Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong, SAR, China.
Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong, SAR, China.
Qual Life Res. 2021 Jun;30(6):1583-1594. doi: 10.1007/s11136-020-02729-6. Epub 2021 Jan 14.
This study aimed to investigate changes of QoL during the first 5 years of survival among disease-free Chinese breast cancer survivors.
A prospective cohort study enrolled 1462 Chinese women with early-stage breast cancer, and longitudinally visited those patients at four time-points, namely baseline (T0), 18- (T1), 36- (T2), and 60-month (T3) after diagnosis. This study included 992 patients who were disease-free during the first 5 years of survival and who had completed QoL assessments at all four time-points.
The score of global health status/QoL improved gradually (T1, T2, T3 > T0; P < 0.001 for overall comparisons). Social functioning score significantly improved when compared to that of T0 (T1, T2, T3 > T0; P < 0.001 for overall comparisons). In contrast, cognitive functioning score decreased (T0 > T1, T2, T3; P < 0.001 for overall comparisons). Scores of physical functioning, role functioning and emotional functioning showed a fluctuated picture, with the highest score achieved at T1. In symptoms profile, most of them scored lowest at T1 (best QoL). Multivariate analysis showed that several characteristics significantly correlated to changes in QoL from T0 to T3. For instance, patients with higher education had better recovery of physical functioning, role functioning, and social functioning.
During the first 5 years of survival, patients' global health status/QoL improved over time, social functioning consistently improved, but cognitive functioning steadily deteriorated. Most of functioning domains and symptoms improved at 18-month follow-up, but such improvements were not maintained and even deteriorated at 36- and 60-month post-diagnosis. This study suggested that some interventions should be investigated during such period.
本研究旨在探讨无病生存 5 年内中国乳腺癌幸存者生活质量（QoL）的变化。
前瞻性队列研究纳入了 1462 例早期乳腺癌中国女性患者，并在四个时间点（基线（T0）、18 个月（T1）、36 个月（T2）和 60 个月（T3））对这些患者进行了纵向随访。本研究纳入了 992 例在无病生存的前 5 年内且在所有四个时间点完成 QoL 评估的患者。
全球健康状况/QoL 评分逐渐提高（T1、T2、T3>T0；整体比较 P<0.001）。与 T0 相比，社会功能评分显著提高（T1、T2、T3>T0；整体比较 P<0.001）。相反，认知功能评分下降（T0>T1、T2、T3；整体比较 P<0.001）。身体功能、角色功能和情感功能评分呈波动变化，T1 时得分最高。在症状谱中，大多数在 T1 时得分最低（QoL 最佳）。多变量分析显示，一些特征与 T0 至 T3 期间 QoL 的变化显著相关。例如，受教育程度较高的患者身体功能、角色功能和社会功能的恢复更好。
在无病生存的前 5 年内，患者的总体健康状况/QoL 随时间逐渐改善，社会功能持续改善，而认知功能则稳定恶化。大多数功能领域和症状在 18 个月随访时改善，但这些改善在 36 个月和 60 个月后并未维持甚至恶化。本研究表明，在此期间应研究一些干预措施。
