临床Ⅰ、Ⅱ期小细胞肺癌手术与非手术综合治疗的临床研究

目的分析临床Ⅰ、Ⅱ期小细胞肺癌的治疗情况,评价手术和非手术综合治疗的疗效和预后因素。方法共收治经病理和细胞学证实的局限期小细胞肺癌358例,其中89例为临床Ⅰ、Ⅱ期病例,55例行手术＋化疗±放疗,34例行化放化疗。化疗以PE、CAP方案为主,一般疗程为4～6个周期。放疗采用6 MV X线照射,包括原发灶、肺门及相应纵隔,总量达56～60 Gy,5～6周。结果总中位生存时间为48个月,1、2、3、5年生存率分别为95%、71%、57%、48%。手术＋化疗±放疗组中位生存时间为50个月,1、2、3、5年生存率分别为96%、70%、58%、52%;失败原因包括局部复发（4%）、远处转移（31%）、局部复发加远处转移（9%）和脑转移（18%）。化放化疗组的中位生存时间为40个月,1、2、3、5年生存率分别为94%、74%、55%、40%;失败原因包括局部复发（12%）、远处转移（44%）、局部复发加远处转移（6%）和脑转移（29%）。手术＋化疗±放疗组与化放化疗组的生存率差异无统计学意义（P=0．404）。脑转移对预后有明显影响（P=0．001）。结论手术＋化疗±放疗和化放化疗对临床Ⅰ、Ⅱ期小细胞肺癌的治疗均有较好的疗效和预后。远处转移是失败的主要原因。脑转移发生率较高。建议术后及放化疗后达CR者进行脑预防性照射。     

rmh-TNF协同顺铂抗小鼠Lewis肺癌血管生成的作用

目的：观察重组改构人肿瘤坏死因子（recombinant mutant human tumor necrosis factor，rmh-TNF）协同顺铂（cisplatin，又称DDP）抗小鼠Lewis肺癌血管生成的作用。方法：建立C57BL／6小鼠Lewis肺癌模型，随机分为4个治疗组：生理盐水对照组、rmh-TNF（150万U／kg）组、DDP（6．15mg／kg）组、联合用药组（DDP＋rmh—TNF）。接种肿瘤细胞后12d开始瘤内注射药物3d，RT-PCR法测定瘤组织中HIF—1α的表达，免疫组化法检测肿瘤组织血管内皮生长因子（vascular endothelial growth factor，VEGF）、激酶结构域受体（kinase domain region receptor，KDR）、微血管密度（microvascular density receptor，MVD）的表达，流式细胞术测定基质金属蛋白酶2（matrix metallopmteinase-2，MMP-2）的表达。结果：对照组、rmh-TNF组、DDP组和联合用药组小鼠肿瘤组织中的MVD数分别为（24．76±1．28）、（18．95±1．22）、（19．53±1．15）、（10．43±1．05），两单药组的MVD数明显低于对照组（P〈0．05）；联合用药组低于两单药组（P〈0．05）。HIF-1αmRNA相对表达水平分别为（0．171±0．004）、（0．138±0．006）、（0．134±0．006）、（0．095±0．006），两单药组较对照组明显下降（P〈0．05），联合用药组明显低于两单药组（P〈0．05）。肿瘤组织中MMP-2蛋白的荧光指数FI值依次为（1．000±0．000）、（0．875±0．020）、（0．848±0．127）、（0．545±0．107），单药组的MMP-2蛋白的（FI）值较对照组明显下降（P〈0．05），联合用药组明显低于两单药组（P〈0．05）。单药组VEGF、KDR表达均明显低于对照组（P〈0．05），联合用药组的表达均低于各单药组（P〈0．05）。结论：rmh—TNF能够增强DDP抗小鼠Lewis肺癌血管生成的作用。     

生存素基因RNAi对宫颈癌裸鼠移植瘤生长、凋亡和放射敏感性的影响

背景与目的：生存素基因是近年来肿瘤研究的焦点之一,本研究旨在观察生存素基因RNAi对宫颈癌裸鼠移植瘤生长、凋亡和放射敏感性的影响。方法：随机选择雌性BALB／c—nu／nu裸小鼠24只,细胞接种法建立4组人宫颈癌裸鼠皮下移植瘤模型,每天观察裸鼠一般状况及肿瘤生长情况,通过绘制肿瘤生长曲线并计算肿瘤生长抑制率,观察生存素基因RNAi对人宫颈癌裸鼠皮下移植瘤生长的影响;通过免疫组化SP法检测各组移植瘤组织中生存素蛋白表达情况,Ⅷ因子相关抗原（factor Ⅷ related antigen,FⅧRAg）表达情况并计算微血管密度（MVD）,HE染色及TUNEL染色观察生存素基因RNAi对人宫颈癌裸鼠皮下移植瘤凋亡的影响;当肿瘤体积达0．2cm^3时予X线放射治疗观察生存素基因RNAi对人宫颈癌裸鼠皮下移植瘤放疗敏感性的影响。结果：成功建立4组人宫颈癌裸鼠皮下移植瘤模型,接种HeLa-s2组裸鼠肿瘤体积在每个检测点均明显小于接种HeLa组。观察结束时,接种HeLa—s2组裸鼠瘤重明显小于接种HeLa组,分别为（0．369±0．043）g和（1．150±0．136）g（P〈0．05）;接种HeLa—s2组裸鼠肿瘤生长抑制率为67．9％。免疫组化结果显示：接种HeLa-s2组裸鼠生存素蛋白表达显著下降;接种HeLa—s2组裸鼠FⅧRag表达亦显著下降,MVD值降至23．4±3．1。HE染色、TUNEL染色结果显示：接种HeLa—s2组裸鼠细胞凋亡明显增多,AI值达（22．7±1．4）％。X线放疗后不同检测点接种HeLa—s2组裸鼠肿瘤体积明显小于接种HeLa组,肿瘤生长明显受抑。观察结束后,接种HeLa～s2组裸鼠瘤重明显小于接种HeLa组,分别为（0．41±0．06）g和（1．38±0．29）g（P〈0．05）。接种HeLa—s2组裸鼠肿瘤细胞凋亡明显增多,与接种HeLa组AI比较,接种HeLa—s2组AI明显升高,分别为（30．06±0．98）％和（4．17±0．64）％（P〈0．05）。结论：生存素基因RNAi可通过下调移植瘤组织生存素蛋白表达降低其MVD,从而抑制移植瘤生长并促进其凋亡,并通过增加X线放射治疗诱导的细胞凋亡,增强放射治疗对移植瘤的生长抑制,进而提高移植瘤的放射敏感性。     

脑胶质瘤术后三维适形放疗加同步化疗的临床观察

背景与目的：脑胶质瘤发病率高,预后差,寻找新的治疗方法成为这种疾病研究的热点。本研究通过前瞻性随机对照研究来观察三维适形放疗（3D—CRT）联合替莫唑胺同步化疗治疗脑胶质瘤术后残留患者的临床疗效。方法：62例术后有残留的脑胶质瘤患者前瞻性分组：单纯三维适形放疗（单放组）及三维适形放疗加同步化疗（放化组）,各31例。两组均接受三维适形放疗,6MV-X射线,2．0Gy／f,1次／天,5次／周,处方剂量50460Gy／5-6周。放化组加用替莫唑胺75mg／（m^2·d）,从放疗第1天开始口服到放疗结束,随后继续给予替莫唑胺150-200mg／（m^2·d）,治疗5d,每28d为1个周期,共3～6个周期。结果：单放组总有效率35．5％（11／31）,放化组61．3％（19／31）,统计学差异显著（P=0．042）;两组生存比较无统计学差异（P=0．263）。分层分析显示：病理Ⅲ级脑胶质瘤同步放化疗生存优于单纯放疗组（P=0．043）。结论：病理Ⅲ级脑胶质瘤术后三维适形放疗联合同步化疗,可以取得较单纯三维适形放疗更好的疗效。     

VEGFR-3 siRNA对人结肠癌细胞黏附力和侵袭一眭的抑制作用

目的：探讨VEGFR-3对人结肠癌细胞黏附力和侵袭性的影响。方法：构建携靶向VEGFR-3基因siRNA（small interfering RNA）表达载体，转染人结肠癌LoVo细胞，半定量RT—PCR和Westernblotting检测转染前后LoVo细胞VEGFR-3mRNA和蛋白表达的变化，基质-黏附实验检测细胞转染后的黏附能力，细胞侵袭实验检测转染后肿瘤细胞侵袭性的改变。结果：携靶向VEGFR-3基因siRNA的表达载体成功构建，RT—PCR检测转染siRNA后LoVo细胞VEGFR-3mRNA表达水平降低；Westernblotting检测转染siRNA后72hLoVo细胞VEGFR-3蛋白表达下降，其表达相对值由（1．26±0．19）降至（0．39±0．12）（P〈0．05）。转染siRNA72h后LoVo细胞的黏附能力显著下降[（0．626±0．047）vs（0．407±0．029），P〈0．05]；LoVo细胞穿膜细胞数（6．38±3．25）明显低于空白对照组（24．82±3．44）、非特异性对照组（23．58±3．73）（P〈0．05）。结论：siRNA能够在LoVo细胞中引发RNA干扰效应，下调VEGFR-3基因的表达，进而抑制LoVo细胞的黏附能力和侵袭性。     

槐耳颗粒对胃癌术后同步放化疗患者生存质量和免疫功能的影响

[目的]探讨金克槐耳颗粒对胃癌术后同步放化疗患者生存质量和免疫功能的影响。[方法]80例胃癌术后接受同步放化疗患者随机分成两组,试验组给予卡培他滨和金克槐耳颗粒,同时接受8MVX线三维适形放疗（3D—CRT）,对照组除槐耳颗粒外,其余治疗方案同试验组。应用欧洲癌症研究与治疗组的生命质量核心量表（EORTCQLQ—C30）对两组患者的生存质量进行评价,采用流式细胞仪检测外周血CD3^＋、CD4^＋、NK细胞数量及CD4^＋／CD8^＋比值。[结果]EORTCQLQ—C30量表具有较好的结构效度,r值多在0．5以上：内部一致性也较好,克朗巴赫系数（仪值）均接近1。通过比较QLQ—C30中文版量表各领域计分前后差值,金克槐耳颗粒可显著改善总健康状况子量表中患者的躯体、角色、情绪、认知和社会等功能：显著改善症状子量表中患者的疲倦、疼痛、失眠、便秘、腹泻等症状（P〈0．05）。对照组治疗后外周血CD3^＋、CD4^＋、NK细胞数量（均值）比试验组分别减少0．0414、0．0466、0．0319;CD4^＋／CD8^＋比值比试验组低26％。[结论]槐耳颗粒能有效改善胃癌术后同步放化疗患者的生存质量,增强免疫功能。     

血管内皮标记物在乳腺癌演变中的表达及意义

目的探讨乳腺癌演变中新生血管表达状况，旨在选择乳腺癌发生发展中新生血管的特异性标记物。方法采用免疫组化（SP）法，分别以CD105、FⅧ、CD31、CD34为标记，对100例乳腺不同病变组织，包括乳腺导管上皮不典型增生（ADH）、导管内癌（DCIS）、微浸润导管癌（MDC）各20例，40例非特殊类型浸润型导管癌（IDC，NOS），计算微血管密度（MVD）。结果ADH、DCIS、MDC和IDC（NOS）中，CD105标记的MVD分别为8．25±5．78、10．05±4．23、25．35±7．62和37．33±5．86，FⅧ标记的MVD分别为10．60±8．99、16．60±3．47、16．90±5．62和17．90±5．62，CD31标记的MVD分别为16．80±3．90、19．40±4．58、20．74±6．67和22．74±6．67，CD34标记的MVD分别为14．40±12．82、25．20±5．39、26．32±4．89和40．32±4．89，仅CD105标记的MVD各组间两两比较差异有统计学意义（P〈0．05）。结论CD105标记MVD用来评估乳腺癌发生发展中的新生血管表达，可能更具价值，这将为今后抗血管生成的治疗提供理论依据。     

同期放化疗联合深部热疗治疗胸段食管癌的临床观察

目的:探讨同期放化疗联合深部热疗治疗胸段食管癌的近期疗效、远期疗效和不良反应。方法:90例胸段食管癌患者随机分为放化疗联合热疗组（联合组）、同期放化疗组（放化疗组）和单纯放疗组（放疗组）,各30例,分别给予不同的治疗方法,观察和比较三组的近期疗效、远期疗效和不良反应。结果:联合组的临床有效率和临床获益率优于放化疗组和放疗组,差异有统计学意义（P<0.05）。联合组和放化疗组的总体生存率优于放疗组,而远处转移率低于放疗组（P<0.05）。联合组与同期放化疗组的骨髓抑制、放射性食管炎、恶性呕吐和肝肾功能损害的发生率均高于放疗组（P<0.05）;但联合组与同期放化疗组比较,差异无统计学意义（P>0.05）。结论:同期放化疗联合深部热疗治疗胸段食管癌的近期疗效优于同步放化疗和单纯放疗,但在提高患者的生存率和降低放化疗的不良反应等方面无明显优势,具有一定的临床使用价值。     

晚期乳腺癌术前区域性动脉灌注化疗后微血管密度及微淋巴管密度的变化

目的探讨术前区域动脉灌注化疗及全身静脉化疗对晚期乳腺癌微血管密度（MVD）、微淋巴管密度（MLVD）的影响。方法将76例晚期乳腺癌患者随机分为2组，术前动脉灌注化疗组35例，术前全身静脉化疗组41例，选其中25例化疗前的乳腺癌患者作对照组。采用免疫组化sP法，用CD34、VEGFR3抗体对3组乳腺癌组织标本进行MVD、MLVD检测。结果术前动脉灌注化疗组的MVD为36．05&#177;13．64，全身静脉化疗组为49．92&#177;12．90，对照组为60．38&#177;13．54，各组间比较（P〈0．01）；术前动脉灌注化疗组的MLVD为6．62&#177;3．70，全身静脉化疗组为9．96&#177;4．57，对照组为11．30&#177;5．32，动脉灌注化疗组与对照组比较显著下降（P〈0．01），与静脉化疗组比较差异有统计学意义（P〈0．05），静脉化疗组与对照组比较差异无统计学意义（P〉0．05）。结论术前区域性动脉灌注化疗比全身静脉化疗更能有效降低肿瘤组织及其周边组织内MVD和MLVD，从而抑制肿瘤细胞生长，减少肿瘤转移的机会。     

三维适形放疗同步化疗对中晚期食管癌患者生存质量影响的临床研究

目的比较三维适形放疗同步化疗与单纯三维适形放疗对中晚期食管癌患者生存质量的影响,治疗期间并发症及临床疗效。方法选取206例中晚期食管癌患者作为研究对象,将其中106例行单纯三维适形放疗患者列为对照组,100例行三维适形放疗同步化疗患者为观察组,比较2组患者治疗期间及治疗结束后生存质量各维度的改变,并发症发生率及临床疗效。结果 1治疗结束时对照组躯体功能、角色功能、总体症状明显好于观察组(P<0.05)。但治疗结束后3个月,观察组躯体功能、角色功能、情绪功能、社会功能以及总体症状均显著优于对照组(P<0.05)。22组患者均未发生严重的4级不良反应,放射性食管炎和放射性肺损伤组间差异不明显(P>0.05);观察组患者白细胞降低、血小板减少、肝功能异常、心脏毒性的发生率显著高于对照组(P<0.05)。观察组临床疗效明显优于对照组(P<0.05)。结论三维适形放疗同步化疗方案治疗期间会影响患者的生存质量评分,但治疗后短期内生存质量即可逐渐恢复,相对于单纯放疗的患者获益更多。     

Assessment of Quality of Life in Patients with Colorectal Cancer in Kazakhstan

Background: The problem of quality of life (QOL) of patients with colorectal cancer (CRC) is particularly relevant due to the dynamics of CRC incidence growth. This study aims to assess QOL of patients with CRC in the Republic of Kazakhstan in order to give an idea about the impact of burden on QOL of patients. Methods: A total of 319 patients diagnosed with CRC participated in this one-stage cross-sectional study. The survey was conducted between November 2021 and June 2022 at cancer centers in Kazakhstan.  Data were collected using the valid and reliable European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, version 3.0). Results: The average age of respondents was 59, 23 (SD=10,604) years. The main age group 50-69 years old accounted for 62.1% of the total sample. Among all ill respondents, 153 (48%) were male and 166 (52%) were female. The mean global health status was 59.24 ± 22.62. Two of the five functional scales were below the ≥66.7% threshold, namely, emotional functioning 61.65 (28.04) and social functioning 61.96 (31.84); while scores for the other three were: physical functioning 69.38 (22.06), role functioning 69.69 (26.45), and cognitive functioning 74.60 (25.07). Conclusions: This study gives an indication of good life functioning among our participants on the functional and symptom scales. However, they reported inadequate global health status.     

Psychometric Validation of the Malaysian Chinese Version of the EORTC QLQ-C30 in Colorectal Cancer Patients

Background and Aims: Colorectal cancer is the second most frequent cancer in Malaysia. We aimed to assess the validity and reliability of the Malaysian Chinese version of European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire core (QLQ-C30) in patients with colorectal cancer. Materials and Methods: Translated versions of the QLQ-C30 were obtained from the EORTC. A cross sectional study design was used to obtain data from patients receiving treatment at two teaching hospitals in Kuala Lumpur, Malaysia. The Malaysian Chinese version of QLQ-C30 was self administered in 96 patients while the Karnofsky Performance Scales (KPS) was generated by attending surgeons. Statistical analysis included reliability, convergent, discriminate validity, and known-groups comparisons. Statistical significance was based on p value ≤0.05. Results: The internal consistencies of the Malaysian Chinese version were acceptable [Cronbach’s alpha (α≥ 0.70)] in the global health status/overall quality of life (GHS/QOL), functioning scales except cognitive scale (α≤0.32) in all levels of analysis, and social/family functioning scale ( =0.63) in patients without a stoma. All questionnaire items fulfilled the criteria for convergent and discriminant validity except question number 5, with correlation with role (r = 0.62) and social/family (r = 0.41) functioning higher than with physical functioning scales (r = 0.34). The test-retest coefficients in the GHS/QOL, functioning scales and in most of the symptoms scales were moderate to high (r = 0.58 to 1.00). Patients with a stoma reported statistically significant lower physical functioning (p=0.015), social/family functioning (p=0.013), and higher constipation (p=0.010) and financial difficulty (p=0.037) compared to patients without stoma. There was no significant difference between patients with high and low KPS scores. Conclusions:Malaysian Chinese version of the QLQ-C30 is a valid and reliable measure of HRQOL in patients with colorectal cancer.     

Quality of Life by Stage of Cervical Cancer among Malaysian Patients

Stage of cervical cancer may adversely affect the quality of life (QOL) among patients. The objective of this study was to predict the QOL among cervical cancer patients by the stage of their cancer. A cross-sectional study from September 2012 until January 2013 was conducted among cervical cancer patients who completed treatment. All patients completed a interviewer-guided questionnaire comprising four sections: (A) sociodemographic data, (B) medical history, (C) QOL measured by general health status questionnaire (QLQ-30) and (D) cervical cancer specific module CX-24 (EORTC) was used to measured patient’s functional, symptom scale and their global health status. Results showed that global health status, emotional functioning and pain score were higher in stage III cervical cancer patients while role functioning was higher in stage I cervical cancer patients. Patients with stage IV cancer have a lower mean score in global health status (adjusted b-22.0, 95 CI% -35.6, -8.49) and emotional functioning (adjusted b -22.5, 95CI% -38.1, -6.69) while stage III had lower meanscore in role functioning (adjusted b -14.3, 95CI% -25.4, -3.21) but higher mean score in pain (adjusted b 22.1, 95 CI% 8.56, 35.7). In conclusion, stage III and IV cervical cancers mainly affect the QOL of cervical cancer patients. Focus should be given to these subgroups to help in improving the QOL.     

The EORTC Core Quality of Life questionnaire (QLQ-C30): validity and reliability when analysed with patients treated with palliative radiotherapy

The EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) is designed to measure cancer patients' physical, psychological and social functions. The questionnaire is composed of multi-item scales and single items. 247 patients completed the EORTC QLQ-C30 before palliative radiotherapy and 181 after palliative radiotherapy. The questionnaire was well accepted with a high completion rate in the present patient population consisting of advanced cancer patients with short life expectancy. In addition, the questionnaire was found to be useful to detect the effect of palliative radiotherapy over time. The scale reliability was excellent for all scales except the role functioning scale. Excellent criterion validity was found for the emotional functioning scale where it was correlated with GHQ-20. Performance of the questionnaire was improved after the second evaluation as compared with the first. The present study shows that the EORTC QLQ-C30 is found to be practical and valid in measuring quality of life in patients with advanced disease.     

Validation of the Turkish Versions of EORTC QLQ-C30 and BR23 Modules in Breast Cancer Patients

Purpose: To test the validity and reliability of The European Organization for Research and Treatment ofCancer (EORTC) core (QLQ-C30) and breast cancer module (QLQ-BR23) for Turkish breast cancer patients.Patients and Methods: A total of 127 patients treated with radiotherapy (RT) enrolled to this prospective study.EORTC QLQ-C30 and QLQ-BR23 modules applied to patients before initiation of RT and at follow-up period.Statistical analyses were performed by SPSS 13.0. Results: Questionnaires’ were found reliable and valid forTurkish breast cancer patients. Six of the 8 multi-item scales of QLQ-C30 had a high reliability (Cronbach’s α>0.7); where physical functioning and pain scores were less reliable (Cronbach’s α of 0.66 and 0.68 respectively).In the QLQ-BR23, 3 of 5 multi-item scales were reliable; less reliable were breast and arm symptoms scale(Cronbach’s α of 0.65 and 0.61 respectively). In our analysis the most determinative subscales of QLQ-C30on global health was emotional functioning followed by fatigue, role functioning and appetite loss (respectivelyp=0.002, p=0.01; p=0.03 and p=0.08). Among QLQ-BR23 scales systemic therapy side effects, future perspectiveand upset by hair loss subscales had high impact on global health status (respectively p=0.006; p=0.01 and p=0.03).Conclusions: The Turkish version of EORTC QLQ-C30 and QLQ-BR23 modules are reliable and valid tools toassess quality of life of Turkish breast cancer patients.     

Quality of life in women with gynecologic cancer in Turkey

Aim: The management of gynecological cancer patients mainly aims at prolonging survival but modern therapy focuses on good survival combined with a good quality of life (QoL). The aim of this study was to evaluate QoL and identify its associated factors in Turkish women with gynecologic cancer. Method: The study included 119 women diagnosed with endometrial, cervical, ovarian or vulvar cancer and treated at the Gynecologic Oncology Department of Celal Bayar University Faculty of Medicine. The data were collected between January and June 2011. QoL was measured with EORTC QLQ-C30 version 3.0. Relationships between clinical and socio-demographic characteristics and QoL scores were analyzed using the Mann-Whitney U, Kruskal Wallis and t-tests. Result: Global health status, physical and role function scores were found higher in women under the age of 60 years. Role function scores were found lower, and emotional and social scores were found to be higher in single women than in married women. Physical scores were found higher in women who had graduated from secondary school or above. Women with ovarian cancer had the highest while women with cervical cancer had the lowest global health score (65.3 ±24.7 and 43.0±24.1, respectively). Women with endometrial cancer were found to have better role function, and social well being than those with vulvar, cervical or ovarian cancer. Global, physical, role function, cognitive and social scores were found higher in women who had been treated with surgery. Conclusion: Gynecological cancer and treatment processes cause significant problems that have negative effects on physical, emotional, social and role function aspects of QoL. Health care providers play a key role in the identification and treatment of the complications of cancer therapy. Minimizing the effect of the symptoms of gynecologic cancer may positively impact on patient QoL.     

The European Organization for Research and Treatment of Cancer QLQ-C30: an examination into the cultural validity and reliability of the Turkish version of the EORTC QLQ-C30

The Turkish version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire version 2.0 (EORTC QLQ-C30 v.2.0) has started to be used in clinical trials recently. The objective of the study was to evaluate the validity and reliability of the Turkish version of the EORTC QLQ-C30 v.2.0 and the correlation between the Karnofsky Performance Scale (KPS) and the EORTC QLQ-C30. Two hundred and two lung cancer patients were included in the study between January and March 2000. All the subscales met the minimal standards of reliability (Cronbach's alpha ≥ 0.70). Only the role functioning scale differed among the three disease stages of patients (local, locoregional and metastatic). There was no statistically significant difference among therapy types. All interscale correlations were statistically significant ( P  < 0.01). The strongest correlations were found among the physical functioning, role functioning and fatigue scales. Social functioning was closely related with physical, role, emotional and cognitive functioning. The weakest correlations were between nausea/vomiting and the other scales. Global quality of life (QOL) was substantially correlated with most of the scales except cognitive functioning. The coefficients for the correlation between the items differed between 0.12 and 0.97 and all the subscales were strongly correlated with the scales which they formed. The highest correlation between the EORTC QLQ-C30 and KPS was for physical functioning ( r  = 0.62, P  < 0.05). The Turkish version of the EORTC QLQ-C30 is a valid (by means of interscales validity) and reliable instrument for Turkish lung cancer patients and can be used in clinical studies but needs supporting by the reference data on the QOL of the Turkish population.     

Feasibility of quality of life assessment in patients with upper gastrointestinal tract cancer

Quality of life (QOL) is an important outcome after treatment for upper gastrointestinal tract cancer but few studies report good accrual and subsequent attrition is usually high. This study investigated the feasibility of a nurse-led service to obtain longitudinal QOL assessments and explored how clinical and sociodemographic factors influence patients' need for help to complete questionnaires. Fully informed patients were invited into the study. Baseline hospital assessments were scheduled by telephone and thereafter by post unless patients' health indicated the need for a home visit. In all, 128 out of 140 (91%) baseline QOL assessments were performed. Follow-up questionnaire completion was good, with 114 patients (89%) completing all but one of the expected assessments. At baseline, 41 (32%) patients required a lot of help to complete questionnaires. Patients requiring help were more likely to be undergoing palliative treatment than treatment aimed at cure (68 vs 33%; odds ratio 3.48, P<0.01). Patients' with advanced stage cancer of the upper gastrointestinal tract receiving palliative treatment require dedicated staff to ensure good compliance with longitudinal QOL data collection. It is essential to budget for this in clinical trails.     

Understanding the reliability and validity of the EORTC QLQ-C30 in Turkish cancer patients

Quality of life (QOL) has become an important area to address. The most commonly used QOL tool in oncology is the European Organization for Research and Treatment of Cancer QOL measure (EORTC QLQ-C30). The aim of this study is to examine the reliability and validity of this widely used questionnaire in Turkish language. A total of 114 cancer patients were recruited in this study. The internal consistency of the subscales, concurrent validity between EORTC QLQ-C30 version 3.0 and Short Form-36 (SF-36), the correlations between the subscales of EORTC QLQ-C30 and Hospital Anxiety and Depression scale-Anxiety (HADS-A), and Hospital Anxiety and Depression scale-Depression (HADS-D) were also evaluated. Cronbach's alpha-coefficient for multi-item scales ranged from 0.56 to 0.85, with emotional functioning having the highest Cronbach's alpha-coefficient. General health/QOL subscale was correlated significantly with all other subscales. Modest correlations were found between relevant subscales of SF-36 and EORTC QLQ-C30 scales indicating good convergent validity. Although score of emotional functioning subscale was significantly correlated with HADS-A, no correlation was found with HADS-D. The correlations between general health/QOL and HADS-A and HADS-D were significant though Pearson's coefficients were below 0.4. The EORTC QLQ-C30 version 3.0 is a reliable and valid instrument and suitable for measuring the QOL in cancer patients in Turkey.     

Quality of life and Its Determinants among Cervical Cancer Patients in South India

Introduction: Cervical Cancer is the leading cause of morbidity and mortality in India. It affects the patient’s, physical and psychological state which results in lower quality of life (QoL). Women with cervical cancer may require counselling and time to enable them to deal with the disease and its treatment. The present study aimed to determine the quality of life and its determinants among cervical cancer patients. Methods: A cross-sectional study was undertaken from April 2017 to September 2017 in a regional cancer centre in South India. Cervical cancer patients (N= 210) with histological confirmation were interviewed at the hospital. European Organization of Research and Treatment of Cancer (EORTC) questionnaire core module, QLQ-C30 Version 3.0, and recommended scoring algorithm were used to measure and analyse QoL. The Association of socio-economic determinants on quality of life was evaluated using multiple logistic regression. Results: Among 210 cervical cancer patients enrolled, the majority 106 (50.5%) of women were between the age group 46 to 59 years and most, i.e.  167(63.0%) were not literate. The median score in the global health status was 50.0[IQR 33.3 – 66.7], 66.7[IQR 60.0 – 80.0] in physical functioning, and 83.3[IQR 66.7 – 83.3] in pain symptoms respectively which were poor compared to reference score of EORTC for all normal females and those with any cancer. The factors which were significantly associated with the GHS QoL score were the advanced stage of disease (OR:2.1, 95%CI: 1.1 – 3.9) and the age of the patients ≥60 years compared with ≤ 45 years (OR:18.4, 95%CI: 6.8 – 50.1). Conclusion: Cervical cancer patients had poor global health status compared to the reference score for all females with any cancer and the normal females. Advanced stage of cancer and older age have a significant association with QoL.