Jeon Hyeonjin, Eo Wankyu, Shim Bumsang, Kim Sehyun, Lee Sookyung
Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
Department of Medical Oncology & Hematology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
Evid Based Complement Alternat Med. 2020 Jan 20;2020:2845401. doi: 10.1155/2020/2845401. eCollection 2020.
The impact of health-related quality of life (HRQoL) on survival has been investigated in patients with various cancers. Here, we evaluated the prognostic value of HRQoL using the Functional Assessment of Cancer Therapy-General (FACT-G) in advanced non-small-cell lung cancer (NSCLC) patients treated with Korean medicine.
A retrospective review of medical records and FACT-G scores of patients with advanced NSCLC who received treatment with Korean medicine was conducted. The reliability of the FACT-G was determined using Cronbach's alpha and calculating floor-and-ceiling effects. Correlations between FACT-G scores were estimated using Pearson's correlation analysis. Overall survival was calculated using the Kaplan-Meier method, and the prognostic impact of FACT-G scores and patients' characteristics was evaluated with Cox proportional hazards regression.
Of the 165 enrolled patients, 115 (70%) had extrathoracic metastasis and 139 (84%) had undergone prior anticancer treatment. The median overall survival was 10.1 months. The mean FACT-G score was 65.0, and Cronbach's alpha for the FACT-G was 0.917. Age ≥65 years, male sex, smoking history, squamous-cell carcinoma, Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≥2, and presence of extrathoracic metastasis were associated with an increased risk of mortality. High FACT-G total scores, physical well-being (PWB), emotional well-being, and functional well-being were associated with prolonged survival. After adjusting for age, sex, smoking history, ECOG-PS, histological type, and presence of extrathoracic metastasis, a high FACT-G total score (hazard ratio (HR): 0.99, =0.032) and high PWB score (HR: 0.94, < 0.001) were associated with prolonged survival as independent prognostic factors in patients with advanced NSCLC.
The FACT-G total score and PWB score as HRQoL measurements were significant prognostic factors for survival in advanced NSCLC patients treated with Korean medicine. This finding implies that the FACT-G can be used in clinical practice as a predictor of survival in patients with advanced NSCLC.
已在各类癌症患者中研究了健康相关生活质量（HRQoL）对生存的影响。在此，我们使用癌症治疗通用功能评估量表（FACT - G）评估了接受韩医学治疗的晚期非小细胞肺癌（NSCLC）患者中HRQoL的预后价值。
对接受韩医学治疗的晚期NSCLC患者的病历和FACT - G评分进行回顾性分析。使用Cronbach's α系数并计算地板效应和天花板效应来确定FACT - G的可靠性。使用Pearson相关分析估计FACT - G评分之间的相关性。采用Kaplan - Meier法计算总生存期，并通过Cox比例风险回归评估FACT - G评分和患者特征的预后影响。
在165例入组患者中，115例（70%）有胸外转移，139例（84%）曾接受过抗癌治疗。中位总生存期为10.1个月。FACT - G平均评分为65.0，FACT - G的Cronbach's α系数为0.917。年龄≥65岁、男性、吸烟史、鳞状细胞癌、东部肿瘤协作组体能状态（ECOG - PS）≥2以及存在胸外转移与死亡风险增加相关。FACT - G总分、生理健康（PWB）、情绪健康和功能健康得分高与生存期延长相关。在调整年龄、性别、吸烟史、ECOG - PS、组织学类型和胸外转移情况后，FACT - G总分高（风险比（HR）：0.99， =0.032）和PWB得分高（HR：0.94， < 0.001）作为独立预后因素与晚期NSCLC患者生存期延长相关。
作为HRQoL测量指标的FACT - G总分和PWB得分是接受韩医学治疗的晚期NSCLC患者生存的重要预后因素。这一发现表明FACT - G可在临床实践中用作晚期NSCLC患者生存的预测指标。
