Shaik Fahmida, Uldrick Thomas S, Mazinu Mikateko, Gwebushe Nomonde, Mosam Anisa
Department of Dermatology, University of Kwa-Zulu Natal, Durban 4001, South Africa.
SAMRC Clinician Researcher Development Scholarship PhD Programme, Tygerberg, Cape Town 7505, South Africa.
Trop Med Infect Dis. 2024 Oct 17;9(10):244. doi: 10.3390/tropicalmed9100244.
Sub-Saharan Africa bears the largest public health burden of Kaposi sarcoma (KS), a leading cause of cancer mortality. Quality of life (QOL) assessments in cancer patients can provide information on prognosis beyond traditional biomarkers or biological measures. The prognostic value of QOL measures in patients with HIV-KS was evaluated. Prognostic associations of baseline QOL scores (by quartiles or thresholds for clinical importance) and changes in QOL scores (using minimum important difference) over the first 3 months of therapy were evaluated in 112 participants with HIV-KS randomised to receive ART, with or without chemotherapy. Cox's regression analysis assessed the prognostic contribution of QOL scores from the EORTC QLQ-C30 questionnaire. Survival curves were generated using the Kaplan-Meier method. Baseline QOL scores did not predict overall survival. The change in the 3-month QOL scores for the global health scale, fatigue, and pain domains was prognostic; the hazard ratios were 3.88 (95% CI 1.32-11.38, = 0.01), 3.72 (95% CI 1.61-8.62, = 0.00) and 5.96 (95% CI 2.46-14.43, = 0.00), respectively. QOL assessments can provide useful prognostic information in patients with HIV-KS. Patients lacking meaningful improvement early into treatment represent a population at high risk of death.
撒哈拉以南非洲地区承受着卡波西肉瘤（KS）最大的公共卫生负担，卡波西肉瘤是癌症死亡的主要原因。癌症患者的生活质量（QOL）评估可以提供超越传统生物标志物或生物学指标的预后信息。对HIV-KS患者生活质量测量的预后价值进行了评估。在112名随机接受抗逆转录病毒治疗（ART）（无论是否接受化疗）的HIV-KS患者中，评估了基线QOL评分（按四分位数或临床重要性阈值）和治疗前3个月QOL评分变化（使用最小重要差异）的预后关联。Cox回归分析评估了欧洲癌症研究与治疗组织（EORTC）QLQ-C30问卷中QOL评分的预后贡献。使用Kaplan-Meier方法生成生存曲线。基线QOL评分不能预测总生存期。全球健康量表、疲劳和疼痛领域3个月QOL评分的变化具有预后意义；风险比分别为3.88（95%CI 1.32-11.38，P = 0.01）、3.72（95%CI 1.61-8.62，P = 0.00）和5.96（95%CI 2.46-14.43，P = 0.00）。QOL评估可为HIV-KS患者提供有用的预后信息。治疗早期缺乏有意义改善的患者代表死亡风险高的人群。
