Eyl-Armbruster Ruth Elisa, Thong Melissa S Y, Carr Prudence R, Jansen Lina, Chang-Claude Jenny, Hoffmeister Michael, Brenner Hermann, Arndt Volker
1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.
2Stuttgart Cancer Center-Tumorzentrum Eva Mayr-Stihl, Klinikum Stuttgart, Stuttgart, Germany.
J Natl Compr Canc Netw. 2022 Nov;20(11):1233-1243.e10. doi: 10.6004/jnccn.2022.7049.
Little is known about how changes in a constellation of lifestyle factors affect health-related quality of life (HRQoL) in colorectal cancer (CRC) survivors. Our study aimed to investigate the association between changes in healthy lifestyle and HRQoL over time in survivors of stage I-IV CRC.
We included 2,283 long-term (≥5 years postdiagnosis) survivors. A healthy lifestyle score (HLS) comprising smoking, alcohol consumption, diet, physical activity, and body fatness was derived at diagnosis and 5-year follow-up (5YFU) and categorized as low, moderate, or high. We assessed HRQoL with the EORTC Quality of Life Questionnaire-Core 30 at 5YFU and 10-year follow-up. We used multivariable linear regression and linear mixed models to explore associations between changes in HLS and HRQoL over follow-up.
A low baseline HLS was associated with poorer functioning and global health/QoL and a higher symptom burden at 5YFU compared with a high baseline HLS. An improved HLS from baseline to 5YFU was associated with better functioning, higher global health/QoL, and fewer symptoms at 5YFU than a maintained-high HLS. In longitudinal analyses, improved HLS was associated with better functioning at follow-up. Survivors with a maintained-high or an improved HLS reported generally less fatigue, pain, and dyspnea at follow-ups compared with survivors with a maintained-low or decreased HLS.
Change toward a healthier lifestyle since diagnosis was associated with better HRQoL in long-term CRC survivors. Our results support the importance of maintaining and/or promoting a healthier lifestyle among CRC survivors postdiagnosis.
对于一系列生活方式因素的变化如何影响结直肠癌（CRC）幸存者的健康相关生活质量（HRQoL），我们知之甚少。我们的研究旨在调查I-IV期CRC幸存者中健康生活方式的变化与HRQoL随时间的关联。
我们纳入了2283名长期（诊断后≥5年）幸存者。在诊断时和5年随访（5YFU）时得出一个包括吸烟、饮酒、饮食、身体活动和身体脂肪的健康生活方式评分（HLS），并将其分为低、中或高。我们在5YFU和10年随访时使用欧洲癌症研究与治疗组织生活质量核心问卷30评估HRQoL。我们使用多变量线性回归和线性混合模型来探索随访期间HLS变化与HRQoL之间的关联。
与高基线HLS相比，低基线HLS与5YFU时较差的功能、总体健康/生活质量以及较高的症状负担相关。从基线到5YFU时HLS改善与5YFU时更好的功能、更高的总体健康/生活质量以及更少的症状相关，优于维持高HLS。在纵向分析中，改善的HLS与随访时更好的功能相关。与维持低或降低HLS的幸存者相比，维持高或改善HLS的幸存者在随访时报告的疲劳、疼痛和呼吸困难通常更少。
自诊断以来向更健康生活方式的转变与长期CRC幸存者更好的HRQoL相关。我们的结果支持在CRC幸存者诊断后维持和/或促进更健康生活方式的重要性。
