhand, India.
PLoS One. 2014 Feb 26;9(2):e89851. doi: 10.1371/journal.pone.0089851. eCollection 2014.
Cervical cancer is the third largest cause of cancer mortality in India. The objectives of the study were to compare the pre and the post treatment quality of life in cervical cancer patients and to develop a prediction model to provide an insight into the possibilities in the treatment modules.
METHODOLOGY/PRINCIPAL FINDINGS: A total of 198 patients were assessed with two structured questionnaires of Health Related Quality of Life (The European Organisation for Research and Treatment of Cancer, EORTC QLQ C-30 and CX-24). The baseline observations were recorded when the patients first reported (T1) and second evaluation was done at 6 months post treatment (T2). The mean age of detection was 50.9 years with the literacy level being non-educated or less than high school. Majority of them were married/cohabiting 179 (90.4%). On histopathological examination (HPE) squamous cell carcinoma was found to be the most common cell type carcinoma 147 (74.2%) followed by Adenocarcinoma 31 (15.7%). Radical hysterectomy was the most common treatment modality 76 (38.4%), followed by Wertheims Hysterectomy 46 (23.2%) and Radiochemotherapy 59 (29.8%). The mean score of global health of cervical cancer patients post treatment was 77.90, which was significantly higher than the pre - treatment score (54.32). Mean "symptoms score" post treatment was 21.69 with an aggravation of 7.32 compared to pre treatment scores. Patients experienced substantial decrease in sexual activity post treatment.
CONCLUSIONS/SIGNIFICANCE: The prediction model(PrediQt-Cx), based on Support Vector Machine(SVM) for predicting post treatment HRQoL in cervical cancer patients was developed and internally cross validated. After external validation PrediQt-Cx can be easily employed to support decision making by clinicians and patients from north India region, through openly made available for access at http://prediqt.org.
宫颈癌是印度癌症死亡的第三大原因。本研究的目的是比较宫颈癌患者治疗前后的生活质量,并开发一个预测模型,以深入了解治疗模式中的可能性。
方法/主要发现:共有198名患者使用两份与健康相关的生活质量结构化问卷(欧洲癌症研究与治疗组织,EORTC QLQ C - 30和CX - 24)进行评估。基线观察在患者首次报告时记录(T1),第二次评估在治疗后6个月进行(T2)。检测时的平均年龄为50.9岁,识字水平为未受过教育或低于高中。他们中的大多数已婚/同居179人(90.4%)。在组织病理学检查(HPE)中,鳞状细胞癌是最常见的细胞类型癌,有147例(74.2%),其次是腺癌31例(15.7%)。根治性子宫切除术是最常见的治疗方式,有76例(38.4%),其次是韦特海姆子宫切除术46例(23.2%)和放化疗59例(29.8%)。宫颈癌患者治疗后的总体健康平均得分为77.90,显著高于治疗前得分(54.32)。治疗后的平均“症状得分”为21.69,与治疗前得分相比加重了7.32。患者治疗后性活动大幅减少。
结论/意义:基于支持向量机(SVM)开发了用于预测宫颈癌患者治疗后健康相关生活质量的预测模型(PrediQt - Cx),并进行了内部交叉验证。经过外部验证后,PrediQt - Cx可通过在http://prediqt.org上公开获取,轻松用于支持印度北部地区临床医生和患者的决策。