Can Quality of Life Assessments Differentiate Heterogeneous Cancer Patients?
Can Quality of Life Assessments Differentiate Heterogeneous Cancer Patients?
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DOI：
10.1371/journal.pone.0099445
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发表时间：
2014-06-11
期刊：
影响因子：
3.7
通讯作者：
Markman, Maurie
中科院分区：
文献类型：
--
作者：
McCabe, Ryan M.;Grutsch, James F.;Markman, Maurie
目的：本研究在一项综合性社区癌症项目中，对在诊断为恶性疾病的自然病史中的异质性癌症患者队列中应用HRQOL评估研究工具的患者反应进行了面部验证研究，其中许多患者不被视为临床研究试验参与的候选人。方法：两个区域癌症治疗中心的癌症登记处在九年内确定了11072名癌症患者。在这些中心首次出现临床表现时，对患者进行EORTC QLQ-C30。为了确定患者亚组之间差异的显著性，使用了两个分析标准。Mann-Whitney检验用于确定统计学显著性;临床相关性定义了一系列的点差异，可以被感知的患者具有不同的健康状态。结果：跨分层变量进行单变量分析的人口，疾病严重程度和人口统计学特征。最大的差异与癌症诊断和疾病复发有关。在起源部位、死亡率和分期方面也存在较大差异;在性别和年龄方面差异最小。一致敏感的QoL量表包括食欲不振、疲劳和疼痛症状，（与工作有关的）、社会和身体功能。1）EORTC QLQ-C30在非基于研究的临床护理背景下收集了有意义的患者健康评估，2）患者评估差异在15个QoL领域中表现明显，以及3）除了指示患者在某个时间点的感觉之外，QoL指标还可以揭示关于对疾病进展、治疗和预期存活的潜在生物学反应的信息。
Purpose: This research conducted a face validation study of patient responses to the application of an HRQOL assessment research tool in a comprehensive community cancer program setting across a heterogeneous cohort of cancer patients throughout the natural history of diagnosed malignant disease, many of whom would not be considered candidates for clinical research trial participation.Methods: Cancer registries at two regional cancer treatment centers identified 11072 cancer patients over a period of nine years. The EORTC QLQ-C30 was administered to patients at the time of their initial clinical presentation to these centers. To determine the significance of differences between patient subgroups, two analytic criteria were used. The Mann-Whitney test was used to determine statistical significance; clinical relevance defined a range of point differences that could be perceived by patients with different health states.Results: Univariate analyses were conducted across stratification variables for population, disease severity and demographic characteristics. The largest differences were associated with cancer diagnosis and recurrence of disease. Large differences were also found for site of origin, mortality and stage; minimal differences were observed for gender and age. Consistently sensitive QoL scales were appetite loss, fatigue and pain symptoms, and role (work-related), social and physical functions.Conclusions: 1) The EORTC QLQ-C30 collected meaningful patient health assessments in the context of non-research based clinical care, 2) patient assessment differences are manifested disparately across 15 QoL domains, and 3) in addition to indicating how a patient may feel at a point in time, QoL indicators may also reveal information about underlying biological responses to disease progression, treatments, and prospective survival.