The added value of health-related quality of life as a prognostic indicator of overall survival and progression-free survival in glioma patients: a meta-analysis based on individual patient data from randomised controlled trials
The added value of health-related quality of life as a prognostic indicator of overall survival and progression-free survival in glioma patients: a meta-analysis based on individual patient data from randomised controlled trials
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DOI：
10.1016/j.ejca.2019.05.012
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发表时间：
2019-07-01
影响因子：
8.4
通讯作者：
Taphoorn, Martin J. B.
中科院分区：
文献类型：
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作者：
Coomans, Marijke;Dirven, Linda;Taphoorn, Martin J. B.
目的：健康相关生活质量(HRQOL)数据的预后价值可能在临床实践中为患者提供信息并指导临床决策。除了已知的预后因素外，我们的研究还调查了在大量不同类型的胶质瘤患者样本中，HRQL对总生存期(OS)和无进展生存期(PFS)的附加预后价值。方法：我们纳入了先前发表的胶质瘤患者随机对照试验(RCT)的个体基线数据，其中HRQL通过欧洲癌症研究和治疗组织QLQ-C30和QLQ-BN20问卷进行评估。首先，只考虑临床变量(年龄、性别、肿瘤类型、功能状态、分配的治疗和切除范围)，然后分别添加OS和PFS的HRQL变量，建立了多变量COX回归模型(按初诊疾病和复发疾病分层)。结果：纳入15个随机对照试验的基线HRQL和临床资料，共5217名患者。在包括临床和HRQOL变量的模型中，较好的认知和角色功能和较少的运动功能与较长的OS独立相关，而较好的角色和认知功能、较少的恶心和呕吐以及较多的食欲不振与较长的PFS独立相关。然而，C指数显示，当将HRQL添加到临床预后变量(OS+1.1%，PFS+.7%)时，OS和PFS的模型的预后只有很小的改善。结论：我们的研究结果表明，几个基线HRQL变量对OS和PFS是独立的预后变量，但HRQL对已知的临床预后变量的附加值很小。(C)2019爱思唯尔有限公司。保留所有权利。
Objective: Prognostic value of health-related quality of life (HRQoL) data may be important to inform patients in clinical practice and to guide clinical decision-making. Our study investigated the added prognostic value of HRQoL for overall survival (OS) and progression-free survival (PFS) in a large heterogeneous sample of glioma patients, besides known prognostic factors.Methods: We included individual baseline data from previously published randomised controlled trials (RCTs) in glioma patients in which HRQoL was assessed through the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BN20 questionnaires. Multivariable Cox regression models (stratified for newly diagnosed versus recurrent disease) were constructed, first with clinical variables (age, sex, tumour type, performance status, allocated treatment and extent of resection) only and subsequently with HRQoL variables added, separately for OS and PFS. The added prognostic value of HRQoL was calculated using C-indices.Results: Baseline HRQoL and clinical data from 15 RCTs were included, comprising 5217 patients. In the model including both clinical and HRQoL variables, better cognitive and role functioning and less motor dysfunction were independently associated with longer OS, whereas better role and cognitive functioning, less nausea and vomiting and more appetite loss were independently associated with prolonged PFS. However, C-indices indicated only a small prognostic improvement of the models for OS and PFS when adding HRQoL to the clinical prognostic variables (+1.1% for OS and +.7% for PFS).Conclusion: Our findings demonstrate that several baseline HRQoL variables are independently prognostic for OS and PFS, yet the added value of HRQoL to the known clinical prognostic variables was small. (C) 2019 Elsevier Ltd. All rights reserved.