Amsterdam University Medical Centers, Department of Otolaryngology-Head and Neck Surgery, Amsterdam, The Netherlands.
Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, department of Epidemiology and Biostatistics, Amsterdam Public Health, Amsterdam, The Netherlands.
Qual Life Res. 2021 Apr;30(4):1145-1153. doi: 10.1007/s11136-020-02716-x. Epub 2020 Dec 8.
We aimed to examine whether pre-treatment, post-treatment and change in health-related quality of Life (HRQoL) is associated with survival, in patients with head and neck cancer (HNC).
We included 948 newly diagnosed HNC patients treated with primary or adjuvant (chemo)radiotherapy with curative intent. The EORTC QLQ-C30 questionnaire was assessed pre-treatment and at 6 weeks, 6 months and 12 months post-treatment. Multivariable Cox regression analyses were performed to examine whether HRQoL at all time points and changes in HRQoL over time were associated with survival, after adjusting for demographic, clinical and lifestyle-related variables.
Higher HRQoL scores were significantly associated with improved 5-year overall survival at all time points, except for the subscale global QoL at 6 weeks. Changes in HRQoL at 6 weeks post-treatment compared to pre-treatment were not significantly associated with survival. Changes in physical (HR: 0.88 95% CI: 0.82-0.96) and emotional functioning (HR: 0.90 95% CI: 0.85-0.96) from pre-treatment to 6 months post-treatment and changes in global QOL, and physical, emotional, and social functioning from pre-treatment to 12 months post-treatment were significantly associated with survival.
Higher HRQoL reported pre-treatment and post-treatment (6 weeks, 6 months and 12 months) are significantly associated with improved survival, as well as changes in HRQoL at 6 and 12 months compared to pre-treatment. Our results highlight the value of monitoring HRQoL and to identify those patients that report decreased or deteriorated HRQOL. This may help to further improve cancer care in a timely and efficient manner.
本研究旨在探讨头颈部癌症（HNC）患者治疗前后健康相关生活质量（HRQoL）的变化是否与生存相关。
我们纳入了 948 例接受根治性或辅助（放）化疗的初诊 HNC 患者。在治疗前及治疗后 6 周、6 个月和 12 个月时采用 EORTC QLQ-C30 问卷进行评估。采用多变量 Cox 回归分析，在校正了人口统计学、临床和生活方式相关变量后，探讨所有时间点的 HRQoL 及 HRQoL 随时间的变化与生存的关系。
除治疗后 6 周的总体健康状况维度外，HRQoL 评分较高与各时间点的 5 年总生存率提高显著相关。与治疗前相比，治疗后 6 周 HRQoL 的变化与生存无显著相关性。与治疗前相比，治疗后 6 个月时的躯体功能（HR：0.88，95%CI：0.82-0.96）和情绪功能（HR：0.90，95%CI：0.85-0.96）的变化，以及治疗后 12 个月时的总体健康状况、躯体功能、情绪功能和社会功能的变化与生存显著相关。
治疗前和治疗后（6 周、6 个月和 12 个月）报告的较高 HRQoL 与生存改善显著相关，与治疗前相比，6 个月和 12 个月时 HRQoL 的变化也与生存相关。本研究结果强调了监测 HRQoL 的重要性，并确定了那些报告 HRQoL 下降或恶化的患者。这可能有助于及时、有效地改善癌症治疗。
