Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Laboratory of Experimental Oncology (LEO), Department of Oncology, KU, Leuven, Belgium.
J Geriatr Oncol. 2019 Nov;10(6):895-903. doi: 10.1016/j.jgo.2019.03.018. Epub 2019 Apr 18.
This study aims to investigate health-related quality of life (HRQOL) at baseline and at follow-up in older patients with cancer and to determine prognostic factors for HRQOL decline.
A prospective Belgian multicentre (n = 22) study was performed. Patients ≥70 years with a malignant tumor and abnormal G8 (≤14/17) screening tool were included. Patients underwent geriatric assessment (GA) and HRQOL evaluation with follow up at three months. Uni- and multivariate regression models were performed to determine factors associated (p < .05) with baseline HRQOL and HRQOL decline at follow-up.
Results reflect data collected from 3673 patients. A multivariate analysis showed that younger patients, and those with poor Eastern Cooperative Oncology Group - Performance Status (ECOG-PS), specific tumor types (gastrointestinal, gynaecological and thorax) and higher stage had lower baseline HRQOL. In addition worse functional status and presence of pain, fatigue, depression and malnutrition were associated with lower baseline HRQOL. During treatment (n = 2972), improvement in HRQOL was observed in 1037 patients (35%) and a decline in 838 patients (28.2%). In multivariate analysis, stage and presence of baseline comorbidities, pain, fatigue or malnutrition were associated with HRQOL evolution.
Baseline HRQOL in older patients with cancer and an abnormal G8 depends on tumor and age related parameters. During follow-up, HRQOL improved in one third of patients, indicating that they may benefit from cancer treatment while one quarter demonstrated a HRQOL decline for which prognostic factors were identified.
本研究旨在调查老年癌症患者基线和随访时的健康相关生活质量（HRQOL），并确定 HRQOL 下降的预测因素。
进行了一项前瞻性的比利时多中心研究（n=22）。纳入年龄≥70 岁、有恶性肿瘤且 G8 筛查工具异常（≤14/17）的患者。患者接受老年评估（GA）和 HRQOL 评估，并在三个月时进行随访。采用单变量和多变量回归模型来确定与基线 HRQOL 和随访时 HRQOL 下降相关的因素（p<0.05）。
结果反映了从 3673 名患者中收集的数据。多变量分析显示，年龄较小、ECOG-PS 评分较差、特定肿瘤类型（胃肠道、妇科和胸部）和较高分期的患者基线 HRQOL 较低。此外，功能状态较差、存在疼痛、疲劳、抑郁和营养不良与基线 HRQOL 较低相关。在治疗期间（n=2972），1037 名患者（35%）的 HRQOL 有所改善，838 名患者（28.2%）的 HRQOL 下降。多变量分析显示，分期和基线合并症的存在、疼痛、疲劳或营养不良与 HRQOL 的演变相关。
异常 G8 的老年癌症患者的基线 HRQOL 取决于肿瘤和年龄相关参数。在随访期间，三分之一的患者 HRQOL 有所改善，这表明他们可能受益于癌症治疗，而四分之一的患者 HRQOL 下降，确定了其预后因素。
