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Suzuki K, Morishita S, Nakano J, Okayama T, Inoue J, Tanaka T, Fukushima T. Association between quality of life and mortality risk in patients with breast cancer: a systematic review and meta-analysis. Breast Cancer 2024; 31:552-561. [PMID: 38592636 DOI: 10.1007/s12282-024-01581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/26/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Patients with breast cancer present with various problems that have an adverse effect on the quality of life (QOL). However, the association between the QOL and mortality among patients with breast cancer remains controversial. Therefore, this systematic review and meta-analysis aimed to determine whether QOL impacts prognosis in patients with breast cancer. METHODS The databases of CINAHL, Scopus, and PubMed databases were searched to retrieve observational studies that assessed the QOL and mortality risk in patients with breast cancer published before December 2022. RESULTS Among the 119,061 articles retrieved, six observational studies were included in the meta-analysis. Physical QOL (hazard ratio [HR]: 1.04, 95% confidence interval [CI]: 1.01-1.07, p = 0.003), emotional QOL (HR: 1.01, 95% CI: 1.00-1.03, p = 0.05), and role QOL (HR: 1.01, 95% CI: 1.00-1.01, p = 0.007) showed significant associations with mortality risk. In contrast, global QOL, cognitive QOL, and social QOL showed no associations with mortality risk. Subgroup analysis performed according to treatment time points revealed that the post-treatment physical QOL was associated with mortality risk. CONCLUSIONS Physical QOL, emotional QOL, and role QOL are associated with mortality risk in patients with breast cancer. Furthermore, post-treatment physical QOL showed a more significant association with prolonged survival than pre-treatment physical QOL.
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Affiliation(s)
- Katsuyoshi Suzuki
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Taro Okayama
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center, Kobe, Japan
| | - Takashi Tanaka
- Department of Rehabilitation, Hyogo Medical University Hospital, Nishinomiya, Japan
| | - Takuya Fukushima
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.
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Badaoui S, Kichenadasse G, Rowland A, Sorich MJ, Hopkins AM. Patient-Reported Outcomes Predict Progression-Free Survival of Patients with Advanced Breast Cancer Treated with Abemaciclib. Oncologist 2021; 26:562-568. [PMID: 33914991 DOI: 10.1002/onco.13806] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 04/20/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Abemaciclib is a CDK4/6 inhibitor used to treat hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer. The prognostic value of patient-reported outcomes (PROs) has been minimally explored for treatment outcomes with CDK4/6 inhibitors. The performance of PROs compared with Eastern Cooperative Oncology Group performance status (ECOG-PS) is unknown. MATERIALS AND METHODS This study pooled data from single-arm trial, MONARCH 1, and randomized trials, MONARCH 2 and 3. In total, 900 patients initiated abemaciclib and 384 comparator therapy. Pretreatment PRO association with progression-free survival (PFS) was modeled using Cox proportional hazards regression. Prediction performance was assessed via the C-statistic (c). PROs were recorded via the European Organisation for Research and Treatment of Cancer QLQ-C30. RESULTS Patient-reported physical function, pain, role function, fatigue, and appetite loss were associated with PFS on univariable and adjusted analysis (p < .05). Physical function (c = 0.55) was most predictive, superior to ECOG-PS (c = 0.54), with multivariable analysis indicating both provide independent information (p < .02). In the pooled randomized arms of MONARCH 2 and 3, the PFS treatment benefit (hazard ratio [95% confidence interval]) of abemaciclib (vs. comparators) was 0.75 (0.57-1.0) for low physical function, compared with 0.48 (0.40-0.59) for intermediate/high (p[interaction] = .01). CONCLUSION PROs were identified as prognostic factors for PFS in patients initiating abemaciclib, with patient-reported physical function containing independent predictive information beyond ECOG-PS. Low physical function was associated with a decrease in the magnitude of PFS benefit from abemaciclib. PROs should be explored as prognostic, predictive, and stratification factors for clinical use and research trials of CDK4/6 inhibitors. IMPLICATIONS FOR PRACTICE For the first time, pretreatment patient-reported outcomes have been shown to be independent prognostic markers for progression-free survival (PFS) in patients diagnosed with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2-) advanced breast cancer treated with abemaciclib. Importantly, patients with low physical function had a smaller PFS benefit from abemaciclib (vs. comparator) than patients with intermediate/high physical function. The present study demonstrates patient-reported outcomes as a simple, effective, inexpensive, and independent prognostic marker for patients with HR+/HER2- advanced breast cancer treated with abemaciclib.
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Affiliation(s)
- Sarah Badaoui
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Ganessan Kichenadasse
- College of Medicine and Public Health, Flinders University, Adelaide, Australia.,Department of Medical Oncology, Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Adelaide, Australia
| | - Andrew Rowland
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Michael J Sorich
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Ashley M Hopkins
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
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Si Y, Yuan P, Hu N, Wang X, Ju J, Wang J, Ma F, Luo Y, Zhang P, Li Q, Xu B. Primary Tumor Surgery for Patients with De Novo Stage IV Breast Cancer can Decrease Local Symptoms and Improve Quality of Life. Ann Surg Oncol 2020; 27:1025-1033. [PMID: 31970572 PMCID: PMC7060161 DOI: 10.1245/s10434-019-08092-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND It was unknown whether surgery for primary tumor would affect the occurrence of local symptoms caused by tumor progression in patients with de novo stage IV breast cancer (BC). Our work attempted to probe the effect of local resection on controlling local symptoms and improving the quality of life in de novo stage IV BC patients. METHODS Our study included patients presenting with de novo stage IV BC at the Cancer Hospital of the Chinese Academy of Medical Sciences from January 2008 to December 2014. In this study, we defined a new term called "local progress/recurrence of symptoms" (LPRS) to refer to the local problems caused by tumor progression/recurrence. All the patients were grouped into surgery and non-surgery groups. The characteristics of the two groups were analyzed by Chi square and Fisher's test. Univariate and multivariate Cox regression models were designed to evaluate independent prognostic factors. RESULTS This study contained 177 patients. The follow-up deadline was April 1, 2019. The median follow-up time was 33 months (range 1-135 months). In included patients, 77 (43.5%) underwent surgery for primary tumors. Primary tumor surgery could reduce the occurrence of LPRS (relative risk/risk ratio (RR = 0.440; 95% CI 0.227-0.852; p = 0.015)) and patients without LPRS had longer OS (45 months vs 29 months, p < 0.001). In addition, patients who had only one symptom had better OS than those who had two or three symptoms (p = 0.0175). CONCLUSIONS The quality of life in patients with de novo stage IV breast cancer can be improved by reducing the incidence of local symptoms through primary tumor surgery.
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Affiliation(s)
- Yiran Si
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Peng Yuan
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Nanlin Hu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xue Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jie Ju
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jiayu Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Fei Ma
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yang Luo
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Pin Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Qing Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Binghe Xu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
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Predictive Impact of Clinical Benefit in Chemotherapy-treated Advanced Pancreatic Cancer Patients in Northern Alberta. Am J Clin Oncol 2019; 41:867-873. [PMID: 28368922 DOI: 10.1097/coc.0000000000000385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Patients with advanced pancreatic cancer (APC) have a poor prognosis and experience a large burden of disease-related symptoms. Despite advancements in the treatment of APC, survival is dismal and controlling disease-related symptoms and maintaining quality of life is paramount. We hypothesize that an improvement in disease-related symptoms, and therefore, a clinical benefit, while on chemotherapy is a predictive marker in APC. MATERIALS AND METHODS Patients 18 and older with APC diagnosed between January 1, 2005 and December 31, 2010 and treated at the Cross Cancer Institute were identified using the provincial cancer registry. Disease symptoms were assessed at baseline and clinical benefit while on chemotherapy was defined using a composite endpoint of improvement in patient-reported pain, opioid consumption, Eastern Cooperative Oncology Group performance status, and/or weight. Best radiologic response, progression-free survival (PFS), and overall survival (OS) were recorded. RESULTS Of 103 patients, the median age was 64, 58% were male and 66% had metastatic disease. At baseline, the majority of patients reported pain (80%), opioid use (61%), or weight loss (71%). In total, 35 (34%) patients received a clinical benefit with treatment but only 6 (17%) of these patients experienced a radiologic response. The median PFS and OS were improved in patients who experienced a clinical benefit (6.6 vs. 4.6 mo; P=0.03 and 11.7 vs. 6.1 mo; P<0.0001, respectively). CONCLUSIONS In patients with APC treated with chemotherapy, experiencing a clinical benefit was associated with improved PFS and OS. However, it did not appear to correlate with radiologic response to chemotherapy. Prospective studies are warranted to further investigate the prognostic and predictive value of clinical benefit and improvement in quality of life as measured by standardized tools, in APC.
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Cottone F, Deliu N, Collins GS, Anota A, Bonnetain F, Van Steen K, Cella D, Efficace F. Modeling strategies to improve parameter estimates in prognostic factors analyses with patient-reported outcomes in oncology. Qual Life Res 2019; 28:1315-1325. [PMID: 30659449 DOI: 10.1007/s11136-018-02097-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE The inclusion of patient-reported outcome (PRO) questionnaires in prognostic factor analyses in oncology has substantially increased in recent years. We performed a simulation study to compare the performances of four different modeling strategies in estimating the prognostic impact of multiple collinear scales from PRO questionnaires. METHODS We generated multiple scenarios describing survival data with different sample sizes, event rates and degrees of multicollinearity among five PRO scales. We used the Cox proportional hazards (PH) model to estimate the hazard ratios (HR) using automatic selection procedures, which were based on either the likelihood ratio-test (Cox-PV) or the Akaike Information Criterion (Cox-AIC). We also used Cox PH models which included all variables and were either penalized using the Ridge regression (Cox-R) or were estimated as usual (Cox-Full). For each scenario, we simulated 1000 independent datasets and compared the average outcomes of all methods. RESULTS The Cox-R showed similar or better performances with respect to the other methods, particularly in scenarios with medium-high multicollinearity (ρ = 0.4 to ρ = 0.8) and small sample sizes (n = 100). Overall, the Cox-PV and Cox-AIC performed worse, for example they did not select one or more prognostic collinear PRO scales in some scenarios. Compared with the Cox-Full, the Cox-R provided HR estimates with similar bias patterns but smaller root-mean-squared errors, particularly in higher multicollinearity scenarios. CONCLUSIONS Our findings suggest that the Cox-R is the best approach when performing prognostic factor analyses with multiple and collinear PRO scales, particularly in situations of high multicollinearity, small sample sizes and low event rates.
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Affiliation(s)
- Francesco Cottone
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy.
| | - Nina Deliu
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - Gary S Collins
- Centre for Statistics in Medicine, NDORMS, University of Oxford, Oxford, UK
| | - Amelie Anota
- Methodology and Quality of Life in Oncology Unit (INSERM UMR 1098), University Hospital of Besançon, Besançon, France
- French National Platform Quality of Life and Cancer, Besançon, France
| | - Franck Bonnetain
- Methodology and Quality of Life in Oncology Unit (INSERM UMR 1098), University Hospital of Besançon, Besançon, France
- French National Platform Quality of Life and Cancer, Besançon, France
| | - Kristel Van Steen
- GIGA-R Medical Genomics Unit, University of Liège, Liège, Belgium
- Department of Human Genetics - Systems Medicine, University of Leuven, Leuven, Belgium
| | - David Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Fabio Efficace
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
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Mai TTX, Choi JH, Lee MK, Chang YJ, Jung SY, Cho H, Lee ES. Prognostic Value of Post-diagnosis Health-Related Quality of Life for Overall Survival in Breast Cancer: Findings from a 10-Year Prospective Cohort in Korea. Cancer Res Treat 2019; 51:1600-1611. [PMID: 30999723 PMCID: PMC6790846 DOI: 10.4143/crt.2018.426] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 04/10/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose We aimed to evaluate health-related quality of life (HRQOL) at 1-year post-diagnosis in breast cancer (BC) patients and its association with overall survival using data from the National Cancer Center Hospital. Materials and Methods Data of a BC cohort were first obtained between 2004 and 2006 and followed up. HRQOL was assessed using EORTC QLQ-C30 and BC specific module QLQ-BR23 few days after diagnosis and 1 year after that. We examined and compared the difference in the two HRQOL scores measured for each patient by the patient’s current survival status. The Cox proportional hazards model was fitted to evaluate the impact of HRQOL on survival, with adjustment for baseline HRQOL and other factors. Results Of 299 enrolled patients, 206 responded at 1-year post-diagnosis (80.6%) and were followed up for 11.6 years on average. At 1-year post-diagnosis, survivors had better HRQOL scores than those who died, although their health status was similar at baseline. Survivors reported significant increase 1 year after diagnosis in global health status and emotional scales. Between the groups, functional scales such as physical, role, and emotional were significantly different. Functional scales, including physical (adjusted hazard ratio [aHR], 0.70), role (aHR, 0.68), emotional (aHR, 0.72), and symptom scales, including fatigue (aHR, 1.34), dyspnea (aHR, 1.29), appetite loss (aHR, 1.24) were significantly associated with overall survival. Patients who were less worried about future health had favorable survival(aHR, 0.83). Conclusion Besides treatment-related symptoms, non-medical aspects at 1-year post-diagnosis, including functional well-being and future perspective, are predictive of long-term survival. Intervention to enhance physical, role, and emotional support for women soon after their BC diagnosis might help to improve disease survival outcomes afterwards.
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Affiliation(s)
- Tran Thi Xuan Mai
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Jin Hyuk Choi
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Myung Kyung Lee
- College of Nursing, Kyungpook National University, Daegu, Korea
| | - Yoon Jung Chang
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Hospice and Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - So-Youn Jung
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Hyunsoon Cho
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eun Sook Lee
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
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Visser S, de Mol M, Cheung K, van Toor JJ, van Walree NC, Stricker BH, Den Oudsten BL, Aerts JGJV. Treatment Satisfaction of Patients With Advanced Non-Small-cell Lung Cancer Receiving Platinum-based Chemotherapy: Results From a Prospective Cohort Study (PERSONAL). Clin Lung Cancer 2018; 19:e503-e516. [PMID: 29705017 DOI: 10.1016/j.cllc.2018.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 02/05/2018] [Accepted: 03/10/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In patients with advanced non-small-cell lung cancer, the treatment benefits and risks need to be constantly weighed. We explored patient-reported satisfaction with therapy (SWT) and assessed its value in addition to quality of life (QoL) and adverse events (AEs). PATIENTS AND METHODS In a prospective multicenter cohort study, patients with stage IIIB/IV non-small-cell lung cancer received platinum-pemetrexed chemotherapy. They completed the World Health Organization Quality of Life-BREF (WHOQoL-BREF) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) before and during chemotherapy. After the last cycle, patients reported on SWT, expectations of therapy, and feelings about side effects (FSE) using the Cancer Therapy Satisfaction Questionnaire. The explained variance (R2) of QoL after treatment by SWT was calculated. Using multivariable linear regression, we examined the association of SWT with patient- and treatment-related variables, FSE, and AEs. RESULTS Eighty-nine patients finished 4 cycles of chemotherapy, 65 of whom completed the Cancer Therapy Satisfaction Questionnaire. Fifty-six patients (86.2%) would probably or definitely decide to undergo the same treatment again, regardless of deterioration or improvement in QoL or a high or low frequency of AEs during chemotherapy. The explained variance of QoL by SWT was greatest for the EORTC QLQ C-30 global health status/QoL scale (R2 = 0.170). Patient age (β = 0.43; 95% confidence interval [CI], 0.05-0.82), FSE (β = 0.17; 95% CI, 0.06-0.29), and tumor response (β = 7.93; 95% CI (1.64 to 14.22)) were independently associated with SWT. CONCLUSION SWT could provide important supplementary information in addition to QoL assessments and treatment toxicities. Tumor response, older age, and FSE score were associated with better SWT. These insights could affect decision-making during palliative chemotherapy.
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Affiliation(s)
- Sabine Visser
- Department of Pulmonary Medicine, Amphia Hospital Breda, Breda, The Netherlands; Department of Pulmonary Medicine, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center University Medical Center, Rotterdam, The Netherlands
| | - Mark de Mol
- Department of Pulmonary Medicine, Amphia Hospital Breda, Breda, The Netherlands; Department of Pulmonary Medicine, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - Kiki Cheung
- Department of Epidemiology, Erasmus Medical Center University Medical Center, Rotterdam, The Netherlands; Inspectorate of Health Care, Utrecht, The Netherlands
| | - Jermo J van Toor
- Department of Pulmonary Medicine, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - Nico C van Walree
- Department of Pulmonary Medicine, Amphia Hospital Breda, Breda, The Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus Medical Center University Medical Center, Rotterdam, The Netherlands; Inspectorate of Health Care, Utrecht, The Netherlands.
| | - Brenda L Den Oudsten
- Department of Medical and Clinical Psychology, Centre of Research on Psychological and Somatic Disorders, Tilburg University, Tilburg, The Netherlands
| | - Joachim G J V Aerts
- Department of Pulmonary Medicine, Amphia Hospital Breda, Breda, The Netherlands; Department of Pulmonary Medicine, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands
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Traore BM, El Fakir S, Charaka H, Benaicha N, Najdi A, Zidouh A, Bennani M, Errihani H, Mellass N, Benider A, Bekkali R, Nejjari C. Evolution of quality of life in patients with breast cancer during the first year of follow-up in Morocco. BMC Cancer 2018; 18:109. [PMID: 29402232 PMCID: PMC5800277 DOI: 10.1186/s12885-018-4008-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 01/18/2018] [Indexed: 11/13/2022] Open
Abstract
Background Quality of life has an important place in the future of patients with breast cancer. The objective of this study is to assess the evolution of the patient’s quality of life with breast cancer in Morocco after a year of follow-up. Methods This study involved the patients with breast cancer with all types of treatment as determined by their physicians. Patient’s quality of life was assessed with the Moroccan Arabic version of QLQ- EORTC QLQ C30 and EORTC-BR23 questionnaires. Data were analyzed using SPSS Version 20 software. Results Regarding EOTRC questionnaires QLQ C-30, there was a significant improvement in global health status and all scales of the functional dimension except the social functional where there was a trend towards improvement and the financial impact of the disease where the situation has deteriorated. Quality of life was improved for most symptom-sized scales dimension of EORTC QLQ- C30 with the exception of diarrhea where it was observed degradation. Most of the EORTC QLQ-scales BR23 questionnaires showed a favorable trend in the quality of life except those of sexual functioning, sexual enjoyment, hair loss and the side effects of systemic therapy. Conclusion The quality of life of the patient is significantly improved after 1 year of follow up. Quality of life instruments can be useful in the early identification of patients whose score low on functional scales and symptoms.
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Affiliation(s)
- B M Traore
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco.
| | - S El Fakir
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco
| | - H Charaka
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco
| | - N Benaicha
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco
| | - A Najdi
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco
| | - A Zidouh
- Fondation Lalla Salma Prevention and Treatment of Cancers, Rabat, Morocco
| | - M Bennani
- Fondation Lalla Salma Prevention and Treatment of Cancers, Rabat, Morocco
| | - H Errihani
- National Institute of Oncology, Rabat, Morocco
| | - N Mellass
- Department ofOncology, University Hospital Center Hassan II Fez, Fez, Morocco
| | - A Benider
- Oncology Center Ibn Rochd, Casablanca, Morocco
| | - R Bekkali
- Fondation Lalla Salma Prevention and Treatment of Cancers, Rabat, Morocco
| | - C Nejjari
- Department of epidemiology and public health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah, Fez, Morocco
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Li J, Sun Y, Ding G, Jiang F. Persistent pain accelerates xenograft tumor growth of breast cancer in rat. Biochem Biophys Res Commun 2017; 495:2432-2438. [PMID: 29277615 DOI: 10.1016/j.bbrc.2017.12.121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 12/21/2017] [Indexed: 11/29/2022]
Abstract
Pain occurs at all stages of the patients who suffer from cancer. Owing to surgery and bone metastasis, breast cancer patients were usually disturbed by persistent pain. However, the pain-relief-right has not been respected enough in clinical cancer treatment. Whether pain has any adverse effects on cancer development is still unclear. In order to uncover this question, we established two preclinical animal models to explore the effects of pain on the tumor. For the first model, we mimicked neuropathic pain by sciatic nerve ligation on rats with xenograft tumor subcutaneously. For the second model, we mimicked the bone cancer pain by injecting tumor cell suspension into the tibial medullary cavity of rats with xenograft tumor subcutaneously. The rats with persistent pain showed higher tumor volume and tumor weight compared with the group without pain. Interestingly, when the neuropathic pain and bone cancer pain were relieved by drug administration, both the tumor volume and tumor weight were lowered compared with the group without pain relief. In summary, our study indicated that persistent pain acted as a contributing factor to tumor growth. Moreover, the pain relief could weakened the accelerating role of pain in tumor growth. Thus, we should be paid more attention to the cancer patients with persistent pain as well as cancer treatment.
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Affiliation(s)
- Jing Li
- Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Yunheng Sun
- Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Gang Ding
- Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China; Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Chongming Branch, Shanghai 202150, China; Xin Hua Translational Institute for Cancer Pain, Shanghai 202150, China; Shanghai International Medical Center, Shanghai 201318, China.
| | - Feng Jiang
- Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Chongming Branch, Shanghai 202150, China; Xin Hua Translational Institute for Cancer Pain, Shanghai 202150, China.
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10
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Zylla D, Steele G, Gupta P. A systematic review of the impact of pain on overall survival in patients with cancer. Support Care Cancer 2017; 25:1687-1698. [PMID: 28190159 DOI: 10.1007/s00520-017-3614-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 02/06/2017] [Indexed: 01/13/2023]
Abstract
PURPOSE Pain commonly occurs in cancer patients, and has been associated with shorter survival. However, the importance of pain is less clear when analyzed with other known prognostic variables. This systematic review was performed to better understand how pain impacts overall survival (OS) in common cancers when key clinical variables are included in multivariate analysis. METHODS A Medline search was completed to find studies examining the relationship between pain, clinical variables, and OS in patients with breast, colorectal, lung, or prostate cancer. Multivariate analysis included known prognostic variables including age, performance status, disease burden, and laboratory parameters. RESULTS Fifty studies met inclusion criteria. In patients with breast, colorectal, and lung cancer, pain was not a significant prognostic factor for OS on multivariate analysis in most studies. In contrast, several studies suggest that pain is an independent prognostic factor for OS in advanced prostate cancer, even when relevant clinical prognostic variables are included. However, analgesic use was often used as a surrogate for prostate cancer pain, making it difficult to determine whether pain or opioid exposure was more important in influencing survival. CONCLUSIONS Pain may be associated with shorter survival in patients with cancer, but the mechanism for this relationship is unknown. The available evidence is insufficient to definitively determine if pain independently influences survival in patients with breast, colorectal, or lung cancer. The majority of studies in prostate cancer show pain to be an independent prognostic factor for OS, and often also incorporate opioid analgesic use in multivariate analysis. Prospective studies are needed to better understand how opioid utilization and pain may affect cancer progression and survival in diverse malignancies.
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Affiliation(s)
- Dylan Zylla
- Division of Hematology/Oncology/Transplantation, Department of Medicine, University of Minnesota, 3931 Louisiana Ave S, Minneapolis, MN, 55426, USA. .,Park Nicollet Oncology Research and HealthPartners Institute, St. Louis Park, MN, USA.
| | - Grant Steele
- Park Nicollet Oncology Research and HealthPartners Institute, St. Louis Park, MN, USA
| | - Pankaj Gupta
- Division of Hematology/Oncology/Transplantation, Department of Medicine, University of Minnesota, 3931 Louisiana Ave S, Minneapolis, MN, 55426, USA.,Hematology/Oncology Section, Department of Medicine, Minneapolis VA Health Care System, Minneapolis, USA
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Galiano-Castillo N, Arroyo-Morales M, Ariza-Garcia A, Fernández-Lao C, Fernández-Fernández AJ, Cantarero-Villanueva I. Factors that Explain the Cancer-Related Insomnia. Breast J 2017; 23:387-394. [DOI: 10.1111/tbj.12759] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Noelia Galiano-Castillo
- Instituto de Investigación Biosanitaria de Granada; Granada Spain
- Department of Physical Therapy; Health Sciences Faculty; University of Granada; Granada Spain
| | - Manuel Arroyo-Morales
- Instituto de Investigación Biosanitaria de Granada; Granada Spain
- Department of Physical Therapy; Health Sciences Faculty; University of Granada; Granada Spain
| | - Angélica Ariza-Garcia
- Department of Physical Therapy; Health Sciences Faculty; University of Granada; Granada Spain
- Physical Medicine and Rehabilitation Department; Clinico Universitario San Cecilio; Granada Spain
| | - Carolina Fernández-Lao
- Instituto de Investigación Biosanitaria de Granada; Granada Spain
- Department of Physical Therapy; Health Sciences Faculty; University of Granada; Granada Spain
| | | | - Irene Cantarero-Villanueva
- Instituto de Investigación Biosanitaria de Granada; Granada Spain
- Department of Physical Therapy; Health Sciences Faculty; University of Granada; Granada Spain
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12
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Smyth EN, Shen W, Bowman L, Peterson P, John W, Melemed A, Liepa AM. Patient-reported pain and other quality of life domains as prognostic factors for survival in a phase III clinical trial of patients with advanced breast cancer. Health Qual Life Outcomes 2016; 14:52. [PMID: 27016084 PMCID: PMC4807577 DOI: 10.1186/s12955-016-0449-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 03/09/2016] [Indexed: 12/16/2022] Open
Abstract
Background Patient-reported outcomes have been associated with survival in numerous studies across cancer types, including breast cancer. However, the Brief Pain Inventory-Short Form (BPI-SF) and the Rotterdam Symptom Checklist (RSCL) have rarely been investigated in this regard in breast cancer. Methods Here we describe a post hoc analysis of the prognostic effect of baseline scores of these instruments on survival in a phase III trial of patients with advanced breast cancer who received gemcitabine plus paclitaxel or paclitaxel alone after anthracycline-based adjuvant or neoadjuvant therapy. The variables for this analysis were baseline BPI-SF “worst pain” and BPI-SF “pain interference” scores, and four RSCL subscales (each transformed to 0–100). Univariate and multivariate Cox models were used, the latter in the presence of 11 demographic/clinical variables. Kaplan-Meier curves and log-rank tests were used to compare survival for patients by BPI-SF or RSCL scores. Results Of 529 randomized patients, 286 provided BPI-SF data and 336 provided RSCL data at baseline. Univariate analyses identified BPI-SF worst pain and pain interference (both hazard ratios [HR], 1.07 for a 1-point increase; both p ≤ 0.0061) and three of four RSCL subscales [activity level, physical distress, and health-related quality of life (HRQOL) (HR, 0.86–0.91 for 10-point increase all p ≤ 0.0104)], to have significant prognostic effect for survival. BPI-SF worst pain (p = 0.0342) and RSCL activity level (p = 0.0004) were prognostic in the multivariate analysis. Median survival for patients categorized by BPI-SF worst pain score was 23.8 (n = 91), 17.9 (n = 94) and 14.6 (n = 94) months for scores 0, 1–4, and 5–10, respectively (log-rank p = 0.0065). Median survival was 23.8 and 14.6 months for patients (n = 330) with above- and below-median RSCL activity level scores respectively (log-rank p < 0.0001). Conclusion Pretreatment BPI-SF worst pain and RSCL activity scores provide distinct prognostic information for survival in patients receiving paclitaxel or gemcitabine plus paclitaxel for advanced breast cancer even after controlling for multiple demographic and clinical factors. Trial registration Clinicaltrials.gov, NCT00006459.
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Affiliation(s)
- Emily Nash Smyth
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA.
| | - Wei Shen
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA
| | - Lee Bowman
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA
| | - Patrick Peterson
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA
| | - William John
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA
| | - Allen Melemed
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA
| | - Astra M Liepa
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA
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13
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Quality of Life and Volume Reduction in Women with Secondary Lymphoedema Related to Breast Cancer. Int J Breast Cancer 2015; 2015:586827. [PMID: 26843988 PMCID: PMC4710936 DOI: 10.1155/2015/586827] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 11/24/2015] [Indexed: 11/17/2022] Open
Abstract
Purpose. To assess the quality of life (QOL) as a predictor of volume reduction in women undergoing complex physical therapy (CPT) for lymphoedema following breast cancer. Methods. Clinical trial in 57 women undergoing CPT. Results. At baseline, in measuring quality of life for the EORTC QLQ-C30 questionnaire subscale of functionality, the worst scores for emotional function (55 points) and better social function (89 points) were observed. The symptom scales showed the worst pain averaged (66 points). The overall quality of life showed a low score (40 points). In the BR 23 module, low scores were observed in the field of future perspective (47 points). After treatment of lymphoedema, absolute reduction of excess volume between the upper limbs of 282 mL was observed, representing a reduction of 15%. No association was observed between the domains of quality of life and response to treatment of lymphoedema. Conclusion. This study included 57 women with advanced and chronic lymphoedema in early treatment with CPT and low scores for quality of life. The lymphoedema therapeutic response was not influenced by the QOL at the beginning of treatment.
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14
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Rafanelli C, Gostoli S, Tully PJ, Roncuzzi R. Hostility and the clinical course of outpatients with congestive heart failure. Psychol Health 2015; 31:228-38. [PMID: 26387801 DOI: 10.1080/08870446.2015.1095299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The role of depression and quality of life on clinical outcomes of congestive heart failure (CHF) is well recognised. However, there are fewer studies investigating the prognostic role of subclinical psychological distress and well-being impairments. The aims of this study were to evaluate clinical/subclinical psychological distress and well-being in CHF outpatients, and the influence of these psychological factors on adverse cardiac events (re-hospitalisation, cardiac death), at 4-year follow-up. DESIGN Sixty-eight CHF outpatients underwent psychological assessment at baseline and, after 4 years, information about cardiac events was collected in 60 patients by means of clinical records. MAIN OUTCOME MEASURES Psychological assessment included structured clinical interview for DSM (major/minor depression), Interview for diagnostic criteria for psychosomatic research (demoralisation), symptom questionnaire, psychological well-being scales. RESULTS At follow-up, 39.7% of the baseline sample reported cardiovascular events (14 CHF-related re-hospitalisations and 13 cardiac deaths) and 5.9% other causes for death. Among the variables examined as potential risk factors for adverse cardiovascular outcomes, only hostility was significant, even after controlling for disease severity (hazard ratio = 2.38, 95%confidence interval: 1.04-5.45, p = .040). CONCLUSION In outpatients with CHF, psychological assessment should include both clinical and subclinical distress such as hostility, in order to better address psychological risk factors for cardiac outcomes.
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Affiliation(s)
- Chiara Rafanelli
- a Department of Psychology , University of Bologna , Bologna , Italy
| | - Sara Gostoli
- a Department of Psychology , University of Bologna , Bologna , Italy
| | - Phillip J Tully
- b Discipline of Medicine , University of Adelaide , Adelaide , Australia
| | - Renzo Roncuzzi
- c Division of Cardiology , Bellaria Hospital , Bologna , Italy
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15
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Cheung K, de Mol M, Visser S, Den Oudsten BL, Stricker BH, Aerts JGJV. Reliability and validity of the Cancer Therapy Satisfaction Questionnaire in lung cancer. Qual Life Res 2015. [PMID: 26195317 PMCID: PMC4706586 DOI: 10.1007/s11136-015-1062-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE To test the reliability and validity of the Cancer Treatment Satisfaction Questionnaire (CTSQ), to assess its relation with quality of life (QoL), and to assess the interpretability of the domain scores in lung cancer patients receiving intravenous chemotherapy. METHODS Patients with stage IIIB and IV non-squamous non-small cell lung carcinoma treated with pemetrexed were enrolled in our study. They completed the 16-item CTSQ and two other (health-related) QoL questionnaires. Information about sociodemographic characteristics, cancer stage, and the experience of adverse events was collected. Internal consistency, construct validity, and clinical interpretability were calculated. RESULTS Fifty-five patients completed the CTSQ. Correlations of the CTSQ items with its domain were all above 0.40. A high correlation between item 8 and the expectations of therapy and satisfaction with therapy domain was observed (0.50 and 0.48, respectively). The CTSQ domains demonstrated good internal consistency and low to moderate correlations of the CTSQ with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 and World Health Organization Quality of Life-BREF. No significant differences in mean domain scores were observed in relation to the number and severity of different adverse events and chemotherapy-related adverse events. CONCLUSIONS The Dutch version of the CTSQ was found to be a reliable and valid instrument to assess satisfaction and expectations of treatment in lung cancer patients receiving intravenous chemotherapy. Furthermore, the CTSQ proved to be of additional informative value as not all of its domains correlated with the various domains of the existing HRQoL instruments.
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Affiliation(s)
- K Cheung
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
- Inspectorate of Health Care, The Hague, The Netherlands.
| | - M de Mol
- Department of Pulmonary Diseases, Amphia Hospital Breda, Breda, The Netherlands
- Department of Pulmonary Diseases, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - S Visser
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Pulmonary Diseases, Amphia Hospital Breda, Breda, The Netherlands
- Department of Pulmonary Diseases, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - B L Den Oudsten
- Department of Medical and Clinical Psychology, Centre of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - B H Stricker
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
- Inspectorate of Health Care, The Hague, The Netherlands.
| | - J G J V Aerts
- Department of Pulmonary Diseases, Amphia Hospital Breda, Breda, The Netherlands
- Department of Pulmonary Diseases, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
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16
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Hamilton BK, Law AD, Rybicki L, Abounader D, Dabney J, Dean R, Duong HK, Gerds AT, Hanna R, Hill BT, Jagadeesh D, Kalaycio ME, Lawrence C, McLellan L, Pohlman B, Sobecks RM, Bolwell BJ, Majhail NS. Prognostic significance of pre-transplant quality of life in allogeneic hematopoietic cell transplantation recipients. Bone Marrow Transplant 2015; 50:1235-40. [PMID: 26030045 DOI: 10.1038/bmt.2015.122] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/25/2015] [Accepted: 04/05/2015] [Indexed: 11/09/2022]
Abstract
Quality of life (QOL) is an important outcome for hematopoietic cell transplantation (HCT) recipients. Whether pre-HCT QOL adds prognostic information to patient and disease related risk factors has not been well described. We investigated the association of pre-HCT QOL with relapse, non-relapse mortality (NRM), and overall mortality after allogeneic HCT. From 2003 to 2012, the Functional Assessment of Cancer Therapy-Bone Marrow Transplant Scale instrument was administered before transplantation to 409 first allogeneic HCT recipients. We examined the association of the three outcomes with (1) individual QOL domains, (2) trial outcome index (TOI) and (3) total score. In multivariable models with individual domains, functional well-being (hazard ratio (HR) 0.95, P=0.025) and additional concerns (HR 1.39, P=0.002) were associated with reduced risk of relapse, no domain was associated with NRM, and better physical well-being was associated with reduced risk of overall mortality (HR 0.97, P=0.04). TOI was not associated with relapse or NRM but was associated with reduced risk of overall mortality (HR 0.93, P=0.05). Total score was not associated with any of the three outcomes. HCT-comorbidity index score was prognostic for greater risk of relapse and mortality but not NRM. QOL assessments, particularly physical functioning and functional well-being, may provide independent prognostic information beyond standard clinical measures in allogeneic HCT recipients.
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Affiliation(s)
- B K Hamilton
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - A D Law
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - L Rybicki
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - D Abounader
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - J Dabney
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - R Dean
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - H K Duong
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - A T Gerds
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - R Hanna
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - B T Hill
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - D Jagadeesh
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - M E Kalaycio
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - C Lawrence
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - L McLellan
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - B Pohlman
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - R M Sobecks
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - B J Bolwell
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - N S Majhail
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
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Mullan S. Assessment of quality of life in veterinary practice: developing tools for companion animal carers and veterinarians. VETERINARY MEDICINE-RESEARCH AND REPORTS 2015; 6:203-210. [PMID: 30101107 PMCID: PMC6070017 DOI: 10.2147/vmrr.s62079] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Quality-of-life assessments aim to provide an all-encompassing evaluation of animal welfare. In comparison to more limited, disease-focused welfare assessments, they have the potential to better identify welfare deficiencies, allowing veterinarians to target improvement strategies for greater benefit. Individuals or populations of companion animals may be assessed and carers and/or veterinarians may contribute to the assessment. Quality-of-life assessments are widely used within the human health care setting, and although the number of veterinary assessment tools is substantially fewer, these tools cover a range of methodologies. Further research to validate existing tools and develop new ones is recommended. Guidance for implementing and evaluating the usefulness of quality-of-life assessment tools within companion animal veterinary clinics is presented.
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Affiliation(s)
- Siobhan Mullan
- Department of Clinical Veterinary Science, University of Bristol Veterinary School, Bristol, UK,
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Nguyen J, Popovic M, Chow E, Cella D, Beaumont JL, Chu D, DiGiovanni J, Lam H, Pulenzas N, Bottomley A. EORTC QLQ-BR23 and FACT-B for the assessment of quality of life in patients with breast cancer: a literature review. J Comp Eff Res 2015; 4:157-66. [DOI: 10.2217/cer.14.76] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: This study aims to compare the development, characteristics and validity of two widely used tools in the breast cancer population, the EORTC QLQ-BR23 and the FACT-B. Methods: A literature search was conducted using Ovid MEDLINE, OLDMEDLINE, Embase, Embase Classic and the Cochrane Central Register of Controlled Trials to identify relevant studies. Results: Both tools were found to be reliable and valid. The QLQ-BR23 focuses on physical function, whereas the FACT-B emphasizes emotional well-being. Scoring, item format, organization and response options differ between questionnaires. Conclusion: Overall, both questionnaires are effective in assessing breast cancer-specific quality of life. Clear similarities and differences between the two tools exist. Decision-making between the questionnaires should be based on the purpose and design of the study.
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Affiliation(s)
- Jasmine Nguyen
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Marko Popovic
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Edward Chow
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jennifer L Beaumont
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Dominic Chu
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Julia DiGiovanni
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Henry Lam
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Natalie Pulenzas
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Andrew Bottomley
- European Organisation for Research & Treatment of Cancer Headquarters, Brussels, Belgium
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Petrick JL, Reeve BB, Kucharska-Newton AM, Foraker RE, Platz EA, Stearns SC, Han X, Windham BG, Irwin DE. Functional status declines among cancer survivors: trajectory and contributing factors. J Geriatr Oncol 2014; 5:359-67. [PMID: 24981125 PMCID: PMC4254190 DOI: 10.1016/j.jgo.2014.06.002] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 05/01/2014] [Accepted: 06/01/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study aimed to quantify functional status (FS) trajectories pre- and post-diagnosis of cancer, FS trajectories among cancer-free individuals, and factors affecting FS. MATERIALS AND METHODS Self-reported FS, scored from 0 (worst) to 100 (best), of Atherosclerosis Risk in Communities (ARIC) Study cohort participants diagnosed with incident cancer (lung (N=303), breast (N=374), prostate (N=529), colorectal (N=228)), and cancer-free participants (N=11,155) over 15 years was examined. FS was evaluated in two ways: 1) until death or follow-up year 15 (Model 1) and 2) same as survivorship model except that a FS value of zero was used for assessments after death to follow-up year 15 (Model 2). Mean FS at discrete time points were used to generate FS trajectories. Differences in repeated measures of FS were assessed using linear growth models. RESULTS Within one year after diagnosis, FS scores declined compared to the cancer-free group, except for prostate cancer. FS continued to decline beyond one year after lung or colorectal cancer diagnosis. FS was lower in all cancer groups, except prostate, compared to the cancer-free group (Model 1: lung -4.76, breast -2.28, colorectal -2.55; Model 2: lung -2.36, breast -2.46, colorectal -2.31). Predictors of decreased FS score independent of cancer diagnosis included low education, comorbidities, obesity, smoking, lack of health insurance, and age. CONCLUSION FS in all incident cancer groups declined during the first year post-diagnosis, which could be due to intensive treatments. Targeting factors related to FS declines could improve health outcomes for patients with cancer.
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Affiliation(s)
- Jessica L Petrick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States.
| | - Bryce B Reeve
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Anna M Kucharska-Newton
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Randi E Foraker
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Sally C Stearns
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Xuesong Han
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, United States
| | - B Gwen Windham
- The University of Mississippi Medical Center, Jackson, MS, United States
| | - Debra E Irwin
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
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Petrick JL, Foraker RE, Kucharska-Newton AM, Reeve BB, Platz EA, Stearns SC, Han X, Windham BG, Irwin DE. Trajectory of overall health from self-report and factors contributing to health declines among cancer survivors. Cancer Causes Control 2014; 25:1179-86. [PMID: 24986768 PMCID: PMC4156906 DOI: 10.1007/s10552-014-0421-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 06/12/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aims to quantify trajectories of overall health pre- and post-diagnosis of cancer, trajectories of overall health among cancer-free individuals, and factors affecting overall health status. METHODS Overall health status, derived from self-rated health report, of Atherosclerosis Risk in Communities cohort participants diagnosed with incident cancer [lung (n = 400), breast (n = 522), prostate (n = 615), colorectal (n = 303)], and cancer-free participants (n = 11,634) over 19 years was examined. Overall health was evaluated in two ways: (1) overall health was assessed until death or follow-up year 19 (survivorship model) and (2) same as survivorship model except that a self-rated health value of zero was used for assessments after death to follow-up year 19 (cohort model). Mean overall health at discrete times was used to generate overall health trajectories. Differences in repeated measures of overall health were assessed using linear growth models. RESULTS Overall health trajectories declined dramatically within one-year of cancer diagnosis. Lung, breast, and colorectal cancer were associated with a significant decreased overall health score (β) compared to the cancer-free group (survivorship model: lung-7.00, breast-3.97, colorectal-2.12; cohort model: lung-7.63, breast-5.07, colorectal-2.30). Other predictors of decreased overall health score included low education, diabetes, cardiovascular disease, and age. CONCLUSIONS All incident cancer groups had declines in overall health during the first year post-diagnosis, which could be due to cancer diagnosis or intensive treatments. Targeting factors related to overall health declines could improve health outcomes for cancer patients.
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Affiliation(s)
- Jessica L Petrick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA,
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Ivanauskienė R, Padaiga Ž, Šimoliūnienė R, Smailytė G, Domeikienė A. Well-being of newly diagnosed women with breast cancer: which factors matter more? Support Care Cancer 2013; 22:519-26. [DOI: 10.1007/s00520-013-2005-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 10/01/2013] [Indexed: 10/26/2022]
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Moro-Valdezate D, Peiró S, Buch-Villa E, Caballero-Gárate A, Morales-Monsalve MD, Martínez-Agulló A, Checa-Ayet F, Ortega-Serrano J. Evolution of Health-Related Quality of Life in Breast Cancer Patients during the First Year of Follow-Up. J Breast Cancer 2013; 16:104-11. [PMID: 23593090 PMCID: PMC3625756 DOI: 10.4048/jbc.2013.16.1.104] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 02/18/2013] [Indexed: 12/04/2022] Open
Abstract
Purpose The objective of this study was to describe the evolution of health-related quality of life (HRQOL) in a cohort of breast cancer patients over 1 year after surgery and to analyse the predictive ability of HRQOL measurement instruments. Methods Observational, multicenter and prospective study of a cohort of breast cancer patients, assessing HRQOL at 1, 6, and 12 months after surgery using three questionnaires: EuroQol-5D-3L, EORTC QLQ-C30, and EORTC QLQ-BR23. Results A total of 364 women participated in the study. Visual Analogue Scale (VAS) scores from the EuroQol improved (1 month vs. 1 year: 70 vs. 80; p<0.0001); however, the EuroQol score showed no significant change (0.81 vs. 0.83; p=0.1323). In contrast, Global Health Status on the EORTC QLQ-C30 improved (66.67 vs. 100.00; p<0.0001), as did all of this instrument's scales and most of its independent items. The EORTC QLQ-BR23 dimensions showed improvement, except for sexual functioning (100.00 vs. 86.67; p=0.0030) and future perspective (33.33 vs. 66.67; p<0.0001). Patients with good HRQOL outcomes at 1 month showed improved levels of HRQOL at 1 year; HRQOL measured at 1 month was predictive of HRQOL at 1 year. Conclusion HRQOL improved during the follow-up period. Likewise, HRQOL measurement instruments can predict early HRQOL.
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Affiliation(s)
- David Moro-Valdezate
- Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain
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Sugrue R, MacGregor G, Sugrue M, Curran S, Murphy L. An evaluation of patient reported outcomes following breast reconstruction utilizing Breast Q. Breast 2013; 22:158-161. [PMID: 23290518 DOI: 10.1016/j.breast.2012.12.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 10/24/2012] [Accepted: 12/07/2012] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Breast Q questionnaire measures patient's perceptions following breast reconstruction using quality of life and satisfaction. This study assessed patient reported outcomes following mastectomy and reconstruction utilizing Breast Q. METHODS All consecutive Letterkenny Hospital patients undergoing mastectomy and breast reconstruction between August 2008 and February 2011 were invited to complete Breast Q evaluation of their care. Collected data included: age; presenting complaint, height, weight; type of operation. RUMM 2020 program evaluated satisfaction where 0 is very dissatisfied to 100 very satisfied. RESULTS 30/33 (91%) patients completed Breast Q; mean age 43 ± 11 (range 29-64); mean BMI 27.3 ± 5 (range 21.7-43.1). 27 patients were symptomatic, and 3 were image detected. 23 had a latissimus dorsi reconstruction, 11 of these with implant augmentation, 5 had a DIEP and 2 implant only reconstruction. The mean satisfaction score of 79.7 indicating good to excellent results. Post reconstructive outcomes were not statistically different from pre-operative perceptions in key areas such as satisfaction with breasts, psychosocial and sexual well-being. CONCLUSION This study identified outcomes as good as if not superior to international averages with preservation of satisfaction with breast and psychosocial well-being. Breast Q could help form a template for national benchmarks in patients undergoing mastectomy and reconstruction.
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Affiliation(s)
- Ryan Sugrue
- Department of Breast Surgery, Letterkenny and Galway University Hospitals, Ireland National University, Galway, Ireland
| | - Geraldine MacGregor
- Department of Breast Surgery, Letterkenny and Galway University Hospitals, Ireland National University, Galway, Ireland
| | - Michael Sugrue
- Department of Breast Surgery, Letterkenny and Galway University Hospitals, Ireland National University, Galway, Ireland.
| | - Sharon Curran
- Department of Breast Surgery, Letterkenny and Galway University Hospitals, Ireland National University, Galway, Ireland
| | - Laura Murphy
- Department of Breast Surgery, Letterkenny and Galway University Hospitals, Ireland National University, Galway, Ireland
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Jung HA, Park S, Cho JH, Kim S, Ko YH, Kim SJ, Kim WS. Prognostic relevance of pretreatment quality of life in diffuse large B-cell lymphoma patients treated with rituximab-CHOP: Results from a prospective cohort study. Ann Hematol 2012; 91:1747-56. [DOI: 10.1007/s00277-012-1516-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Accepted: 06/12/2012] [Indexed: 11/12/2022]
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