Pretreatment Quality of Life As a Predictor of Distant Metastasis and Survival for Patients With Nasopharyngeal Carcinoma
Pretreatment Quality of Life As a Predictor of Distant Metastasis and Survival for Patients With Nasopharyngeal Carcinoma
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DOI：
10.1200/jco.2010.28.8324
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发表时间：
2010-10-01
影响因子：
45.3
通讯作者：
Lee, Chien-Hung
中科院分区：
文献类型：
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作者：
Fang, Fu-Min;Tsai, Wen-Ling;Lee, Chien-Hung
本研究旨在探讨鼻咽癌患者治疗前的生活质量(QOL)数据对局部区域控制(LRC)、无远处转移生存期(DMFS)和总生存期(OS)的预测价值。治疗前完成《欧洲癌症研究与治疗组织生活质量问卷C30》台湾中文版。结果5年LRC率为72.9%，DMFS率为79.1%，OS率为68.4%。调整临床变量后，观察到10个QOL变量与OS显著相关(P<；0.05)，4个QOL变量与DMF相关。QOL变量均不能预测LRC。在显著预测OS和DMF的QOL变量中，身体功能是最强大的预测因子。躯体功能评分每增加10分，死亡的可能性降低23%(95%CI，12%~34%)，远处转移的可能性降低22%(95%CI，9%~36%)。结论我们的研究结果表明，治疗前的QOL变量，尤其是生理功能，为鼻咽癌患者的远处转移和生存提供了容易获得的预后价值。
PurposeThe purpose of this study was to examine the prognostic value of pretreatment quality of life (QoL) data on locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) in patients with nasopharyngeal carcinoma (NPC).Patients and MethodsA total of 347 new patients with NPC, who were curatively treated by conformal radiotherapy from March 2003 to December 2007, were recruited. The Taiwan Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 was completed before treatment. Multivariate Cox's proportional hazards models were used to analyze the impact of clinical and QoL variables on the treatment results.ResultsThe 5-year LRC, DMFS, and OS rates were 72.9%, 79.1%, and 68.4%, respectively. After adjusting the clinical variables, 10 QoL variables were observed to be significantly (P < .05) related to OS, and four QoL variables were related to DMFS. No QoL variable was predictive of LRC. Among the QoL variables that significantly predicted OS and DMFS, physical functioning was the most powerful predictor. A 10-point increase in the physical functioning score was associated with a 23% (95% CI, 12% to 34%) reduction in the likelihood of death and a 22% (95% CI, 9% to 36%) reduction in the likelihood of distant metastasis.ConclusionOur findings indicate that pretreatment QoL variables, especially physical functioning, provide easily available prognostic value for distant metastasis and survival in patients with NPC.