European Organization for Research and Treatment of Cancer (EORTC), Brussels, Belgium.
European Organization for Research and Treatment of Cancer (EORTC), Brussels, Belgium.
Eur J Cancer. 2022 Jul;170:1-9. doi: 10.1016/j.ejca.2022.03.039. Epub 2022 May 13.
The European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) measures 15 health-related quality of life (HRQoL) scales relevant to the disease and treatment of patients with cancer. A study by Martinelli (2011) demonstrated that these scales could be grouped into three main clusters: physical, psychological and gastrointestinal. This study aims to validate Martinelli's findings in an independent dataset and evaluate whether these clusters are consistent across cancer types and patient characteristics.
Pre-defined criteria for successful validation were three main clusters should emerge with a minimum R-squared value of 0.51 using pooled baseline-data. A cluster analysis was performed on the 15 QLQ-C30 HRQoL-scales in the overall dataset, as well as by cancer type and selected patient characteristics to examine the robustness of the results.
The dataset consisted of 20,066 patients pooled across 17 cancer types. Overall, three main clusters were identified (R = 0.61); physical-cluster included role-functioning, physical-functioning, social-functioning, fatigue, pain, and global-health status; psychological-cluster included emotional-functioning, cognitive-functioning, and insomnia; gastro-intestinal-cluster included nausea/vomiting and appetite loss. The results were consistent across different levels of disease severity, socio-demographic and clinical characteristics with minor variations by cancer type. Global-health status was found to be strongly linked to the scales included in the physical-functioning-related cluster.
This study successfully validated prior findings by Martinelli (2011): the QLQ-C30 scales are interrelated and can be grouped into three main clusters. Knowing how these multidimensional HRQoL scales are related to each other can help clinicians and patients with cancer in managing symptom burden, guide policymakers in defining social-support plans and inform selection of HRQoL scales in future clinical trials.
欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ-C30）测量了 15 个与癌症患者疾病和治疗相关的健康相关生活质量（HRQoL）量表。Martinelli（2011）的研究表明，这些量表可以分为三个主要集群：身体、心理和胃肠道。本研究旨在验证 Martinelli 在独立数据集上的研究结果，并评估这些集群是否在不同癌症类型和患者特征中具有一致性。
成功验证的预定义标准是使用汇总的基线数据，三个主要集群应该出现最小 R 平方值为 0.51。对整个数据集以及按癌症类型和选定的患者特征的 15 个 QLQ-C30 HRQoL 量表进行聚类分析，以检验结果的稳健性。
该数据集包含来自 17 种癌症类型的 20,066 名患者。总体而言，确定了三个主要集群（R=0.61）；身体集群包括角色功能、身体功能、社会功能、疲劳、疼痛和总体健康状况；心理集群包括情绪功能、认知功能和失眠；胃肠道集群包括恶心/呕吐和食欲减退。结果在不同疾病严重程度、社会人口统计学和临床特征水平上是一致的，不同癌症类型略有差异。总体健康状况与身体功能相关集群中包含的量表密切相关。
本研究成功验证了 Martinelli（2011）的先前发现：QLQ-C30 量表相互关联，可以分为三个主要集群。了解这些多维 HRQoL 量表如何相互关联，可以帮助癌症患者的临床医生和患者管理症状负担，指导政策制定者制定社会支持计划，并为未来的临床试验中 HRQoL 量表的选择提供信息。
