Relationship Between Advanced Gastric Cancer Patients’ Prognosis And Changes Of Quality Of Life Scores During First-line Chemotherapy

Objective：To explore the relationship between advanced gastric cancer patients’prognosis and changes of quality of life scores during first-line chemotherapy.Methods：During September2010to June2012, new patients with advancedgastric cancer in the first affiliated hospital of Nanchang university were enrolled inthis study,170cases were finally analysed. All patients were treated with5-fluorouracil based doublets regimens and completed European Organization forResearch and Treatment of Cancer core questionnaire (EORTC QLQ-C30) atbaseline and after2cycles of chemotherapy. Meanwhile, age、sex、performancestatus、histological type、hemoglobin、neutrophil to lymphocyte count ratio (NLR)、albumin、lactate dehydrogenase、liver metastasis、ascites、bone metastasis、the numberof metastatic sites、response to chemotherapy were collected. The differences scoresof QOL before and after treatment were performed by T-test.Cox’s proportionalhazards models were performed to find which factor influenced patients’ survival inunivariate analyses, and multivariable analyses were then performed to controlconfounding effects of factors significantly influenced OS at a level of P values＜0.05in the univariate analysis.Results: There existed differences in patients’ QOL in some domains duringchemotherapy, including global scale(P<0.001)、physical function(P<0.001)、rolefunction(P=0.011)、 social functio(P<0.001)、 pain(P<0.001)、 nausea andvomiting(P<0.001)、 appetit(P<0.001)、 constipation(P<0.001) and financeproblem(P<0.001)；univariate factors associated with patients’ survival includedchanges of scores in global scale(P=0.002)、 social function(P<0.001)、 painscale(P<0.001),and bone metastasis(P<0.001)、 PS(P<0.001)、 response tochemotherapy(P<0.001)、ascites(P<0.001)、the number of metastatic sites(P<0.001)、hemoglobin(P<0.001)、 liver metastasis(P<0.001)、 NLR(P=0.010)、 histologicaltype(P=0.020)；Further multivariable analyses suggested that only changes in globalscale(P=0.049) and pain scale(P=0.016)、response to chemotherapy(P<0.001)、 PS(P<0.001) and the number of metastatic sites(P=0.004) were related to patients’survival.Conclusion：Our exploratory study indicates that changes of scores duringfirst-line chemotherapy in global scale and pain scale are independent prognosticfactors in predicting survival in advanced gastric cancer， other independentprognostic factors included response to chemotherapy、PS and the number ofmetastatic sites.