Quality of life of patients with lung cancer: A scoping review

Abstract Objective: To characterize scientific publications on the quality of life of people with lung cancer in order to explore current knowledge of the subject, with emphasis on assessment instruments and methodological aspects. Method: A scoping type literature review was performed. Articles were sought in the databases of the Virtual Health Library, in an integrative manner, with the descriptors: Quality of life and Lung Neoplasms, with no date of publication or language restrictions (n=138). The selection of articles was based on inclusion and exclusion criteria defined in the study proposal. Results: We included 18 publications published between 2006 and 2017, the majority (n = 10) of which had a cross-sectional design. Eight different instruments were used to evaluate the quality of life of patients with lung cancer, four of which were specific for people with cancer. There was a prevalence of the use of the European Organization for Research and Treatment of Cancer Care Quality of Life Questionnaire - EORTC QLQ-C30 (n=8). Prospective studies (n=8) assessed quality of life before and after chemotherapy, physical therapy or pulmonary resection. The studies adopted different methodologies and provided conflicting results of quality of life. Cross-sectional studies with comparatively healthy subjects found an inferior quality of life for people with lung cancer. Conclusion: The scoping review contributed to the identification of the multiple evaluated instruments, both generic and specific. It found a lack of homogeneity in the methodological approaches of the studies. Further prospective studies with a specific instrument and methodological standardization to evaluate the quality of life of people with lung cancer are recommended.

摘要 目的：系统梳理针对肺癌患者生活质量（Quality of life）的科研文献，以探究该领域当前的研究认知，重点聚焦于评估工具与方法学层面。方法：本研究采用范围综述（scoping review）方法，以整合检索策略在虚拟卫生图书馆（Virtual Health Library）数据库中检索文献，检索词为：生活质量（Quality of life）与肺肿瘤（Lung Neoplasms），未设置发表年限与语言限制，共检索得到138篇文献。文献筛选基于研究方案中预先设定的纳入与排除标准完成。结果：最终纳入2006年至2017年间发表的18篇文献，其中多数（n=10）采用横断面研究设计（cross-sectional design）。研究共使用8种不同工具评估肺癌患者的生活质量，其中4种为癌症患者专用评估工具。使用频次最高的为欧洲癌症研究与治疗组织生活质量核心问卷（European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - EORTC QLQ-C30），共8项研究采用该工具。另有8项前瞻性研究（prospective studies）评估了化疗、物理治疗或肺切除术前后的患者生活质量。各研究采用的方法学存在差异，所得生活质量相关结果亦存在分歧。针对相对健康对照人群的横断面研究显示，肺癌患者的生活质量更差。结论：本次范围综述明确了该领域已使用的各类生活质量评估工具，涵盖通用型与癌症专用型两类。研究发现现有文献在方法学层面缺乏同质性。建议未来开展采用专用评估工具且方法学标准化的前瞻性研究，以进一步评估肺癌患者的生活质量。