Health-Related Quality of Life and Utility in Patients with Advanced Non-Small-Cell Lung Cancer: A Prospective Cross-Sectional Patient Survey in a Real-World Setting
Health-Related Quality of Life and Utility in Patients with Advanced Non-Small-Cell Lung Cancer: A Prospective Cross-Sectional Patient Survey in a Real-World Setting
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DOI：
10.1097/jto.0b013e318299243b
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发表时间：
2013-08-01
影响因子：
20.4
通讯作者：
Mitchell, Paul L. R.
中科院分区：
文献类型：
--
作者：
Chouaid, Christos;Agulnik, Jason;Mitchell, Paul L. R.
背景：非小细胞肺癌（NSCLC）对患者的健康相关生活质量（HRQOL）有显着影响。本研究旨在测量代表个人对晚期 NSCLC 患者特定健康相关结果的偏好的健康状态效用值，并评估预测参数。 方法：我们对欧洲、加拿大、澳大利亚和土耳其 25 家医院的晚期 NSCLC 患者进行了前瞻性生活质量调查。使用 EuroQol (EQ-5D) 问卷评估 HRQOL，并估计 EQ-5D 效用和 EQ-视觉模拟 (EQ-VAS) 评分。 结果：招募了 319 名患者，其中 263 名具有可评估数据。无进展 (PF) 患者接受一线、二线和三线/四线治疗的平均效用分别为 0.71 (SD = 0.24)、0.74 (SD = 0.18) 和 0.62 (SD = 0.29)。接受一线、二线和三线/四线治疗的进展性疾病 (PD) 患者的平均效用分别为 0.67 (SD = 0.2)、0.59 (SD = 0.34) 和 0.46 (SD = 0.38)。总体而言，PD 患者的平均效用得分低于 PF 患者（0.58 比 0.70）。 EQ-VAS 结果显示，随着治疗线的后期，评分下降。与 PF 患者相比，PD 患者的 VAS 评分下降了 10 分（53.7 比 66.6）。回归分析显示，IV 期疾病、更高的治疗线和健康状况是 10% 水平上效用的显着预测因素。结论：得出的结果表明肺癌对患者的 HRQOL 产生重大影响，IV 期疾病、更高的治疗线和 PD 导致效用显着恶化。此处获得的值将为非小细胞肺癌治疗的成本效益评估提供信息。
Background:Non-small-cell lung cancer (NSCLC) has a significant impact on patients' health-related quality of life (HRQOL). This study aimed to measure health state utility values representing the individual's preferences for specific health-related outcomes in advanced NSCLC patients and to assess predictive parameters.Methods:We conducted a prospective quality-of-life survey on advanced NSCLC patients in 25 hospitals in Europe, Canada, Australia, and Turkey. HRQOL was assessed using the EuroQol (EQ-5D) questionnaire and EQ-5D utility and EQ-visual analog (EQ-VAS) scores were estimated.Results:Three hundred nineteen patients were recruited of which 263 had evaluable data. Mean utility for progression-free (PF) patients on first-, second-, and third-/fourth-line treatment was 0.71 (SD = 0.24), 0.74 (SD = 0.18), and 0.62 (SD = 0.29), respectively. Mean utility for patients with progressive disease (PD) while on first-, second- and third-/fourth-line treatment was 0.67 (SD = 0.2), 0.59 (SD = 0.34), and 0.46 (SD = 0.38), respectively. Overall, patients with PD had lower mean utility scores than PF patients (0.58 versus 0.70). The results of the EQ-VAS showed that the score decreased with later treatment lines. Patients with PD had a 10-point decrease in VAS scores compared with PF patients (53.7 versus 66.6). The regression analysis revealed that stage IV disease, higher lines of treatment, and health state were significant predictors of utility at the 10% level.Conclusion:The results presented indicate a substantial impact of lung cancer on patients' HRQOL, with stage IV disease, line of treatment, and PD, resulting in considerable deterioration of utility. The values obtained here will inform evaluations of cost-utility for NSCLC therapies.