Maslana Kelsey E, Burns Ryan D, Estabrooks Paul A, Playdon Mary C, Shaw Janet M, Akerley Wallace, Coletta Adriana M
Department of Health and Kinesiology, University of Utah, 2000 Circle of Hope Drive, Research South Building RM 4747, Salt Lake City, UT, 84112, USA.
Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA.
BMC Cancer. 2025 Aug 26;25(1):1377. doi: 10.1186/s12885-025-14820-7.
To investigate the association between patient-reported habitual physical activity (PA) and physician-assessed physical performance scores, specifically the Eastern Cooperative Oncology Group (ECOG) score, and experimental therapeutic clinical trial enrollment in adult cancer survivors.
This was a secondary data analysis of patient-reported and clinical cancer data from the Total Cancer Care (TCC) cohort at the Huntsman Cancer Institute between 2016 and 2022. Patients completed a modified Godin questionnaire to assess average weekly PA (MET/hrs-week) for the previous 12 months. A demographics questionnaire collected information on sex, race, ethnicity, education level, and income status. ECOG performance scores were retrieved from the medical record and classified as either "Good" (ECOG of 0 or 1) or "Poor" (ECOG of 2, 3 or 4) physical function. Binary logistic regressions were used to assess the relationship between PA levels (total PA, moderate-vigorous PA, and light PA) and ECOG ratings, and PA levels and clinical trial enrollment (yes/no). Models were adjusted for demographics and cancer characteristics.
Patients who completed the TCC questionnaire packet (n = 603) were primarily female (51%), non-Hispanic (95%), white (95%) with an average age of 61.9 ± 15.5 years. The top three cancer types represented were Head and Neck (30%), Thyroid (24%), and Lung (24%); all cancer stages were represented. Higher PA levels were linked with increased odds of having a good ECOG rating in unadjusted models (OR 1.01, 95% CI 1.00 to 1.02), but not in adjusted models (OR 1.01, 95% CI 0.99 to 1.03). Higher levels of light PA were linked with greater odds of having good ECOG rating in unadjusted and adjusted models (OR 1.05, 95% CI 1.00 to 1.11; OR 1.072, 95% CI 1.01 to 1.13; respectively). Statistically significant associations were not observed between moderate-vigorous PA and ECOG rating, and PA and clinical trial enrollment.
Patient-reported light PA may serve utility in physician decision making of ECOG rating. More work is needed identifying patient centered subjective and objective tools to complement physician-assessed ECOG scores considering the implications of ECOG in cancer treatment decisions and eligibility for clinical trials.
探讨患者自我报告的习惯性身体活动（PA）与医生评估的身体表现评分之间的关联，特别是东部肿瘤协作组（ECOG）评分，以及成年癌症幸存者参与实验性治疗临床试验的情况。
这是对2016年至2022年期间亨茨曼癌症研究所全面癌症护理（TCC）队列中患者自我报告和临床癌症数据的二次数据分析。患者完成一份改良的戈丁问卷，以评估过去12个月的平均每周PA（代谢当量/小时-周）。一份人口统计学问卷收集了关于性别、种族、民族、教育水平和收入状况的信息。从病历中检索ECOG表现评分，并将其分类为身体功能“良好”（ECOG为0或1）或“较差”（ECOG为2、3或4）。采用二元逻辑回归评估PA水平（总PA、中等强度至剧烈强度PA和轻度PA）与ECOG评级之间的关系，以及PA水平与临床试验入组情况（是/否）之间的关系。模型对人口统计学和癌症特征进行了调整。
完成TCC问卷包的患者（n = 603）主要为女性（51%）、非西班牙裔（95%）、白人（95%），平均年龄为61.9±15.5岁。代表的前三种癌症类型为头颈癌（30%）、甲状腺癌（24%）和肺癌（24%）；涵盖了所有癌症阶段。在未调整的模型中，较高的PA水平与ECOG评级良好的几率增加相关（比值比1.01，95%置信区间1.00至1.02），但在调整后的模型中并非如此（比值比1.01，95%置信区间0.99至1.03）。在未调整和调整后的模型中，较高水平的轻度PA与ECOG评级良好的几率增加相关（分别为比值比1.05，95%置信区间1.00至1.11；比值比1.072，95%置信区间1.01至1.13）。未观察到中等强度至剧烈强度PA与ECOG评级之间以及PA与临床试验入组之间存在统计学显著关联。
患者自我报告的轻度PA可能有助于医生进行ECOG评级决策。鉴于ECOG在癌症治疗决策和临床试验资格方面的影响，需要开展更多工作，确定以患者为中心的主观和客观工具，以补充医生评估的ECOG评分。
