Analysis of related factors affecting quality of life in patients with advanced lung cancer chemotherapy and construction of prediction model

Feng Yexia; He Liang; Zhang Jia; Gao Shijuan; Cui Yuhua; Xia Yanyan; Zhao Hongyan; Tang Ziru

doi:10.11986/j.issn.1673-873X.2024.12.14

Abstract：Objective To analyze the related factors affecting the quality of life in patients with advanced lung cancer undergo-ing chemotherapy,and to construct a prediction model.Methods The clinical data of 142 patients with advanced lung canc-er chemotherapy were collected from May 2021 to December 2023.According to the Functional Assessment of Cancer Ther-apy-General(FACT-G)score,they were divided into good quality of life group(FACT-G≥average score)and poor group(FACT-G<average score).The differences in demographic data,chemotherapy regimen,physical status,kinesiophobia and other general data were compared between groups.The risk factors affecting the poor quality of life in patients with ad-vanced lung cancer chemotherapy were analyzed.The prediction model of poor quality of life was constructed by using the nomogram.Results The difference in medical payment method between the two groups was statistically significant(P<0.05).The rate of poor physical status(60.61%vs 34.21%),proportion of kinesiophobia(45.45%vs 18.42%),propor-tion of cancer-related fatigue(50.00%vs 23.68%),proportion of sleep disorders(42.42%vs 17.11%)and proportion of depression(48.48%vs 14.47%)in poor group were higher than those in good group(P<0.05).Multivariate Logistic re-gression analysis showed that medical payment method and depression were independent influencing factors of poor quality of life in patients with advanced lung cancer chemotherapy(OR=0.294,6.134,P<0.05).Medical payment method of self-paying was used as a reference category to set a dummy variable,and it was found that both new rural cooperative medical system and commercial insurance reduced the risk of poor quality of life(OR=0.085,0.046,P<0.05).The above two in-dependent influencing factors were used to construct a risk nomogram warning model for poor quality of life in patients with advanced lung cancer chemotherapy.The internal validation of Bootstrap repeated sampling revealed that the calibration curve approached the ideal curve,and receiver operating characteristic(ROC)curve indicated that the area under the curve(AUC)was 0.701(95%:0.613-0.790,P<0.05).Conclusion The risk of poor quality of life in patients with advanced lung cancer chemotherapy with medical payment method of self-paying and depression is higher.The prediction model based on the two can assist clinical screening of high-risk group and is conducive to disease management.