Earlam S, Glover C, Fordy C, Burke D, Allen-Mersh T G
Department of Surgery, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, London, United Kingdom.
J Clin Oncol. 1996 Jan;14(1):171-5. doi: 10.1200/JCO.1996.14.1.171.
This study assessed the relationship between survival, tumor size, and quality of life (QoL; Rotterdam Symptom Checklist [RSC], Hospital Anxiety and Depression Scale [HAD], and Sickness Impact Profile [SIP]) in 50 patients with colorectal liver metastases (CLM).
Physical symptom score (RSC) was a stronger survival predictor than tumor size measured on computed tomographic (CT) scan. The best model for predicting survival included QoL questions about diarrhea, eating, restlessness, and ability to work and sleep. The only clinically measured variable included in this best survival prediction model was serum alkaline phosphatase level. This is the first study to show that QoL indices predict survival in CLM. The findings suggest that differences in tumor products and not just in tumor size could influence patient fitness and survival in CLM. Such differences are more accurately estimated by QoL assessment than measurement of tumor size.
QoL provides a better survival estimate than measurement of tumor size and could be used as a surrogate end point for survival in treatment trials.
本研究评估了50例结直肠癌肝转移（CLM）患者的生存率、肿瘤大小与生活质量（QoL；鹿特丹症状清单[RSC]、医院焦虑抑郁量表[HAD]和疾病影响概况[SIP]）之间的关系。
身体症状评分（RSC）比计算机断层扫描（CT）测量的肿瘤大小更能预测生存率。预测生存率的最佳模型包括有关腹泻、饮食、不安以及工作和睡眠能力的生活质量问题。该最佳生存预测模型中纳入的唯一临床测量变量是血清碱性磷酸酶水平。这是第一项表明生活质量指标可预测CLM患者生存率的研究。研究结果表明，肿瘤产物的差异而非仅仅肿瘤大小的差异可能会影响CLM患者的健康状况和生存率。通过生活质量评估比测量肿瘤大小能更准确地估计此类差异。
生活质量比测量肿瘤大小能更好地估计生存率，并且可在治疗试验中用作生存的替代终点。
