QLQ-BR23和EORTC QLQ-C30测量康复锻炼对乳腺癌患者生命质量的影响

 目的  探讨康复期锻炼对乳腺癌患者生命质量的影响。方法  采用横断面研究方法,整群抽样上海癌症康复俱乐部1 956名女性乳腺癌康复期患者进行问卷调查,调查问卷采用欧洲癌症研究与治疗组织生命质量量表(quality of life questionnaire core 30,EORTC QLQ-C30)和乳腺癌生存质量量表(quality of life questionnaire breast cancer module 23,QLQ-BR23)。结果  QLQ-BR23的信度和效度分别为0.898和0.904,EORTC QLQ-C30的信度和效度分别为0.988和0.989;对于QLQ-BR23量表,康复锻炼、锻炼次数和生命质量均无统计学意义。但是参与康复锻炼和锻炼次数≥5次/周患者的功能症状总得分高于未参加康复锻炼和康复锻炼＜5次/周患者。对于EORTC QLQ-C30量表,通过调整社会人口学等因素,参加康复锻炼患者的躯体功能及总体健康状况得分均显著高于不参加体育锻炼患者(P<0.05,PAdjusted<0.05);康复锻炼≥5次/周患者的5个功能维度及总体健康状况得分均高于康复锻炼＜5次/周患者,但只有躯体功能差异有统计学意义(P<0.05,PAdjusted<0.05)。结论  参加康复锻炼的乳腺癌患者总体生命质量高于未参加锻炼者,康复锻炼对提高乳腺癌患者的生命质量有积极影响。     

EORTC QLQ量表评估影响食管癌患者生活质量的相关因素

目的评估食管癌化疗患者的生活质量并探究与生活质量相关的影响因素。方法自2004年11月1日至2005年12月31日采用EORTCQLQ问卷表访问133例食管癌患者。影响生活质量的因素经t检验和单变量方差检验处理。结果无论化疗有效与否,本研究入组患者化疗后第1周生活质量得分多稍有降低,但4周后可恢复至化疗前水平。年龄较轻、临床分期较早及KPS评分较高者生活质量较好。术后辅助化疗组患者生活质量相对较好。结论对食管癌化疗患者的生活质量进行分析,其结果对建立化疗食管癌患者生活质量的评价标准及临床医师选择合适的治疗方式有一定的指导意义。     

Health-related quality of life in patients with pharyngeal carcinoma: a five-year follow-up

PURPOSE: The purpose was to evaluate the health-related quality of life (HRQL) of patients with pharyngeal carcinoma at diagnosis and after 1 and 5 years in relation to tumor location and treatment modality in a prospective multicenter study. METHODS: Eighty-nine patients with pharyngeal carcinoma (mean age, 60.0 years; 76% men) were evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Cancer Module (EORTC QLQ-H&N35). RESULTS: Problems with dry mouth and teeth became worse between diagnosis and the 5-year follow-up. Problems with thick secretions and teeth increased between 1 and 5 years. The HRQL at diagnosis was associated with survival. Patients with oropharyngeal carcinoma reported better HRQL than patients with hypopharyngeal carcinoma. CONCLUSIONS: For patients with pharyngeal carcinoma, the HRQL at diagnosis seems to be an important factor for the prognosis of both HRQL over time and survival. Treatment of pharyngeal carcinoma often results in long-term side effects such as dry mouth, problems with teeth, and thick secretions.     

The domain structure of the EORTC QLQ-STO22 supported by Japanese validation data

This paper evaluates the scale structure of the EORTC QLQ-STO22 gastric cancer module using Japanese validation data. We additionally tested two single items regarding dumping syndrome. Of 246 patients who participated in phase II clinical trials of chemotherapy to treat advanced gastric cancer, we analyzed 206 who completed the pretreatment questionnaire. The factor analysis supported the scale structure hypothesized for the initial development phase conducted by the EORTC Quality of Life Group, not the alternations made in the final psychometric testing phase. The elicited scales exhibited high internal consistency and high clinical validity. Our data suggest that there is no need to examine the dumping syndrome items. This study revealed a slightly different scale structure of the QLQ-STO22 from that obtained in the European study. Extensive discussions with the EORTC Group are needed from both cross-cultural and clinical perspectives in order to establish a consensus on the various language versions of the QLQ-STO22.     

A prospective comparison of quality of life measures for patients with esophageal cancer

Among the most widely used instruments to assess quality of life (QOL) in patients with cancer are the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30) and the Functional Assessment of Chronic Illness Therapy, cancer instrument (FACT-G). This study compared these approaches in patients who had undergone esophagectomy for cancer. The EORTC core questionnaire and esophageal module and the FACT-G and esophageal scale were completed by 57 patients. Missing data, relationships between QOL scales and analyses of patients preferences were examined. There were 14/2736 (0.5%) missing items from EORTC questionnaires and 45/2565 (1.8%) from FACT instruments (p < 0.01). Relationships between corresponding generic EORTC and FACT scales were average to good (r 0.57) except for the social function scale (r = 0.01). EORTC symptom scores were moderately correlated with the FACT general scale, but poorly related to the FACT esophageal scale (r < 0.28). EORTC swallowing scores were moderately correlated with all FACT scales. The FACT-E and EORTC QLQ-C30 measure assess similar generic aspects of QOL (except social function). EORTC esophageal symptom scores relate poorly to FACT esophageal scales, except for swallowing. Choice of QOL measure after esophagectomy for cancer depends upon outcomes of interest. Future studies will determine which instruments are appropriate in each context.     

The impact of generalized malignant melanoma on quality of life evaluated by the EORTC questionnaire technique

Eighty-nine patients with generalized malignant melanoma, 63% men and median age 53 years, were included in a longitudinal quality of life (QOL) study before the start of chemotherapy. QOL was assessed by the EORTC core questionnaire technique (QLQ-C36), a study-specific melanoma (MM) module and the Hospital Anxiety and Depression (HAD) scale. The questionnaires displayed good psychometric qualities and were able to document the florid symptomatology of disseminated melanoma. They were well accepted by the patients. Before treatment the patients reported a relatively low symptom burden, good physical and social functioning, moderate psychological distress and a high overall QOL rating during the past week. Fatigue and pain were the most frequent symptoms reported. The QOL measurement differentiated between subgroups of patients differing in performance status and the tumour burden. We conclude that the EORTC questionnaire technique is feasible and clinically relevant in generalized malignant melanoma patients.This study was made possible by grants from the King Gustav V Jubilee Fund, Stockholm, Sweden.     

Patient reported outcomes: integration into clinical practices

Patient-centered care is a growing focus of research and modern surgical practice. To this end, there has been an ever-increasing utilization of patient reported outcomes (PRO) and health-related quality of life metrics (HR-QOL) in thoracic surgery research. Here we describe reasons and methods for integration of PRO measurement into routine thoracic surgical practice, commonly utilized PRO measurement instruments, and several examples of successful integration.     

Quality of life scores: An independent prognostic variable in a general population of cancer patients receiving chemotherapy

This report examines the prognostic associations between QOL scores measured by the EORTC QLQ-C30 and survival in a large heterogeneous population of cancer patients. Eight hundred and fifty-one cancer patients who were to receive chemotherapy were enrolled in two National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) antiemetic trials. All patients completed the EORTC QLQ-C30 immediately prior to their first chemotherapy. Survival data were available and obtained for 474 of 639 patients (74%). Cox's proportional hazards model was used to assess the independent impact of QOL and demographic variables on survival. Presence of metastatic disease, diagnosis of lung or ovarian cancer, ECOG performance status, global quality of life and emotional functioning were significantly associated with survival. Global QOL was predictive in all patients, in subgroups of patients with metastatic disease, with breast and lung cancer and other tumour types. In patients with low global quality of life scores, patients with low emotional functioning ratings lived longer than did patients with high emotional functioning ratings. Patients with high global QOL live significantly longer than do patients with low global QOL. The relationship between emotional functioning in patients with low global QOL and survival needs confirmation.     

73例生存期3年以上急性白血病患者生活质量及影响因素分析

目的：探讨生存期3年以上急性白血病患者生活质量及其影响因素。方法：采用一般状况调查问卷、癌症患者生活质量测定量表（European Organization for Research and Treatment of Cancer, EORTC QLQ-C30）中文版、体能状况评估表（ECOG）对73例生存期3年以上急性白血病患者进行问卷调查。结果：生存期3年以上急性白血病患者生活质量总分为（82.2±20.7）分,其中躯体功能得分最高,社会功能得分最低。在症状维度中,恶心呕吐症状最轻微,经济困难情况最严重。影响急性白血病患者生活质量总健康状况的因素为：体能状况、是否恢复工作。结论：生存期3年以上急性白血病患者生活质量得到改善,癌症相关症状得到控制。可根据患者体能状况及恢复工作情况给与康复指导,提高其生活质量。