caa a22 4500 606179631 CHVBK 20210128100802.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s11136-014-0821-6 doi (NATIONALLICENCE)springer-10.1007/s11136-014-0821-6 Joint modeling of longitudinal health-related quality of life data and survival [Elektronische Daten] [Divine Ediebah, Francisca Galindo-Garre, Bernard Uitdehaag, Jolie Ringash, Jaap Reijneveld, Linda Dirven, Efstathios Zikos, Corneel Coens, Martin van den Bent, Andrew Bottomley, Martin Taphoorn] Purpose: In cancer research, outcome measures may co-vary. Treatment and treatment related impairment of health-related quality of life (HRQoL) may affect survival. When these effects are analyzed separately, bias may arise. Therefore, we investigated the combined effect of treatment and longitudinally measured HRQoL on survival. Methods: Patients with anaplastic oligodendrogliomas (n=288) who were randomized (EORTC 26951) to radiotherapy (RT) alone or RT plus procarbazine, lomustine, and vincristine (PCV) chemotherapy were analyzed. HRQoL [appetite loss (AP)] was assessed with the EORTC QLQ-C30. We compared survival results from different analysis strategies: Cox model with treatment only [model 1 (M1)] or with treatment and time-dependent AP score [model 2 (M2)] and the joint model combining longitudinal AP score and survival [model 3 (M3)]. Results: The estimated hazard ratio (HR) for RT plus PCV was 0.76 (95% CI 0.58-1.00) for M1, 0.72 (0.55-0.96) for M2, and 0.69 (0.52-0.92) for M3. This corresponds to a lower risk of death of 24% in M1, 28% in M2, and 31% in M3, for patients treated with RT plus PCV chemotherapy. AP resulted in an increased risk of death, with estimated HR of 1.06 (1.01-1.12) for M2 and 1.13 (1.03-1.23) for M3: Every 10-point increase of AP resulted in a 13% increased risk of death in M3 as compared to 6% in M2. Conclusion: Part of the survival benefit of treatment with RT plus PCV chemotherapy can be masked by the negative effect that this treatment has on patients' HRQoL. In our study, up to 7% of the theoretical treatment efficacy was lost when AP was not adjusted through joint modeling. Springer International Publishing Switzerland, 2014 Glioma nationallicence Health-related quality of life nationallicence Joint model nationallicence Association nationallicence Time-dependent covariate nationallicence Dynamic predictions nationallicence Ediebah Divine Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium aut Galindo-Garre Francisca Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands aut Uitdehaag Bernard Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands aut Ringash Jolie Department of Radiation Oncologist, The Princess Margaret Hospital and the University of Toronto, Toronto, Canada aut Reijneveld Jaap Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands aut Dirven Linda Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands aut Zikos Efstathios Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium aut Coens Corneel Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium aut van den Bent Martin Department of Neuro-Oncology, Brain Tumor Center Erasmus MC-Cancer Center, Rotterdam, The Netherlands aut Bottomley Andrew Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium aut Taphoorn Martin Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands aut Quality of Life Research Springer International Publishing 24/4(2015-04-01), 795-804 0962-9343 24:4<795 2015 24 11136 https://doi.org/10.1007/s11136-014-0821-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s11136-014-0821-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ediebah Divine Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium aut NATIONALLICENCE 700 1- Galindo-Garre Francisca Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Uitdehaag Bernard Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Ringash Jolie Department of Radiation Oncologist, The Princess Margaret Hospital and the University of Toronto, Toronto, Canada aut NATIONALLICENCE 700 1- Reijneveld Jaap Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Dirven Linda Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Zikos Efstathios Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium aut NATIONALLICENCE 700 1- Coens Corneel Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium aut NATIONALLICENCE 700 1- van den Bent Martin Department of Neuro-Oncology, Brain Tumor Center Erasmus MC-Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Bottomley Andrew Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium aut NATIONALLICENCE 700 1- Taphoorn Martin Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands aut NATIONALLICENCE 773 0- Quality of Life Research Springer International Publishing 24/4(2015-04-01), 795-804 0962-9343 24:4<795 2015 24 11136