Department of Oncology, The People's Hospital of Danyang, Affiliated Danyang Hospital of Nantong University, Danyang, 212399, China.
Cancer Institute, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, 212002, China.
Qual Life Res. 2024 Jun;33(6):1455-1468. doi: 10.1007/s11136-023-03591-y. Epub 2024 Jan 16.
A consensus has not been reached on the value of quality of life (QoL) as a prognostic factor for survival in gastrointestinal cancer. This meta-analysis aimed to investigate the association between functioning scales of the EORTC QoL Questionnaire Core 30 (QLQ-C30) and the overall survival (OS) in patients with gastrointestinal cancer.
A systematic literature search was conducted in PubMed, Web of Science, and Embase databases, until February 7, 2023. The studies included were those that investigated the association between baseline QoL measured by the functioning scales of EORTC QLQ-C30 and OS in patients with gastrointestinal cancer. The prognostic capacity of QoL was calculated by pooling the adjusted hazard ratios (HR) with 95% confidence intervals (CI).
Twenty-four studies' analyses reported by 22 eligible articles involving 11,609 patients were included. When compared with good parameters of QoL, poor global QoL (HR 1.81; 95% CI 1.53-2.13), physical functioning (HR 1.51; 95% CI 1.31-1.74), social functioning (HR 1.67; 95% CI 1.30-2.15), and role functioning scale (HR 1.42; 95% CI 1.20-1.29) were significantly associated with decreased OS. For each 10-point increase in QLQ-C30 parameters, the pooled HR of OS was 0.87 (95% CI 0.83-0.92) for global QoL, 0.87 (95% CI 0.83-0.92) for physical functioning, and 0.93 (95% CI 0.88-0.97) for role functioning. However, each 10-point increase in social, emotional, or cognitive functioning scale did not significantly predict OS.
Baseline health-related QoL defined by the physical functioning or global QoL scale of EORTC QLQ-C30 significantly predicts OS in patients with gastrointestinal cancer.
生活质量（QoL）作为胃肠道癌症患者生存的预后因素的价值尚未达成共识。本荟萃分析旨在研究欧洲癌症研究与治疗组织生活质量核心问卷 30 个功能量表（QLQ-C30）的功能量表与胃肠道癌症患者总体生存（OS）之间的关系。
系统地检索了 PubMed、Web of Science 和 Embase 数据库，检索时间截至 2023 年 2 月 7 日。纳入的研究是那些调查了基线时由 EORTC QLQ-C30 的功能量表测量的 QoL 与胃肠道癌症患者 OS 之间关系的研究。通过汇总调整后的危险比（HR）及其 95%置信区间（CI）来计算 QoL 的预后能力。
纳入了 22 篇符合条件的文章中 24 项研究的分析，涉及 11609 名患者。与 QoL 的良好参数相比，较差的全球 QoL（HR 1.81；95%CI 1.53-2.13）、身体功能（HR 1.51；95%CI 1.31-1.74）、社会功能（HR 1.67；95%CI 1.30-2.15）和角色功能量表（HR 1.42；95%CI 1.20-1.29）与 OS 降低显著相关。对于 QLQ-C30 参数每增加 10 分，OS 的汇总 HR 为全球 QoL 为 0.87（95%CI 0.83-0.92），身体功能为 0.87（95%CI 0.83-0.92），角色功能为 0.93（95%CI 0.88-0.97）。然而，社会、情感或认知功能量表每增加 10 分并不显著预测 OS。
EORTC QLQ-C30 的身体功能或全球 QoL 量表定义的基线健康相关 QoL 显著预测胃肠道癌症患者的 OS。
