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脑肿瘤患者康复后健康相关生活质量的改善不受肿瘤类型的影响。

Improved health-related quality of life after rehabilitation in patients with brain tumors is not affected by tumor type.

作者信息

Watanabe Takahiro, Noto Shinichi, Natsumeda Manabu, Kimura Shinji, Ikarashi Fumie, Tabata Satoshi, Takano Mayuko, Tsukamoto Yoshihiro, Oishi Makoto

机构信息

Department of Clinical Technology, University Medical and Dental Hospital of Niigata, Niigata, Japan -

Department of Rehabilitation Sciences, University of Health and Welfare Graduate School of Niigata, Niigata, Japan -

出版信息

Eur J Phys Rehabil Med. 2025 Apr;61(2):239-249. doi: 10.23736/S1973-9087.25.08573-9. Epub 2025 Feb 17.

Abstract

BACKGROUND

The effect of rehabilitation therapy on health-related quality of life (HRQOL) among patients with brain tumors has not been fully investigated.

AIM

This study aimed to evaluate the effect of rehabilitation therapy on HRQOL among patients with brain tumors using the HRQOL index. We also examined factors that influenced changes in HRQOL, including differences in brain tumor type.

DESIGN

Prospective cohort study.

SETTING

University Medical and Dental Hospital.

POPULATION

Patients with brain tumors aged 20 years or older undergoing rehabilitation therapy were included. Patients with cognitive decline, aphasia, or poor general condition who had difficulty answering HRQOL questions were excluded.

METHODS

The EuroQol-5 Dimension 5-Level (EQ-5D-5L), EORTC Quality of Life Questionnaire Core 30 (QLQ-C30), and EORTC Quality of Life Questionnaire Brain Cancer Module (BN20) were used to assess HRQOL before and after rehabilitation treatment. Brain tumor type was classified into five groups: World Health Organization (WHO) grade 1, WHO grade 2/3, WHO grade 4, primary central nervous system lymphoma, and metastatic brain tumor. We compared EQ-5D-5L index scores and QLQ-C30 and BN20 scores before and at the end of rehabilitation. Multiple regression analysis was used to examine factors affecting changes in EQ-5D-5L index score (EQ-5D-5L gain).

RESULTS

In total, 112 patients participated in this study. The median EQ-5D-5L index score significantly improved from 0.698 before rehabilitation to 0.772 at the end of rehabilitation (P<0.001, r=0.46). QLQ-C30 and BN20 scores showed significant improvement in physical functioning, global health status, pain, and motor dysfunction (P<0.001, r>0.3). Multiple regression analysis revealed that recurrence (β=-0.191, P=0.037) and baseline EQ-5D-5L index score (β=-0.595, P<0.001) affected EQ-5D-5L gain, whereas differences in brain tumor type did not.

CONCLUSIONS

HRQOL among patients with brain tumors improved at the end of rehabilitation therapy compared with before therapy. Furthermore, the EQ-5D-5L index score gain was not affected by brain tumor type.

CLINICAL REHABILITATION IMPACT

These results suggest rehabilitation therapy may contribute to improved HRQOL irrespective of brain tumor type.

摘要

背景

康复治疗对脑肿瘤患者健康相关生活质量(HRQOL)的影响尚未得到充分研究。

目的

本研究旨在使用HRQOL指数评估康复治疗对脑肿瘤患者HRQOL的影响。我们还研究了影响HRQOL变化的因素,包括脑肿瘤类型的差异。

设计

前瞻性队列研究。

地点

大学医学和牙科学院医院。

研究对象

纳入年龄在20岁及以上接受康复治疗的脑肿瘤患者。排除认知功能下降、失语或一般状况较差而难以回答HRQOL问题的患者。

方法

使用欧洲五维健康量表5级(EQ-5D-5L)、欧洲癌症研究与治疗组织生活质量核心问卷30项(QLQ-C30)和欧洲癌症研究与治疗组织脑癌生活质量问卷模块(BN20)在康复治疗前后评估HRQOL。脑肿瘤类型分为五组:世界卫生组织(WHO)1级、WHO 2/3级、WHO 4级、原发性中枢神经系统淋巴瘤和脑转移瘤。我们比较了康复治疗前和康复结束时的EQ-5D-5L指数得分以及QLQ-C30和BN20得分。采用多元回归分析来研究影响EQ-5D-5L指数得分变化(EQ-5D-5L增益)的因素。

结果

共有112名患者参与本研究。EQ-5D-5L指数得分中位数从康复前的0.698显著提高到康复结束时的0.772(P<0.001,r=0.46)。QLQ-C30和BN20得分在身体功能、总体健康状况、疼痛和运动功能障碍方面有显著改善(P<0.001,r>0.3)。多元回归分析显示,复发(β=-0.191,P=0.037)和基线EQ-5D-5L指数得分(β=-0.595,P<0.001)影响EQ-5D-5L增益,而脑肿瘤类型的差异则没有影响。

结论

与治疗前相比,脑肿瘤患者在康复治疗结束时HRQOL有所改善。此外,EQ-5D-5L指数得分增益不受脑肿瘤类型的影响。

临床康复影响

这些结果表明,无论脑肿瘤类型如何,康复治疗都可能有助于改善HRQOL。

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