New study validates clustering of QLQ-30 HRQoL scales, which can help symptom burden management and inform clinical trial design 

While survival remains the primary focus and goal in cancer clinical trials, health-related quality of life (HRQoL) is increasingly considered as an important secondary, if not co-primary, endpoint for assessing clinical benefit of cancer treatment.

With this in mind, the new study by Machingura et al.1 aimed to perform a validation of findings from a prior study, by Martinelli et al. (2011), on the clustering of HRQoL scales of the QLQ-C30 questionnaire. This questionnaire is one of the most widely used tools in assessing patients’ HRQoL in cancer clinical trials.

To perform this validation, Machingura et al. looked at the data from 20,066 cancer patients from published clinical trials and pooled across 17 cancer types. This study confirmed that the QLQ-C30 scales are in fact interrelated and can be grouped into the three main clusters previously identified by Martinelli et al. :

  • physical cluster which includes role-functioning, physical-functioning, social-functioning, fatigue, pain, and global-health status;
  • psychological cluster including emotional-functioning, cognitive-functioning, and insomnia;
  • gastro-intestinal cluster that includes nausea/vomiting and appetite loss.

Importantly also, and as highlighted by the authors, the results were consistent across different levels of disease severity, socio-demographic and clinical characteristics. Minor variations by cancer type were noted.

Abigirl Machingura, from the European Organisation for Research and Treatment of Cancer (EORTC), Belgium, and lead author, explains the importance of knowing how these multidimensional HRQoL scales are related to each other, highlighting that this can in turn “help clinicians and patients with cancer in managing symptom burden, guide policymakers in defining social-support plans and inform selection of HRQoL scales in future clinical trials.”

About the Quality of life Group

The Quality of Life Group (QLG) strives to improve health-related quality of life (HRQoL) of cancer patients, through dedicated research and the use of HRQoL measures within cancer clinical trials and clinical practice. HRQoL constitutes an important aspect of cancer research and care: it gives voice to patients, putting their experience at the forefront. The QLG is part of the European Organisation for Research and Treatment of Cancer (EORTC).


The European Organisation for Research and Treatment of Cancer (EORTC) is a non-governmental, non-profit organisation, which unites clinical cancer research experts, throughout Europe, to define better treatments for cancer patients to prolong survival and improve quality of life. Spanning from translational to large, prospective, multi-centre, phase III clinical trials that evaluate new therapies and treatment strategies as well as patient quality of life, its activities are coordinated from EORTC Headquarters, a unique international clinical research infrastructure, based in Brussels, Belgium.
For further information, please visit the EORTC website:

1 Abigirl Machingura, Mekdes Taye, Jammbe Musoro, Jolie Ringash, Madeline Pe, Corneel Coens, Francesca Martinelli, Dongsheng Tu, Ethan Basch, Yvonne Brandberg, Mogens Grønvold, Alexander Eggermont, Fatima Cardoso, Jan Van Meerbeeck, Winette T.A. van der Graaf, Martin Taphoorn, Jaap C. Reijneveld, Riccardo Soffietti, Jeff Sloan, Galina Velikova, Henning Flechtner, Andrew Bottomley. Clustering of EORTC QLQ-C30 health-related quality of life scales across several cancer types: Validation study. European Journal of Cancer, Volume 170, 2022, Pages 1-9. ISSN 0959-8049.

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