Quality of life during chemotherapy, hormonotherapy or antiHER2 therapy of patients with advanced, metastatic breast cancer in clinical practice

Krzysztof Adamowicz1,2, Zuzanna Baczkowska-Waliszewska3
1Pomeranian Oncology Center, Gdynia, Poland
2Department of Oncology, Pomeranian Hospitals in Wejherowo, Gdynia, Poland
37th Naval Hospital, Gdansk, Poland

Tóm tắt

Abstract Introduction Breast cancer is one of the most important health problems in the world. In recent years, this cancer has achieved a reduction in mortality, which is attributed to the introduction of mass screening and greater efficacy of post-operative treatment. Many patients with breast cancer have indications only for palliative therapy, but the impact of these methods on the quality of life of patients remains a subject of controversy. It remains unknown whether the progress in improving the quality of life in clinical trials also applies to patients treated as part of daily clinical practice. Data on the results of the impact of conducted therapies on the quality of life outside of clinical trials are scarce. Methods The results of palliative chemotherapy and first-line hormonotherapy in 351 patients with advanced, metastatic breast cancer treated in the period from January 2010 to December 2016 in two centres were analysed. Results The average age of patients was 62 ± 9.8 years; 139 patients received chemotherapy, 91 - therapy containing trastuzumab, and 121 - hormone therapy. A partial response was obtained in 111 patients (32%), stabilization in 150 (43%), and in 90 patients (26%) progression. Median survival time in the whole group of patients was 36 months. Chemotherapy compared to trastuzumab and hormonotherapy was associated with greater total toxicity (p = 0.03). There was a significant relationship between the type of therapy (hormonotherapy, chemotherapy, targeted therapy) and the general average quality of women’s life measured with the EORC-QLQ-C30 questionnaire. In addition, a statistically significant difference was found in some somatic complaints (the scale of QLQ-BR23 symptoms) depending on the type of therapy performed. The lowest intensity of complaints was reported by patients during hormonotherapy, then during targeted therapy, and the largest during chemotherapy. Conclusions There is no effect of chemotherapy on the overall quality of life. Hormone therapy and trastuzumab therapy improved the quality of life of the treated patients in clinical practice.

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Tài liệu tham khảo

Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide: IARC CancerBase no. 11 [internet]. Lyon: International Agency for Research on Cancer; 2013. http://globocan.iarc.fr.

Wojciechowska U, Didkowska J, Zatonski W. Malignant neoplasms in Poland. Warszawa: Centrum Onkologii Instytut; 2012.

Greimel E, Thiel I, Peintinger F, Cegnar I, Pongratz E. Prospective assessment of quality of life of female cancer patients. Gynecol Oncol. 2002;85:140–7.

Arndt V, Merx H, Stürmer T, Stegmaier C, Ziegler H, Brenner H. Age-specific detriments to quality of life among breast cancer patients one year after diagnosis. Eur J Cancer. 2004;40:673–80.

Ballinger RS, Fallowfield LJ. Quality of life and patient-reported outcomes in the older breast cancer patient. Clin Oncol. 2009;21:140–55.

Pandey M, Singh SP, Behere PB, Roy SK, Singh S, Shukla VK. Quality of life in patients with early and advanced carcinoma of the breast. Eur J Surg Oncol. 2000;26:20–4.

Mols F, Vingerhoets JJM, Coebergh JW, van de Poll-Franse LV. Quality of life among long-term breast cancer survivors: a systematic review. Eur J Cancer. 2005;41:2613–9.

Pikler V, Winterowd C. Racial and body image differences in coping for women diagnosed with breast cancer. Health Psychol. 2003;22:632–7.

Kenny P, King LM, Shiell A, Seymur J, et al. Early stage breast cancer: costs and quality of life one year after treatment by mastectomy or conservative surgery and radiation therapy. Breast. 2000;9:37–44.

Munshi A, Dutta D, Kakkar S, Budrukkar A, et al. Quality of life after radiotherapy. Comparison of early quality of life in patients treated with radiotherapy following mastectomy or breast conserving therapy: a prospective study. Radiother Oncol. 2010;97:288–93.

Shimozuma K, Ganz PA, Petersen L, Hirji K. Quality of life in the first year after breast cancer surgery: rehabilitation needs and patterns of recovery. Breast Cancer Res Treat. 1999;56:45–57.

Montazeri A. Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Cancer Res. 2008;27:1–32.

Zawisza K, Tobiasz-Adamczyk B, Nowak W, Kulig J, Jędrys J. Relevance and reliability of the EORTC QLQ C30 quality-of-life questionnaire and its module on patients with breast cancer (EORTC QLQ BR23). Ginekol Pol. 2010;81:262–7.

Gokgoz S, Sadikoglu G, Paksoy E, Guneytepe U, et al. Health related quality of life among breast cancer patients: a study from Turkey. Global J Health Sci. 2011;3:40–152.

Kulesza-Brończyk B, Terlikowski R, Dobrzycka B, Filipowska J, et al. The quality of life of women after surgical treatment of breast cancer. Zdr Publ. 2009;119:293–7.

Arora NK, Gustafson DH, Hawkins RP, McTavish F, et al. Impact of surgery and chemotherapy on the quality of life of younger women with breast carcinoma; a prospective study. Cancer. 2001;92:1288–98.

Arndt V, Merx H, Stürmer T, Stegmaier C, Ziegler H, Brenner H. Age specific determinants to quality of life among breast cancer patients one year after diagnosis. Eur J Cancer. 2004;40:673–80.

Watters JM, Yau JC, O’Rourke K, Tomiak E, Gertler SZ. Functional status is well maintained in older women during adjuvant chemotherapy for breast cancer. Ann Oncol. 2003;14:1744–50.