RESUMO
PURPOSE: Lung cancer (LC) has a significant impact on patients' health-related quality of life (HRQoL). We investigate the correlations between pre-radiation therapy HRQoL and survival. MATERIALS AND METHODS: A prospective, intention-to-treat, multicentre study of 437 patients with LC recruited at the radiation oncology departments of three different institutions was conducted between 2012 and 2016. QoL was assessed using the EORTC-QLQ-C30 (v3.0) and EORTC-QLQ-LC13 questionnaires. Global health status (GHS), physical (PF), role functioning (RF), emotional (EF), cognitive (CF), and social functioning (SF) as well as symptoms scores were evaluated in univariate and multivariate analyses. RESULTS: The cohort consisted of 376 men (86%) and 61 women, with a median age of 66 years (range 31-88). Histology was: 72% (n = 315) non-small cell lung cancer and 28% small cell lung cancer. The most common stage was III (80%) and the median follow-up for alive patients was 30 months (range 7-76). Multivariate analysis showed that RF was associated with a lower risk of mortality (HR: 0.693; p = 0.008) and recurrence (HR: 0.737; p = 0.040). Additionally, lower scores on EF and PF were associated with higher mortality (HR: 0.696; p = 0.003 and HR: 0.765; p = 0.044, respectively). Appetite loss, constipation, and dysphagia were associated with a higher risk of mortality (HR: 1.985; p < 0.001, HR: 1.373; p = 0.036, and HR: 1.659; p = 0.002, respectively), while appetite loss was the only symptom associated with a higher risk of recurrence (HR: 1.525; p = 0.014). CONCLUSIONS: Pre-radiation therapy scores on RF, EF, and PF and symptoms like appetite loss, dysphagia, and constipation were associated with the risk of mortality. This information could be added to other prognostic factors to guide our treatment decisions.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/psicologia , Neoplasias Pulmonares/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Feminino , Nível de Saúde , Humanos , Análise de Intenção de Tratamento , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/radioterapia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários , Taxa de SobrevidaRESUMO
The simulation of hydrodynamics and transport phenomena in waste stabilization ponds is a developing tool worth studying in order to understand their internal processes and interactions. Pond design involves several physical, hydrological, geometric and dynamic variables so as to provide high hydrodynamic efficiency and maximum substrate utilization rates. CFD modelling allows the combination of these factors to predict the behaviour of ponds having different configurations. The two-dimensional depth-integrated model MIKE 21 was used in this study to simulate hydrodynamic and advection-dispersion processes in a full-scale anaerobic pond (AP) located in southwest Colombia. A set of 12 configurations including sludge contents, inlet-outlet positioning, baffling and pond geometry were modelled. Results showed that a crosswise (diagonally opposite) inlet-outlet layout, a length-to-breadth ratio of 2:1, plus provision of two cross baffles at 1/3 L and 2/3 L were the most effective measures to improve overall AP hydrodynamics and dispersion patterns.