Inequalities in Cancer Outcomes Network, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
Qual Life Res. 2023 Nov;32(11):3123-3133. doi: 10.1007/s11136-023-03460-8. Epub 2023 Jun 30.
To investigate associations between quality of life (QoL) and 1) immunotherapy and other cancer treatments received three months before QoL measurements, and 2) the comorbidities at the time of completion or in the year prior to QoL measurements, among patients with advanced cancer.
A cross-sectional study is conducted on patients with advanced cancer in the Netherlands. The data come from the baseline wave of the 2017-2020 eQuiPe study. Participants were surveyed via questionnaires (including EORTC QLQ-C30). Using multivariable linear and logistic regression models, we explored statistical associations between QoL components and immunotherapy and other cancer treatments as well as pre-existing comorbidities while adjusting for age, sex, socio-economic status.
Of 1088 participants with median age 67 years, 51% were men. Immunotherapy was not associated with global QoL but was associated with reduced appetite loss (odds ratio (OR) = 0.6, 95%CI = [0.3,0.9]). Reduced global QoL was associated with chemotherapy (adjusted mean difference (β) = - 4.7, 95% CI [- 8.5,- 0.8]), back pain (β = - 7.4, 95% CI [- 11.0,- 3.8]), depression (β = - 13.8, 95% CI [- 21.5,- 6.2]), thyroid diseases (β = - 8.9, 95% CI [- 14.0,- 3.8]) and diabetes (β = - 4.5, 95% CI [- 8.9,- 0.5]). Chemotherapy was associated with lower physical (OR = 2.4, 95% CI [1.5,3.9]) and role (OR = 1.8, 95% CI [1.2,2.7]) functioning, and higher pain (OR = 1.9, 95% CI [1.3,2.9]) and fatigue (OR = 1.6, 95% CI [1.1,2.4]).
Our study identified associations between specific cancer treatments, lower QoL and more symptoms. Monitoring symptoms may improve QoL of patients with advanced cancer. Producing more evidence from real life data would help physicians in better identifying patients who require additional supportive care.
探讨生活质量（QoL）与以下方面之间的关联：1）在 QoL 测量前三个月接受的免疫疗法和其他癌症治疗；2）在 QoL 测量完成时或前一年存在的合并症，在晚期癌症患者中。
对荷兰的晚期癌症患者进行横断面研究。数据来自 2017-2020 年 eQuiPe 研究的基线波。参与者通过问卷（包括 EORTC QLQ-C30）进行调查。使用多变量线性和逻辑回归模型，我们在调整年龄、性别、社会经济地位后，探讨了 QoL 成分与免疫疗法和其他癌症治疗以及预先存在的合并症之间的统计学关联。
在 1088 名中位年龄为 67 岁的参与者中，51%为男性。免疫疗法与整体 QoL 无关，但与食欲减退减少相关（比值比（OR）=0.6，95%CI=[0.3,0.9]）。整体 QoL 下降与化疗相关（调整平均差异（β）=-4.7，95%CI[-8.5，-0.8]）、背痛（β=-7.4，95%CI[-11.0，-3.8]）、抑郁（β=-13.8，95%CI[-21.5，-6.2]）、甲状腺疾病（β=-8.9，95%CI[-14.0，-3.8]）和糖尿病（β=-4.5，95%CI[-8.9，-0.5]）。化疗与较低的身体（OR=2.4，95%CI[1.5,3.9]）和角色（OR=1.8，95%CI[1.2,2.7]）功能以及更高的疼痛（OR=1.9，95%CI[1.3,2.9]）和疲劳（OR=1.6，95%CI[1.1,2.4]）相关。
我们的研究确定了特定癌症治疗、较低 QoL 和更多症状之间的关联。监测症状可能会改善晚期癌症患者的 QoL。从现实生活数据中获得更多证据将有助于医生更好地识别需要额外支持性护理的患者。
