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Fleischer A, Humphrey C. Women's Experiences after Hormone Positive Breast Cancer: Beginning of Radiation to 3-4 Years Post-Radiation. Occup Ther Health Care 2024; 38:364-384. [PMID: 36112023 DOI: 10.1080/07380577.2022.2121991] [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: 01/06/2022] [Revised: 08/23/2022] [Accepted: 09/03/2022] [Indexed: 06/15/2023]
Abstract
This study found that a breast cancer survivor cohort who were 3-4 years post-treatment returned to near baseline activity levels, and their important activity categories were nearly evenly distributed among instrumental activities of daily living, high-demand leisure, and social participation. When describing their experiences, three themes emerged: exercise is important physically and emotionally, participating in important activities feels good, and plans have been made to continue engaging in important activities. Further research is needed to compare activity resumption among those receiving or not receiving occupational therapy-at different timepoints-to understand when occupational therapy can make the greatest impact.
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Affiliation(s)
- Anne Fleischer
- Occupational Therapy Program, Department of Rehabilitation, Exercise and Nutrition Sciences, University of Cincinnati
| | - Casey Humphrey
- Department of Occupational Science and Occupational Therapy, Eastern Kentucky University
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Forster T, Hommertgen A, Häfner MF, Arians N, König L, Harrabi SB, Schlampp I, Köhler C, Meixner E, Heinrich V, Weidner N, Hüsing J, Sohn C, Heil J, Golatta M, Hof H, Krug D, Debus J, Hörner-Rieber J. Quality of life after simultaneously integrated boost with intensity-modulated versus conventional radiotherapy with sequential boost for adjuvant treatment of breast cancer: 2-year results of the multicenter randomized IMRT-MC2 trial. Radiother Oncol 2021; 163:165-176. [PMID: 34480960 DOI: 10.1016/j.radonc.2021.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND We recently published 2-year results of the prospective, randomized IMRT-MC2 trial, showing non-inferior local control and cosmesis in breast cancer patients after conventionally fractionated intensity-modulated radiotherapy with simultaneously integrated boost (IMRT-SIB), compared to 3D-conformal radiotherapy with sequential boost (3D-CRT-seqB). Here, we report on 2-year quality of life results. PATIENTS AND METHODS 502 patients were enrolled and randomized to IMRT-SIB (50.4 Gy in 1.8 Gy fractions with a 64.4 Gy SIB to the tumor bed) or to 3D-CRT-seqB (50.4 Gy in 1.8 Gy fractions, followed by a sequential boost of 16 Gy in 2 Gy fractions). For quality of life (QoL) assessment, patients completed the QLQ-C30 and QLQ-BR23 questionnaires at baseline, 6 weeks and 2 years after radiotherapy. RESULTS Significant differences between treatment arms were seen 6 weeks after radiotherapy for pain (22.3 points for IMRT vs. 27.0 points for 3D-CRT-seqB; p = 0.033) and arm symptoms (18.1 points for IMRT vs. 23.6 points for 3D-CRT-seqB; p = 0.013), both favoring IMRT-SIB. Compared to baseline values, both arms showed significant improvement in global score (IMRT: p = 0.009; 3D-CRT: p = 0.001) after 2 years, with slight deterioration on the role (IMRT: p = 0.008; 3-D-CRT: p = 0.001) and social functioning (IMRT: p = 0.013, 3D-CRT: p = 0.001) as well as the future perspectives scale (IMRT: p = 0.003; 3D-CRT: p = 0.0034). CONCLUSION This is the first randomized phase III trial demonstrating that IMRT-SIB was associated with slightly superior QoL compared to 3-D-CRT-seqB. These findings further support the clinical implementation of SIB in adjuvant breast cancer treatment.
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Affiliation(s)
- Tobias Forster
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Adriane Hommertgen
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Matthias Felix Häfner
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Nathalie Arians
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Laila König
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Semi Ben Harrabi
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Ingmar Schlampp
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Clara Köhler
- Department of Radiation Oncology, Heidelberg University Hospital, Germany
| | - Eva Meixner
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Vanessa Heinrich
- Department of Radiation Oncology, Eberhard-Karls-University Tuebingen, Germany
| | - Nicola Weidner
- Department of Radiation Oncology, Eberhard-Karls-University Tuebingen, Germany
| | - Johannes Hüsing
- Division of Biostatistics, Coordination Centre for Clinical Trials, University of Heidelberg, Germany
| | - Christof Sohn
- Department of Gynecology and Obstetrics, University of Heidelberg, Germany
| | - Jörg Heil
- Department of Gynecology and Obstetrics, University of Heidelberg, Germany
| | - Michael Golatta
- Department of Gynecology and Obstetrics, University of Heidelberg, Germany
| | - Holger Hof
- Strahlentherapie Rhein-Pfalz, Neustadt, Germany
| | - David Krug
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany; Department of Radiation Oncology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Jürgen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany; Department of Radiation Oncology, University Hospital Schleswig Holstein, Kiel, Germany; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Germany
| | - Juliane Hörner-Rieber
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany; Department of Radiation Oncology, University Hospital Schleswig Holstein, Kiel, Germany; German Cancer Consortium (DKTK), partner site, Heidelberg, Germany.
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Ilie G, Bradfield J, Moodie L, Lawen T, Ilie A, Lawen Z, Blackman C, Gainer R, Rutledge RDH. The Role of Response-Shift in Studies Assessing Quality of Life Outcomes Among Cancer Patients: A Systematic Review. Front Oncol 2019; 9:783. [PMID: 31482068 PMCID: PMC6710367 DOI: 10.3389/fonc.2019.00783] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/02/2019] [Indexed: 12/11/2022] Open
Abstract
Objective: Response-shift has been cited as an important measurement consideration when assessing patient reported quality of life (QoL) outcomes over time among patients with severe chronic conditions. Here we report the results of a systematic review of response shift in studies assessing QoL among cancer patients. Methods: A systematic review using MEDLINE, EMBASE, and PsychINFO along with a manual search of the cited references of the articles selected, was conducted. A quality review was performed using STROBE criteria and reported according to PRISMA guidelines. Results: A systematic review of 1,487 records published between 1,887 and December 2018 revealed 104 potentially eligible studies, and 35 studies met inclusion criteria for content and quality. The most common cancer patient populations investigated in these studies were breast (18 studies), lung (14 studies), prostate (eight studies), and colorectal (eight studies). Response shift was identified among 34 of the 35 studies reviewed. Effect sizes were reported in 17 studies assessing QoL outcomes among cancer patients; 12 of which had negligible to small effect sizes, four reported medium effect sizes which were related to physical, global QoL, pain, and social (role) functioning and one reported a large effect size (fatigue). The most prevalent method for assessing response shift was the then-test, which is prone to recall bias, followed by the pre-test and post-test method. Given the heterogeneity among the characteristics of the samples and designs reviewed, as well as the overall small to negligible effect sizes for the effects reported, conclusions stating that changes due to internal cognitive shifts in perceived QoL should account for changes observed in cancer patients' QoL outcomes should be interpreted with caution. Conclusion: Further work is needed in this area of research. Future studies should control for patient characteristics, time elapsed between diagnosis and baseline assessment and evaluate their contribution to the presence of response shift. Time between assessments should include short and longer periods between assessments and evaluate whether the presence of response shift holds over time. Possible avenues for inquiry for future investigation are discussed.
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Affiliation(s)
- Gabriela Ilie
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Department of Urology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Jillian Bradfield
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Louise Moodie
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Tarek Lawen
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Urology, Halifax Infirmary-QEII-Nova Scotia Health Authority, Halifax Regional Municipality, NS, Canada
| | - Alzena Ilie
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Zeina Lawen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Chloe Blackman
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Ryan Gainer
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Robert D H Rutledge
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Nova Scotia Cancer Centre, Queen Elizabeth II Health Sciences Centre, Halifax Regional Municipality, NS, Canada
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Zhang Y, Li J, Jia S, Wang Y, Kang Y, Zhang W. Down-regulation of lncRNA-ATB inhibits epithelial-mesenchymal transition of breast cancer cells by increasing miR-141-3p expression. Biochem Cell Biol 2018; 97:193-200. [PMID: 30352165 DOI: 10.1139/bcb-2018-0168] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Long noncoding RNA activated by transforming growth factor-beta (lnc-ATB) is abnormally expressed in a number of tumor types. The aim of this study was to investigate the expression of lnc-ATB and miR-141-3p, and to determine whether lnc-ATB can regulate epithelial-mesenchymal transition (EMT) by miR-141-3p in breast cancer. Here, we found that lnc-ATB was highly expressed, whereas there was low expression of miR-141-3p in breast cancer tissues and cells. Knockdown of lnc-ATB in two breast cancer cell lines (MDA-MB-231 and BT549) significantly increased miR-141-3p expression. Down-regulation of lnc-ATB resulted in a morphological change of breast cancer cells from spindle-like to a round shape, and in a remarkable inhibition of cell migration and invasion, which were reversed by miR-141-3p inhibitor. Furthermore, we demonstrated that lnc-ATB knockdown decreased ZEB1, ZEB2, N-cadherin, and vimentin expression, and promoted E-cadherin expression, while miR-141-3p inhibitor could reverse those effects. Moreover, we proved that miR-141-3p directly bound to the 3' untranslated region (UTR) of ZEB1 and ZEB2 and negatively regulated ZEB1 and ZEB2 expression. Taken together, our results show that knockdown of lnc-ATB significantly inhibits the EMT process of breast cancer cells by increasing the expression of miR-141-3p, indicating that lnc-ATB might serve as a novel therapeutic target for breast cancer.
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Affiliation(s)
- Yang Zhang
- a Department of the 7th General Surgery and 1st Breast Surgery, Shengjing Hospital of China Medical University, Shenyang 110022, People's Republic of China
| | - Jianyi Li
- a Department of the 7th General Surgery and 1st Breast Surgery, Shengjing Hospital of China Medical University, Shenyang 110022, People's Republic of China
| | - Shi Jia
- a Department of the 7th General Surgery and 1st Breast Surgery, Shengjing Hospital of China Medical University, Shenyang 110022, People's Republic of China
| | - Yitong Wang
- a Department of the 7th General Surgery and 1st Breast Surgery, Shengjing Hospital of China Medical University, Shenyang 110022, People's Republic of China
| | - Ye Kang
- b Department of Pathology, Shengjing Hospital of China Medical University, Shenyang 110004, People's Republic of China
| | - Wenhai Zhang
- a Department of the 7th General Surgery and 1st Breast Surgery, Shengjing Hospital of China Medical University, Shenyang 110022, People's Republic of China
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