头颈癌患者健康相关生活质量与5年总体生存率之间的关系：一项前瞻性队列研究

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-05-19 DOI:10.1016/j.oraloncology.2025.107367

Irma M. Verdonck-de Leeuw , Birgit I. Lissenberg-Witte , Remco de Bree , Laurien M. Buffart , Jose Hardillo , Femke Lamers , Johannes A. Langendijk , C.René Leemans , Robert P. Takes , Femke Jansen

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引用次数: 0

摘要

目的在校正潜在混杂因素后，评估头颈癌（HNC）患者基线（T0）、治疗后6个月（M6）健康相关生活质量（HRQOL）、HRQOL （T0-M6）变化与5年总生存期（OS）之间的关系。此外，我们还探讨了个人、临床、生理、心理、社会、生活方式、hnc相关因素和生物因素是否会调节这种关联。方法采用前瞻性多中心队列研究（NET-QUBIC）。本研究纳入了T0 （n = 596）、M6 （n = 489）、T0和M6 （n = 463）时HRQOL数据的患者。HRQOL采用EORTC QLQ-C30全球生活质量量表（QL）和综合评分（SumSc）进行操作。Cox回归分析调查了HRQOL和OS之间的关联，调整了混杂因素，并探讨了哪些变量调节了这种关联。结果调整后的模型显示，较高的基线QL （HR: 0.85 (95% CI: 0.76-0.96)）和SumSc （HR: 0.90 (95% CI: 0.81-0.99)）与较长的OS相关。调整后的M6车型和调整后的T0-M6车型没有发现这种关联。QL和OS之间的关联受性别（男性显著）和平均动脉血压（BP）（高血压患者显著）的影响。SumSc和OS之间的关联被应对（对无回避应对方式的患者显著）和全身性血压（对血压正常的患者显著）所调节。结论基线时较高的HRQOL（患者如何进入癌症轨迹）与较长的生存期相关，但6个月时HRQOL（患者如何克服癌症治疗）的变化与较长的生存期无关。这一知识对于个性化治疗计划非常重要。

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The association between health-related quality of life and five-year overall survival among head and neck cancer patients: A prospective cohort study

Objective

To estimate associations between health-related quality of life (HRQOL) at baseline (T0), six months after treatment (M6), and change in HRQOL (T0-M6) and five-year overall survival (OS) among head and neck cancer (HNC) patients, after adjusting for potential confounders. Furthermore, we explored whether personal, clinical, physical, psychological, social, lifestyle, HNC-related and biological factors moderate the association.

Methods

Data of a prospective multi-center cohort study (NET-QUBIC) was used. In this specific study, patients with HRQOL data at T0 (n = 596), M6 (n = 489), and T0 and M6 (n = 463) were included. HRQOL was operationalized by the EORTC QLQ-C30 global quality of life subscale (QL) and summary score (SumSc). Cox regression analyses investigated associations between HRQOL and OS, adjusted for confounders, and explored which variables moderate the association.

Results

Adjusted models showed that higher baseline QL (HR: 0.85 (95% CI: 0.76–0.96)) and SumSc (HR: 0.90 (95% CI: 0.81–0.99)) were associated with longer OS. Adjusted M6 models and adjusted T0-M6 models found no such association. The association between QL and OS was moderated by sex (significant among males) and mean arterial blood pressure (BP) (significant for patients with high BP). The association between SumSc and OS was moderated by coping (significant for patients with no avoidant coping style) and systemic BP (significant for patients with normal BP).

Conclusion

Higher HRQOL at baseline (how patients enter the cancer trajectory) was associated with longer OS, but (change in) HRQOL at 6 months (how they overcome cancer treatment) was not. This knowledge is important to personalize treatment plans.

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.