Quality of life assessment and research in the EORTC
(European Organisation for Research and Treatment
of Cancer)
H. Flechtner
1
, A. Bottomley
2
On behalf of the EORTC Quality of Life Group and Quality of Life Unit
1
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
2
Quality of Life Unit, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
Correspondance: H. Flechtner, Klinik fu ¨ r Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Universita ¨ t zu
Ko ¨ ln, Robert-Koch-Str.10, 50931 Ko ¨ ln, Germany, e-mail: hans-henning.flechtner@uk-koeln.de
Abstract: Quality of Life (QOL)
assessment and research within the
European Organisation for Research
and Treatment of Cancer (EORTC)
has become increasingly important
over the past 25 years, starting
already in 1979 with the founding of
the EORTC Quality of Life Group
(EORTC QLG), and QOL has become
part of many cancer clinical trial
protocols in different ways. This
paper briefly presents an overview
of QOL within the EORTC, the deve-
lopment of the QLQ-C30 instrument,
the construction of specific modules,
issues of cross-cultural validation
and translation, and the various
other activities of the QLG and the
Data Centre Quality of Life Unit
(QLU). The article also includes key
findings from selected QOL studies
published by the EORTC, highlight-
ing this large international clinical
trial organisation’s contribution to
this field of oncology.
Keywords: Cancer – Quality of life –
Clinical trials – EORTC – QLQ-C30
The EORTC quality of life
group
The formation of the Quality of Life
Group (QLG) dates back to 1979,
when a group of dedicated physi-
cians and researchers met during a
NCI-EORTC cancer drug symposium
in Brussels to discuss the topic of
« Quality of Life » in cancer medi-
cine. An European Organisation for
Research and Treatment of Cancer
(EORTC) Quality of Life Study Group
was founded and held its first mee-
tings in Marseille and Amsterdam.
The proceedings of these early
workshops already included a num-
ber of topics that set the scene for
developments that would come in
forthcoming years, such as theoreti-
cal considerations of quality of life,
measurement of quality of life in
cancer patients, and management
of psychological stress in cancer
patients. Subsequent meetings
consolidated the group’s assess-
ment strategies and the develop-
ment of the new instrument, later
known as EORTC QLQ-C30, in var-
ious European and non-European
languages. In 1988, a report on the
first EORTC quality of life field study
#15861, studying the properties of
the newly developed instrument in
lung cancer patients, already inclu-
ded 373 patients from 21 institutions
in 15 countries. In 1987, the EORTC
Monograph on Quality of Life was
published [1], and in the following
years formal subcommittees for
module development and liaison
work were created. The first EORTC
Guidelines for module development
were published, followed by transla-
tion guidelines [4, 10]. Project groups
for QOL in various areas started
working and finally in 1993 the
results of the big international field
studies with the EORTC QLQ-C30
were published, making the instru-
ment and its psychometric proper-
ties available to the scientific
community [2]. In 1994, the Quality
of Life Unit (QLU) at the EORTC Data
Centre in Brussels began work and
the first manual in the series of « blue
books », the QLQ-C30 scoring
manual, was published, followed by
an atlas of norms in 1996 [16]. The
construction of the item bank follo-
wed, along with the professional
treatment of the growing number of
QLQ-C30 translations and the multi-
plying number of modules [8]. The
series of « blue books » now
comprise: Scoring Manual QLQ-
C30, Reference Values Manual,
Translation Guidelines, Module
Development Guidelines, Guideli-
nes for Assessing QOL in EORTC
Clinical Trials, Item Bank Guidelines.
QOL core instrumenT QLQ-C30
By 1993 the EORTC QLG had
completed the development and
validation of the QLQ-C30 core
instrument. It was designed to be
cancer-specific, multidimensional,
self-administered, for use in cross-
cultural settings and in conjunction
with additional tumour- or treat-
ment-specific modules. The 30
items on a four- or seven-category
answer format cover five functional
scales (physical, role, cognitive,
emotional, and social), three symp-
tom scales (fatigue, pain, and nau-
sea and vomiting), and a global
QOL scale. A number of single
items address dyspnoea, loss of
appetite, insomnia, constipation,
diarrhoea, and financial impact of
the disease. Instrument develop-
ment continues and currently a
Qualite ´ de vie
Oncologie (2006) 8: 443–446
© Springer 2006
DOI 10.1007/s10269-006-0412-4
ORIGINAL
443