Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials
Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials
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DOI：
10.1016/s1470-2045(09)70200-1
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发表时间：
2009-09-01
期刊：
影响因子：
51.1
通讯作者：
Bottomley, Andrew
中科院分区：
文献类型：
--
作者：
Quinten, Chantal;Coens, Corneel;Bottomley, Andrew
背景 尽管个别研究表明基线健康相关生活质量 (HRQOL) 是生存的预后因素，但已发表的结果相互矛盾，并且很少有荟萃分析证实这一发现。我们对具有不同疾病部位的大样本患者进行汇总，检验 HRQOL 评分是否与生存相关。方法 我们从欧洲癌症研究与治疗组织 (EORTC) 1986 年至 2004 年间启动的 30 项随机对照试验中选择了 30 项随机对照试验，其中包括 11 个不同癌症部位的 10108 名患者的生存数据。如果患者已使用 EORTC 核心生活质量问卷完成基线 HRQOL 评估（QLQ-C30；n=7417），则有资格纳入。社会人口统计学变量包括年龄（60 岁）和性别（男性与女性），临床变量包括 WHO 表现状态（0-1 与 2-3）、远处转移（无与有）和癌症部位。我们使用 Cox 比例风险模型评估了社会人口统计学和临床变量以及 15 个 QLQ-C30 量表的预后意义。结果在包括社会人口统计学、临床和 HRQOL 数据的分层多变量模型中，身体机能的 HRQOL 参数（风险比 0.94，95% CI 0.92-0-96；p
Background Although individual studies show that baseline health-related quality of life (HRQOL) is a prognostic factor for survival, contradictory results have been published and very few meta-analyses have confirmed the finding. We examined whether HRQOL scores are associated with survival when pooled across a large sample of patients with different disease sites.Methods We selected 30 randomised controlled trials from the European Organisation for Research and Treatment of Cancer (EORTC) started between 1986 and 2004, which included survival data for 10108 patients with 11 different cancer sites. Patients were eligible for inclusion if they had completed a baseline HRQOL assessment with the EORTC core quality of life questionnaire (QLQ-C30; n=7417). Sociodemographic variables were age (60 years) and sex (men vs women), and clinical variables were WHO performance status (0-1 vs 2-3), distant metastases (no vs yes), and cancer site. We assessed prognostic significance of sociodemographic and clinical variables and the 15 QLQ-C30 scales with Cox proportional hazard models.Findings In the stratified multivariate model including sociodemographic, clinical, and HRQOL data, the HRQOL parameters of physical functioning (hazard ratio 0.94, 95% CI 0.92-0-96; p