Patient-reported acute fatigue in elderly breast cancer patients treated with and without regional nodal radiation

2020 ◽  
Vol 183 (2) ◽  
pp. 391-401
Author(s):  
Shagun Misra ◽  
Grace Lee ◽  
Yasmin Korzets ◽  
Lisa Wang ◽  
Anthea Lau ◽  
...  
BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e033461
Author(s):  
Kyeore Bae ◽  
Si Yeon Song

IntroductionAromatase inhibitor-induced arthralgia (AIA) is a major adverse event of aromatase inhibitors (AIs) and leads to premature discontinuation of AI therapy in breast cancer patients. The objective of this protocol for a systematic review and network meta-analysis (NMA) is to provide the methodology to compare the change in pain intensity between different AIA treatments and demonstrate the rank probabilities for different treatments by combining all available direct and indirect evidence.Methods and analysisPubMed, the Cochrane Controlled Register of Trials (CENTRAL), EMBASE, Web of Science and ClinicalTrials.gov will be searched to identify publications in English from inception to November 2019. We will include randomised controlled trials (RCTs) assessing the effects of different treatments for AIA in postmenopausal women with stage 0–III hormone receptor-positive breast cancer. The primary endpoints will be the change in patient-reported pain intensity from baseline to post-treatment. The number of adverse events will be presented as a secondary outcome.Both pairwise meta-analysis and NMA with the Frequentist approach will be conducted. We will demonstrate summary estimates with forest plots in meta-analysis and direct and mixed evidence with a ranking of the treatments as the P-score in NMA. The revised Cochrane risk-of-bias tool for randomised trials will be used to assess the methodological quality within individual RCTs. The quality of evidence will be assessed.Ethics and disseminationAs this review does not involve individual patients, ethical approval is not required. The results of this systematic review and NMA will be published in a peer-reviewed journal. This review will provide valuable information on AIA therapeutic options for clinicians, health practitioners and breast cancer survivors.PROSPERO registration numberCRD42019136967.


2021 ◽  
Vol 161 ◽  
pp. S43-S44
Author(s):  
D. Mink van der Molen ◽  
M. Batenburg ◽  
A. Doeksen ◽  
T. van Dalen ◽  
E. Schoenmaeckers ◽  
...  

2021 ◽  
Author(s):  
Yishu Qi ◽  
Ning Zhang ◽  
Ye Ma ◽  
Ewen Xu ◽  
Qingmei Huang ◽  
...  

Abstract Introduction: Identifying the pattern of change in symptoms is critical to effective symptom management. This study aimed to determine the trajectory of Main Chemotherapy-related Symptoms (MCRS) in breast cancer patients, explore the influencing factors of potential categories of MCRS trajectory.Methods: Patient-reported Outcomes Measurement System- breast-chemotherapy was used to measure the four highest incidence MCRS (pain, fatigue, anxiety, and depression) weekly in Breast cancer patients. The Growth Mixture Model (GMM) was used to fit the potential categories of the MCRS trajectory. Logistic regression was used to explore the influencing factors of potential categories of MCRS change trajectory.Results: 239 breast cancer patients completed the study. Fatigue and depression showed an overall upward trend during the chemotherapy cycle, while pain and anxiety showed a downward trend. There are two potential categories of anxiety trajectory, three potential categories of fatigue and pain trajectory, and four potential categories of depression trajectory. Compared with the mild-fatigue group, Patients in the moderate and high fatigue groups were more likely to be less educated, have lower household income, and be treated with anthracyclines. Compared with the mild-pain group, patients in the pain-declining and fluctuating-pain groups were young, live-alone, and treated with paclitaxel. Patients in the anxiety-rising group were younger, had premenopausal menstruation with regular monthly menstruation, and had stage II disease. Patients in the depression-rising and severe depression groups were more likely to be solitary and younger.Conclusion: The potential classes of major chemotherapy-related symptom trajectories vary in breast cancer patients. As for fatigue management, great attention should be paid to patients with low education, low family income, and anthracycline chemotherapy. For pain management, close attention should be paid to younger, solitary, and paclitaxel chemotherapy patients; For anxiety management, attention should be paid to younger patients with premenopausal menstruation and regular monthly menstruation patients, and those with stage II disease. In managing depression, attention should be paid to younger and solitary patients.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6589-6589
Author(s):  
Alexandre Chan ◽  
Yu Lee Foo ◽  
Maung Shwe Ham Guo ◽  
Yuan Chuan Kee ◽  
Yee Pin Tan ◽  
...  

6589 Background: Establishing the Minimal Clinically Important Difference (MCID) is essential for interpreting the clinical relevance of patient reported outcomes. This is the first study to date to determine the MCID of FACT-Cog, a 37-item validated subjective neuropsychological instrument designed to evaluate cancer patients’ perceived cognitive deterioration on their quality of life. Methods: This prospective, observational study involved 220 breast cancer patients who have completed FACT-Cog and EORTC-QLQ-C30 at two time points: baseline and at least 3 months following chemotherapy. The MCID was computed using 3 approaches: 1) an anchor-based approach utilized the validated EORTC-QLQ-C30-Cognitive Functioning scale (CF) as the anchor for patients who showed a minimal deterioration on the CF (defined as a one-step deterioration on the CF scale); 2) a Receiver Operating Characteristic (ROC) curve was used to identify an optimal MCID cut-off point for deterioration; 3) a distribution-based approach utilized the 0.33 SD, 0.5 SD and one standard error of measurement (SEM) of the total FACT-Cog score (148 points) to estimate the MCID. Results: There was moderate correlation between the mean change scores of FACT-Cog and CF (rp= 0.43, p<0.001). The CF-anchored MCID was 9.6 points (95% CI 4.4 - 14.8). MCID derived from the ROC method was 7.5 points (AUC: 0.75; sensitivity: 75.6%; specificity: 68.8%). Using the distribution-based approach, MCID corresponding to effect sizes of 0.33SD to 0.5SD of the total FACT-Cog score ranged from 6.9 – 10.3 points and one-SEM criterion resulted in a MCID estimate of 10.6 points. Combining results from all approaches, the MCID identified for FACT-Cog ranged from 6.9 – 10.6 points (4.7% to 7.2% of total score). Conclusions: A 6.9 to 10.6 points reduction of the FACT-Cog score corresponds to the smallest clinically-relevant perceived cognitive deterioration. These estimates are important as they can facilitate the interpretation of patient-reported cognitive changes and sample size estimation in future studies.


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