Montazeri A, Gillis C R, McEwen J
Department of Public Health, University of Glasgow, Ruchill Hospital, Scotland.
Chest. 1998 Feb;113(2):467-81. doi: 10.1378/chest.113.2.467.
A review of the literature was carried out covering the last 25 years (1970 to 1995) by searching through the MEDLINE and manually. The review consists of two companion parts. The first includes studies of quality of life in lung cancer patients in general, while the second part is restricted to defined samples of small and non-small cell lung cancer patients. Excluding non-English and review articles, in total 151 citations were identified and all have been reviewed. Over 50 instruments were used to measure quality of life in lung cancer studies. Of these, the European Organisation for Research and Treatment of Cancer Quality of Life Lung Cancer Questionnaire (EORTC QLQ-LC13) in conjunction with the core cancer questionnaire (QLQ-C30) was found to be the best developed instrument, although there were two other lung cancer-specific measures with good reliability and validity. Several topics in this chapter have been highlighted, including the importance of regularly measuring quality of life in lung cancer patients. Progress and achievements in areas such as performance status as a proxy of quality of life measure, psychological morbidity and symptom distress as predictive factors of quality of survival, and communication problems in quality of life studies of lung cancer patients have been emphasized and their implications in lung cancer care discussed. It is argued that palliation of symptoms, psychosocial interventions, and understanding patients' feelings and concerns all contribute to improving quality of life in lung cancer patients. It is concluded that the future challenge in treatment of lung cancer lies not only in improving the survival, but mainly the patients' quality of life regardless of cell type. Clinical trial and epidemiologic population-based outcome studies are recommended to provide this and to allow a better understanding of the contribution of the socioeconomic characteristics of the patients to their pretreatment and posttreatment quality of life.
通过检索MEDLINE数据库并人工查阅，对过去25年（1970年至1995年）的文献进行了综述。该综述由两个配套部分组成。第一部分包括对肺癌患者总体生活质量的研究，而第二部分则限于小细胞肺癌和非小细胞肺癌患者的特定样本。排除非英文文献和综述文章后，共确定了151篇引文并全部进行了审阅。在肺癌研究中，超过50种工具被用于测量生活质量。其中，欧洲癌症研究与治疗组织肺癌生活质量问卷（EORTC QLQ-LC13）与核心癌症问卷（QLQ-C30）相结合，被认为是发展最为完善的工具，不过还有另外两种肺癌特异性测量方法也具有良好的信度和效度。本章突出了几个主题，包括定期测量肺癌患者生活质量的重要性。强调了在诸如将体能状态作为生活质量测量指标的替代、心理发病率和症状困扰作为生存预测因素以及肺癌患者生活质量研究中的沟通问题等方面取得的进展和成就，并讨论了它们在肺癌护理中的意义。有人认为，缓解症状、心理社会干预以及理解患者的感受和担忧都有助于提高肺癌患者的生活质量。得出的结论是，肺癌治疗未来的挑战不仅在于提高生存率，更主要的是无论细胞类型如何都要提高患者的生活质量。建议开展临床试验和基于流行病学人群的结局研究，以实现这一目标，并更好地了解患者的社会经济特征对其治疗前和治疗后生活质量的影响。
