Quality-adjusted survival: a rigorous assessment of cure after cancer during childhood and adolescence.
Survivors of cancer in childhood and adolescence, while increasing gratifyingly in number with ever more effective therapy, have a life expectancy that is compromised all-too-often in both duration and value as a result of adverse treatment-related sequelae. Accounting for this burden of morbidity and mortality is essential for a proper appreciation of cure. Adjusting estimates of survival by measures of its quality affords a means of accomodating this requirement. It can be accomplished by "weighting" the length of survival according to preference-based assessments of health-related quality of life (HRQL), which allow the calculation of quality-adjusted life years. Inclusion of measures of HRQL in clinical trials is imperative as we reach to the ultimate objective; the truly cured child restored to normal health.
Barr
Ronald D
RD
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. rbarr@mcmaster.ca
Sala
Alessandra
A
D000293:Adolescent; D002648:Child; D006801:Humans; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy; D011788:Quality of Life