Friis Rasmus Blechingberg, Hjøllund Niels Henrik, Pappot Helle, Taarnhøj Gry Assam, Vestergaard Jesper Medom, Skuladottir Halla
Department of Oncology, Hospital Unit West Jutland, Herning, Denmark.
AmbuFlex/WestChronic, Occupational Medicine, University Research Clinic, Aarhus University, Herning, Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Clin Lung Cancer. 2021 Mar;22(2):e169-e179. doi: 10.1016/j.cllc.2020.09.014. Epub 2020 Oct 15.
Patient-reported outcome (PRO) measures have been increasingly implemented in routine care to aid in clinical decision-making. However, the prognostic value of PRO measures as a tool for decision making is not easily interpreted by clinicians. Our aims were to explore the prognostic value of PRO measures at disease progression and the changes in PRO measures between treatment start (baseline) and disease progression.
Since 2014, patients with lung cancer have completed an electronic version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires C30 and LC-13 before every outpatient visit at the Department of Oncology, Hospital Unit West, Jutland, Denmark. The patients' responses were used in routine care. Patients receiving palliative antineoplastic treatment were eligible for analysis if the questionnaire had been completed at the initiation of first-line treatment and at disease progression. The prognostic value of the scores was evaluated using a Cox proportional hazard model. A P value < .01 was considered statistically significant.
A total of 94 screened patients were included. At disease progression, survival could be predicted from the absolute score of the global health scale, 3 functional scales (physical, role, emotional), and 7 symptom scales (fatigue, pain, dyspnea, hemoptysis, lung cancer dyspnea, chest pain). In addition, changes in hemoptysis, dysphagia, dyspnea, and chest pain predicted for survival at progression.
PRO measures used in routine care can provide clinicians with relevant prognostic information about patients with lung cancer at disease progression. These results show the potential value of PRO measures when used in clinical decision-making.
患者报告结局（PRO）指标已越来越多地应用于常规护理中，以辅助临床决策。然而，PRO指标作为决策工具的预后价值，临床医生并不容易解读。我们的目的是探讨PRO指标在疾病进展时的预后价值，以及从治疗开始（基线）到疾病进展期间PRO指标的变化。
自2014年以来，丹麦日德兰半岛西部医院肿瘤科的肺癌患者在每次门诊就诊前都要完成一份电子版的欧洲癌症研究与治疗组织生活质量问卷C30和LC-13。患者的回答用于常规护理。接受姑息性抗肿瘤治疗的患者，如果在一线治疗开始时和疾病进展时完成了问卷，就有资格进行分析。使用Cox比例风险模型评估评分的预后价值。P值<0.01被认为具有统计学意义。
共纳入94例经过筛选的患者。在疾病进展时，可根据总体健康量表的绝对得分、3个功能量表（身体、角色、情感）和7个症状量表（疲劳、疼痛、呼吸困难、咯血、肺癌相关呼吸困难、胸痛）预测生存率。此外，咯血、吞咽困难、呼吸困难和胸痛的变化可预测疾病进展时的生存率。
常规护理中使用的PRO指标可为临床医生提供肺癌患者疾病进展时的相关预后信息。这些结果显示了PRO指标在临床决策中的潜在价值。
