Impact of adjuvant therapy on quality of life in women with node-positive operable breast cancer. International Breast Cancer Study Group

Autor:	C, Hürny, J, Bernhard, A S, Coates, M, Castiglione-Gertsch, H F, Peterson, R D, Gelber, J F, Forbes, C M, Rudenstam, E, Simoncini, D, Crivellari, A, Goldhirsch, H J, Senn
Rok vydání:	1996
Předmět:	Tamoxifen Antineoplastic Agents Hormonal Chemotherapy Adjuvant Lymphatic Metastasis Surveys and Questionnaires Antineoplastic Combined Chemotherapy Protocols Quality of Life Humans Breast Neoplasms Female Menopause Attitude to Health
Zdroj:	Lancet (London, England). 347(9011)
ISSN:	0140-6736
Popis:	Adjuvant therapy for early breast cancer is effective but may be toxic. Our aim was to investigate the impact of the presence, timing, and duration of adjuvant chemotherapy on patients' perceptions of their quality of life (QL).International Breast Cancer Study Group trial VI assessed adjuvant chemotherapy in 1475 premenopausal and perimenopausal patients, and trial VII assessed adjuvant tamoxifen or chemoendocrine therapy in 1212 postmenopausal patients with node-positive breast cancer. Patients were asked to complete a QL questionnaire-single-item linear analogue self-assessment scales measured physical wellbeing, mood, appetite, and perceived adjustment/coping. QL was assessed in this way at the beginning of treatment, 2 months after the start of treatment, every 3 months, and at 1 and 6 months after recurrence.Baseline QL scores decreased as the number of involved axillary nodes increased (for example, mean mood score: 66.1 for women with one positive node, 66.4 for two to four positive nodes, 61.3 for five to nine positive nodes, and 59.1 for ten or more positive nodes; p = 0.008 for trends), and were lower in patients with oestrogen-receptor-negative than in patients with oestrogen-receptor-positive tumours (61.4 vs 66.3, p = 0.0009). All treatment groups showed substantial improvement in QL scores during adjuvant therapy. Patterns of QL scores reflected presence, duration, and timing of cytotoxic treatment. Longer initial cytotoxic therapy delayed improvement in QL scores. Later cytotoxic therapy had transient adverse effects. Anticipation of future therapy also affected QL scores.Overall, chemotherapy had a measurable adverse effect on QL, but this effect was transient and minor compared with patients' adaptation/coping after diagnosis and surgery. This finding should encourage patients and doctors to choose appropriate adjuvant therapy with less concern for initial toxicity.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=pmid________::8ba1c5534d6931e1ff50eef8bbd580a9 https://pubmed.ncbi.nlm.nih.gov/8622502 Zobrazit plný text záznamu Plný text ve formátu HTML
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