Thong Melissa S Y, Kicinski Michal, Coens Corneel, Giusti Francesco, van de Poll-Franse Lonneke, Bogaerts Jan, Liu Lifang
aDepartment of Medical Psychology, Academic Medical Hospital, Amsterdam Public Health Research Institute, University of Amsterdam bDivision of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam cNetherlands Comprehensive Cancer Organisation (IKNL), Utrecht dDivision of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands eDepartment of Statistics fDepartment of Quality of Life, European Organisation for the Research and Treatment of Cancer (EORTC), Brussels, Belgium gEU Commission Joint Research Center, Ispra, Italy.
Eur J Cancer Prev. 2017 Sep;26 Joining forces for better cancer registration in Europe:S223-S228. doi: 10.1097/CEJ.0000000000000381.
Survival discrepancy between patients treated in a clinical trial and routine practice is well recognized. No study has assessed the health-related quality of life (HRQL) of long-term Hodgkin's lymphoma survivors (HLS) according to trial participation. We applied a population-based approach to examine the differences in HRQL, healthcare utilization, and satisfaction with healthcare among long-term HLS who had participated in a trial (tHLS) and those treated in routine care (rHLS). All HLS diagnosed during the period 1989-1998 and living in southern Netherlands were selected from the Netherlands Cancer Registry in 2004 to participate in the Patient Reported Outcomes Following Initial treatment and Long-term Evaluation of Survivorship registry study. Data linkage with the European Organisation for Research and Treatment of Cancer was performed in 2015 to identify trial participation. The 65 tHLS and 67 rHLS had comparable demographic and clinical characteristics. Unadjusted and adjusted models indicated no association between trial participation and HRQL. There was no evidence of differences in healthcare satisfaction. Trial participation was associated with 48% more visits to specialists in the past year (adjusted 95% confidence interval: 10-99). No association of trial participation with cancer-related contacts was observed. tHLS and rHLS had comparable long-term HRQL. Although trial participation was associated with more specialist visits, there was no evidence of an association with healthcare satisfaction and the number of cancer-related visits. Identification of trial participation in population-based cancer registry through data linkage with clinical trials enables a population-based approach to examine patient-reported outcomes differences between tHLS and rHLS.
临床试验中接受治疗的患者与常规医疗中接受治疗的患者之间的生存差异已得到充分认识。尚无研究根据是否参与试验评估长期霍奇金淋巴瘤幸存者(HLS)的健康相关生活质量(HRQL)。我们采用基于人群的方法,研究参与试验的长期HLS(tHLS)与接受常规治疗的长期HLS(rHLS)在HRQL、医疗保健利用以及对医疗保健的满意度方面的差异。2004年从荷兰癌症登记处选取了1989年至1998年期间在荷兰南部被诊断出且仍在世的所有HLS,参与初始治疗后患者报告结局及幸存者长期评估登记研究。2015年与欧洲癌症研究与治疗组织进行了数据关联,以确定试验参与情况。65名tHLS和67名rHLS具有可比的人口统计学和临床特征。未调整和调整后的模型均表明试验参与与HRQL之间无关联。没有证据表明在医疗保健满意度方面存在差异。试验参与与过去一年中多48%的专科就诊次数相关(调整后的95%置信区间:10 - 99)。未观察到试验参与与癌症相关就诊次数之间的关联。tHLS和rHLS具有可比的长期HRQL。尽管试验参与与更多的专科就诊次数相关,但没有证据表明与医疗保健满意度和癌症相关就诊次数存在关联。通过与临床试验进行数据关联在基于人群的癌症登记处识别试验参与情况,能够采用基于人群的方法来研究tHLS和rHLS之间患者报告结局的差异。