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影响转移性乳腺癌患者健康相关生活质量的因素

Factors Affecting Health-Related Quality of Life in Patients With Metastatic Breast Cancer.

作者信息

Park Mihai, Yu Su-Yeon, Jeon Ha-Lim, Song Inmyung

机构信息

School of Pharmacy, Sungkyunkwan University, Suwon, Korea.

Department of Medical Information, College of Nursing and Health, Kongju National University, Gongju, Korea.

出版信息

J Breast Cancer. 2023 Oct;26(5):436-445. doi: 10.4048/jbc.2023.26.e29. Epub 2023 Jul 11.

Abstract

PURPOSE

Improving survival and health-related quality of life (HRQOL), along with symptom relief, is important for the treatment of metastatic breast cancer (MBC). This study measured HRQOL and analyzed its influence on sociodemographic and clinical factors in patients with MBC.

METHODS

We interviewed 298 patients with MBC to investigate their sociodemographic characteristics and HRQOL by using EuroQol-5D-5L (EQ-5D) between September and October 2014. We also reviewed medical records to examine the clinical condition of the patients, including disease progression, adverse events, treatments, chronic disease, and metastatic areas. The distribution of the EQ-5D index was compared between different clinical conditions by using the Kruskal-Wallis test. We also conducted multiple regression analyses to identify the factors affecting HRQOL in patients with MBC.

RESULTS

The mean EQ-5D index was 0.79 for all patients surveyed. The mean EQ-5D index score was significantly lower in patients in the progressed state than in those in the progression-free survival state (0.73 vs. 0.80, = 0.0002). The HRQOL of patients treated with chemotherapy alone was significantly lower than that of patients treated with hormonal or targeted therapy (0.76 vs. 0.82 or 0.85; = 0.0020). Regression analysis revealed that the clinical factors associated with lower HRQOL were progressed state, chemotherapy, and adverse events, such as hair loss or stomatitis. Finally, young age, high income, and employment were the sociodemographic factors that were positively associated with better HRQOL.

CONCLUSION

This study provides new information on the health utility of MBC patients on the basis of various patient characteristics and offers insights that can assist medical professionals in treating patients with MBC and help policymakers implement cancer strategies. Further research is needed to reflect the changing environment of cancer treatment and enrich available evidence.

摘要

目的

提高生存率和健康相关生活质量(HRQOL)以及缓解症状,对于转移性乳腺癌(MBC)的治疗至关重要。本研究测量了MBC患者的HRQOL,并分析了其对社会人口统计学和临床因素的影响。

方法

2014年9月至10月期间,我们对298例MBC患者进行了访谈,使用欧洲五维健康量表(EQ-5D)调查其社会人口统计学特征和HRQOL。我们还查阅了病历,以检查患者的临床状况,包括疾病进展、不良事件、治疗、慢性病和转移部位。使用Kruskal-Wallis检验比较不同临床状况下EQ-5D指数的分布。我们还进行了多元回归分析,以确定影响MBC患者HRQOL的因素。

结果

所有接受调查患者的EQ-5D指数平均为0.79。进展期患者的EQ-5D指数平均得分显著低于无进展生存期患者(0.73对0.80,P = 0.0002)。单纯接受化疗患者的HRQOL显著低于接受激素或靶向治疗的患者(0.76对0.82或0.85;P = 0.0020)。回归分析显示,与较低HRQOL相关的临床因素为疾病进展、化疗以及脱发或口腔炎等不良事件。最后,年轻、高收入和就业是与较好HRQOL呈正相关的社会人口统计学因素。

结论

本研究基于各种患者特征提供了关于MBC患者健康效用的新信息,并提供了有助于医疗专业人员治疗MBC患者以及帮助政策制定者实施癌症策略的见解。需要进一步研究以反映癌症治疗环境的变化并丰富现有证据。

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