Association of Disease Progression With Health-Related Quality of Life Among Adults With Breast, Lung, Pancreatic, and Colorectal Cancer

摘要: Importance Mortality, morbidity, and health-related quality of life (HRQoL) are patient-relevant end points generally considered in the early benefit assessments new cancer treatments. Progression-related points, such as time to progression or progression-free survival, not included, although patients physicians testify detrimental association disease with HRQoL. Objective To examine HRQoL 4 prevalent solid-cancer entities routine clinical practice. Design, Setting, Participants This cohort study evaluated data from prospective, nonintervention, multicenter registries collected between 2011 2018 203 centers Germany. Patients’ was assessed regularly for up 5 years. The change scores after examined linear mixed models, adjusting demographic covariates. Patients metastatic breast, pancreatic, lung, colorectal were recruited at start systemic first-line treatment. Data analysis performed February 2019 April 2019. Exposures All received systemic, palliative treatment according their physician’s choice. Main Outcomes Measures primary outcome deterioration associated progression, measured by validated questionnaires: Functional Assessment Cancer Therapy–General version 4, European Organization Research Treatment QLQ-C30 3.0, QLQ-C15-PAL 1, Hospital Anxiety Depression Scale. Results More than 8000 questionnaires 2314 2562 documented progressions analyzed. In total, 464 had breast (464 [100.0%] female; median [range] age, 61.6 [26.4-90.1] years), 807 pancreatic (352 [43.6%] 70.0 [39.0-93.0] 341 lung (118 [34.6%] 65.9 [28.4-88.2] 702 (248 [35.3%] 66.9 [26.9-92.1] years). first a statistically significant worsening 37 45 scales; 17 these scales, clinically meaningful. Scale appetite loss (pancreatic cancer, 10.2 [95% CI, 6.8-13.5 points]; 10.8 5.4-16.2 8.8 5.5-12.2]; allP  Conclusions Relevance These findings suggest that is among cancer. evidence highlights importance progression-related additional when evaluating treatments