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肺癌患者诊断时的生活质量问卷与生存的关系。

Association Between Quality of Life Questionnaire at Diagnosis and Survival in Patients With Lung Cancer.

机构信息

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Department of Statistics and Data Science, Yonsei University, Seoul, Republic of Korea.

出版信息

Clin Lung Cancer. 2023 Jul;24(5):459-466. doi: 10.1016/j.cllc.2023.03.007. Epub 2023 Mar 21.

Abstract

BACKGROUND

Patients with lung cancer experience considerable symptom burden, which can decrease patients' QOL. Our aim was to investigate the association between QOL questionnaire at diagnosis and survival of lung cancer.

PATIENTS AND METHODS

This was a multicenter study of lung cancer patients at 7 medical centers of the Catholic University of Korea that responded to a quality of life questionnaire between December 1, 2017 and December 31, 2020. We analyzed 5 functional (physical, role, emotional, cognitive, and social functioning) and nine symptom (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties) scales and examined their associations with survival. A Cox proportional hazards model was used to evaluate the prognostic value.

RESULTS

In total, 1297 lung cancer patients were enrolled. The results of multivariable analysis showed that female, younger age, never smoker, stage I or II cancer, higher physical functioning, and emotional functioning were statistically significant favorable predictors for survival. On subgroup analysis according to early (stage I and II) or advanced (stage III or IV) stage, higher physical functioning and emotional functioning were each found to be favorable prognostic factors for survival. Meanwhile, fatigue, pain, insomnia, and financial difficulties were found to be associated with low scores on the emotional functioning scale; fatigue, pain, dyspnea, and financial difficulties were associated with low scores on the physical functioning scale.

CONCLUSION

Assessing the physical functioning and emotional functioning scales of QOL questionnaire items at diagnosis can help clinicians predict the survival of patients with lung cancer.

摘要

背景

肺癌患者承受着相当大的症状负担,这会降低患者的生活质量。我们的目的是研究肺癌患者诊断时的生活质量问卷与生存之间的关系。

患者和方法

这是一项多中心研究,纳入了韩国天主教大学 7 家医疗中心的肺癌患者,他们在 2017 年 12 月 1 日至 2020 年 12 月 31 日期间回答了生活质量问卷。我们分析了 5 个功能(身体、角色、情感、认知和社会功能)和 9 个症状(疲劳、恶心和呕吐、疼痛、呼吸困难、失眠、食欲减退、便秘、腹泻和经济困难)量表,并检查了它们与生存的关系。使用 Cox 比例风险模型评估预后价值。

结果

共纳入 1297 例肺癌患者。多变量分析结果显示,女性、年龄较小、从不吸烟、I 期或 II 期癌症、较高的身体功能和情感功能是生存的统计学上显著有利预测因素。根据早期(I 期和 II 期)或晚期(III 期或 IV 期)分期的亚组分析,较高的身体功能和情感功能均为生存的有利预后因素。同时,疲劳、疼痛、失眠和经济困难与情感功能量表得分较低有关;疲劳、疼痛、呼吸困难和经济困难与身体功能量表得分较低有关。

结论

在诊断时评估生活质量问卷项目的身体功能和情感功能量表可以帮助临床医生预测肺癌患者的生存情况。

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