Patient-reported outcomes in older breast cancer survivors with and without prior chemotherapy treatment.

Autor: Adesoye T; Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Liao KP; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Peterson S; Department of Behavioral Science, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Li L; Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Zorzi D; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Holmes HM; Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Texas Houston McGovern Medical School, Houston, Texas, USA., Chavez-MacGregor M; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.; Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Giordano SH; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.; Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2023 Sep; Vol. 12 (17), pp. 17740-17752. Date of Electronic Publication: 2023 Aug 08.
DOI: 10.1002/cam4.6394
Abstrakt: Background: Little is known about long-term treatment-related symptoms in older breast cancer survivors. We characterized long-term patient-reported symptoms and examined factors associated with the presence and severity of symptoms, and symptom interference with daily activities.
Methods: Texas Cancer Registry (TCR) Medicare linkage data was used to identify breast cancer patients age 65 and older with local/regional stage disease diagnosed between 2012-2013. Symptom burden was assessed using breast-specific items from the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE™). Demographic and clinical data also were collected. Logistic regression models were used to assess the association between symptom burden and respondent sociodemographic and clinical characteristics.
Results: Of 4448 eligible patients, 1594 (response-rate 35.8%) completed questionnaires. Of these, 1245 eligible respondents were included in the analysis based on self-reported data. Median time from diagnosis to survey completion was 68 months (IQR: 62-73). Most frequently reported symptoms were fatigue/lack of energy (76.8%), aching muscles (72.1%) and aching joints (72.5%). Receipt of chemotherapy was associated with higher symptom burden. Patients treated with adjuvant chemotherapy had higher risk of numbness/tingling (OR: 3.16; 95% CI: 2.36-4.24), hair loss (OR: 2.72; 95% CI: 2.05-3.60), and fatigue/lack of energy (OR: 1.80; 95% CI: 1.29-2.52). Similarly, patients who received chemotherapy were more likely to report the majority of symptoms as moderate to severe and as interfering with daily activities.
Conclusion: Receipt of chemotherapy is associated with significant symptom burden more than 5 years after breast cancer treatment. Long-term chemotherapy impact should be discussed with patients in a shared-decision making process and approaches to symptom management during survivorship care are needed.
(© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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