Lau Jerrald, Peh Cherie Hui, Ng Alyssa, Koh Wei-Ling, Luo Nan, Tan Ker-Kan
Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore C/O NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Health Qual Life Outcomes. 2025 Apr 5;23(1):30. doi: 10.1186/s12955-025-02363-1.
Research on health-related quality of life (HRQOL) using minimally important differences for cancer care in Asian settings are sparse. This study aimed to describe functional HRQOL trajectories among Colorectal Cancer (CRC) patients undergoing adjuvant chemotherapy (AC) compared to those who did not (No AC), evaluate if AC was associated with change in HRQOL prospectively, and examine QOL differences between elderly and non-elderly CRC patients requiring AC.
CRC patients diagnosed between February 2018 to August 2021 were recruited from three Singapore public hospitals. Participants completed the EORTC QLQ-C30 over seven timepoints (diagnosis, predischarge, 1-, 3-, 6-, 9-, 12-months post-surgery). Clinical characteristics were collected from electronic medical records.
The sample comprised 251 participants (102 in AC group; 40.64%). Clinically relevant deteriorations in functional HRQOL were observed in both groups between baseline and predischarge. These returned to baseline by 12-month. AC was associated with poorer physical (β = -35.34, p < 0.05) and role functioning (β = -71.17, p < 0.05) over time. Being elderly was associated with poorer physical functioning (β = -0.44, p < 0.05) over time. However, the non-elderly AC subgroup tended to experience poorer HRQOL in general compared to elderly.
Functional recovery remains a challenge for CRC patients in general. However, non-elderly AC patients may experience more severe impacts to role and social functioning.
在亚洲环境中，使用最小重要差异来研究癌症护理中与健康相关的生活质量（HRQOL）的研究很少。本研究旨在描述接受辅助化疗（AC）的结直肠癌（CRC）患者与未接受辅助化疗（无AC）的患者之间的功能性HRQOL轨迹，前瞻性评估AC是否与HRQOL的变化相关，并检查需要AC的老年和非老年CRC患者之间的生活质量差异。
从新加坡的三家公立医院招募了2018年2月至2021年8月期间诊断的CRC患者。参与者在七个时间点（诊断、出院前、术后1、3、6、9、12个月）完成了欧洲癌症研究与治疗组织的QLQ-C30问卷。从电子病历中收集临床特征。
样本包括251名参与者（AC组102名；40.64%）。在基线和出院前，两组的功能性HRQOL均出现了临床相关的恶化。这些在12个月时恢复到基线水平。随着时间的推移，AC与较差的身体功能（β=-35.34，p<0.05）和角色功能（β=-71.17，p<0.05）相关。随着时间的推移，老年与较差的身体功能（β=-0.44，p<0.05）相关。然而，与老年人相比，非老年AC亚组总体上往往经历更差的HRQOL。
一般来说，功能恢复对CRC患者来说仍然是一个挑战。然而，非老年AC患者可能在角色和社会功能方面受到更严重的影响。
