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食管癌或癌前病变患者的健康相关生命质量评估:一项多中心横断面研究。

Health-related quality of life in patients with esophageal cancer or precancerous lesions assessed by EQ-5D: A multicenter cross-sectional study.

机构信息

Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences/Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences/Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou, China.

Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Thorac Cancer. 2020 Apr;11(4):1076-1089. doi: 10.1111/1759-7714.13368. Epub 2020 Mar 4.

Abstract

BACKGROUND

We aimed to obtain a set of health state utility scores of patients with esophageal cancer (EC) and precancerous lesions in China, and to explore the influencing factors of health-related quality of life (HRQoL).

METHODS

A hospital-based multicenter cross-sectional study was conducted. From 2013 to 2014, patients with EC or precancerous lesions were enrolled. HRQoL was assessed using a European quality of life-5 dimension (EQ-5D-3L) instrument. Multivariable linear regression analysis was performed to explore the influencing factors of the EQ-5D utility scores.

RESULTS

A total of 2090 EC patients and 156 precancer patients were included in the study. The dimension of pain/discomfort had the highest rate of self-reported problems, 60.5% in EC and 51.3% in precancer patients. The mean visual analog scale (VAS) score for EC and precancer patients were 68.4 ± 0.7 and 64.5 ± 3.1, respectively. The EQ-5D utility scores for EC and precancer patients were estimated as 0.748 ± 0.009 and 0.852 ± 0.022, and the scores of EC at stage I, stage II, stage III, and stage IV were 0.693 ± 0.031, 0.747 ± 0.014, 0.762 ± 0.015, and 0.750 ± 0.023, respectively. According to the multivariable analyses, the factors of region, occupation, household income in 2012, health care insurance type, pathological type, type of therapy, and time points of the survey were statistically associated with the EQ-5D utility scores of EC patients.

CONCLUSIONS

There were remarkable decrements of utility scores among esophageal cancer patients, compared with precancer patients. The specific utility scores of EC would support further cost-utility analysis in populations in China.

摘要

背景

本研究旨在获得中国食管癌(EC)及癌前病变患者的健康状态效用评分,并探讨其健康相关生命质量(HRQoL)的影响因素。

方法

采用医院为基础的多中心横断面研究。2013 年至 2014 年,入组 EC 或癌前病变患者。采用欧洲生命质量五维量表(EQ-5D-3L)评估 HRQoL。采用多变量线性回归分析探讨 EQ-5D 效用评分的影响因素。

结果

共纳入 2090 例 EC 患者和 156 例癌前病变患者。在 EC 和癌前病变患者中,维度疼痛/不适的自我报告问题发生率最高,分别为 60.5%和 51.3%。EC 和癌前病变患者的视觉模拟量表(VAS)评分均值分别为 68.4±0.7 和 64.5±3.1。EC 和癌前病变患者的 EQ-5D 效用评分分别估计为 0.748±0.009 和 0.852±0.022,EC 患者的Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期评分分别为 0.693±0.031、0.747±0.014、0.762±0.015 和 0.750±0.023。多变量分析显示,地区、职业、2012 年家庭收入、医保类型、病理类型、治疗方式和调查时间点是 EC 患者 EQ-5D 效用评分的影响因素。

结论

与癌前病变患者相比,食管癌患者的效用评分明显下降。EC 的具体效用评分将支持在中国人群中进行进一步的成本效用分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8212/7113059/6eaddbc65123/TCA-11-1076-g001.jpg

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