作者:Sabrina Trippoli、Monica Vaiani、Carlo Lucioni、Andrea Messori
DOI:10.2165/00019053-200119080-00007
日期:——
Background: Although several studies have determined quality of life in patients with lung cancer, there is still little information about the use of generic questionnaires [e.g. the 36-item Short Form health survey (SF-36)] and utility questionnaires [e.g. the EuroQOL instrument (EQ-5D)] in this disease. Objectives: To (i) measure quality of life and utility in patients with non-small cell lung cancer (NSCLC) using the SF-36 and the EuroQOL questionnaires; (ii) to evaluate the impact of some clinical variables on quality of life and utility; (iii) to assess the correlation between the measurements produced by the 2 questionnaires. Study design: Cross-sectional study. Participants: 95 patients from15 Italian hospitals with NSCLC (93% male, mean age 62 years) completed both questionnaires. Results: The mean scores for the 8 domains of the SF-36 ranged from 20.8 (physical role) to 63.0 (social functioning). The mean physical and mental summed scores of the SF-36 were 36.8 [standard deviation (SD) 9.8] and 43.0 (SD 11.5), respectively. The EuroQOL mean score was 0.58 (SD 0.32) in the self-classifier (SC) version and 0.58 (SD 0.20) in the visual analogue scale (VAS) version. Among the clinical variables that affected quality of life and utility, the presence of metastasis had the greatest impact: patients with metastasis had statistically significantly lower scores for 2 domains of the SF-36 (physical functioning, p = 0.009; bodily pain, p = 0.016), for the physical component summed score of the SF-36 (p = 0.015) and for both utility estimates (EuroQOL-SC, p = 0.027; EuroQOL-VAS, p = 0.038) than patients without metastasis. Both the SC and VAS EuroQOL scores showed a statistically significant correlation with each of the 8 domains of the SF-36. The scores for both the SF-36 and the EuroQOL in patients with NSCLC were considerably worse (relative differences ranging from −8 to −73%) than the corresponding values (normative data) previously reported for healthy individuals. Conclusions: Our study quantified the degree to which quality of life is impaired in patients with NSCLC, showed that the presence of metastasis had an important role, and indicated a strong correlation between the measurements produced by the 2 questionnaires. The EuroQOL measurements obtained from these patients will aid evaluation of the cost-utility ratio for NSCLC therapies.
背景:尽管多项研究确定了肺癌患者的生命质量,但对这一疾病中使用通用问卷 (例如 36 项简明健康量表 (SF-36))乃至效用问卷 (例如 EuroQol 量表 (EQ-5D))的信息仍然较少。目的:采用 SF-36 和 EuroQol 问卷 (i) 评估非小细胞肺癌 (NSCLC) 患者的生命质量及效用; (ii) 评价一些临床变量对生命质量及效用的影响; (iii) 评价上述两种问卷所得测量结果的相关性。研究设计:横断面研究。研究对象: 95 例来自 15 个意大利医院的 NSCLC 患者 (男性占 93%,平均年龄 62 岁) 完成了问卷。结果: SF-36 量表 8 个领域的平均分 20.8 分 (身体角色) ~ 63.0 分 (社会功能)。 SF-36 身体及精神总分分别为 36.8 [标准差 (SD) 9.8]和 43.0 (SD 11.5)。 EuroQol 自评量表 (SC)及目视模拟量表 (VAS)的平均得分分别为 0.58 (SD 0.32)和 0.58 (SD 0.20)。转移的存在对生命质量及效用的临床变量影响最大:与无转移患者相比,有转移患者的 SF-36 两领域 (躯体功能, P = 0.009;躯体疼痛, P = 0.016)、 SF-36 身体总分 ( P = 0.015)及两效用评估 (EuroQOL-SC, P = 0.027;EuroQOL-VAS, P = 0.038)的得分显著降低。 EuroQOL 的 SC 及 VAS 均与 SF-36 的 8 个领域显著相关。与既往健康人的对照值相比, NSCLC患者的 SF-36 及 EuroQOL 均显著降低 (相对差异 −8%至 −73%)。结论:本研究量化了 NSCLC 患者的生命质量损害程度,并表明转移起着重要作用,而且上述两种问卷所得测量结果之间呈强相关。该患者人群的 EuroQOL 测量结果有助于 NSCLC 疗法的成本效用评估。