Does change in health-related quality of life score predict survival? Analysis of EORTC 08975 lung cancer trial
Menée à partir de données portant sur 391 patients atteints d'un cancer du poumon non à petites cellules et inclus dans un essai évaluant des chimiothérapies à base de cisplatine, cette étude évalue l'intérêt de mesurer, durant le traitement et à l'aide de deux systèmes de score, l'évolution de la qualité de vie des patients pour prédire leur survie
Background : Little is known about whether changes in health-related quality of life (HRQoL) scores from baseline during treatment also predict survival, which we aim to investigate in this study.
Methods : We analysed data from 391 advanced non-small-cell lung cancer (NSCLC) patients enrolled in the EORTC 08975 study, which compared palliative chemotherapy regimens. HRQoL was assessed at baseline and after each chemotherapy cycle using the EORTC QLQ-C30 and QLQ-LC13. The prognostic significance of HRQoL scores at baseline and their changes over time was assessed with Cox regression, after adjusting for clinical and socio-demographic variables.
Results : After controlling for covariates, every 10-point increase in baseline pain and dysphagia was associated with 11% and 12% increased risk of death with hazard ratios (HRs) of 1.11 and 1.12, respectively. Every 10-point improvement of physical function at baseline (HR=0.93) was associated with 7% lower risk of death. Every 10-point increase in pain (HR=1.08) was associated with 8% increased risk of death at cycle 1. Every 10-point increase in social function (HR=0.91) at cycle 2 was associated with 9% lower risk of death.
Conclusions : Our findings suggest that changes in HRQoL scores from baseline during treatment, as measured on subscales of the EORTC QLQ-C30 and QLQ-LC13, are significant prognostic factors for survival.
British Journal of Cancer , résumé, 2013