Using health-related quality of life and treatment measures to predict 10-year mortality in older survivors of early stage breast cancer.

e21548 Background: Older women make up the growing majority of breast cancer (BC) survivors. Guideline BC treatments are known contributors to long-term survival, and health-related quality of life (HRQOL) is emerging as not only an important outcome in survivorship care but also as a factor thought to influence mortality. However, prognostic models that include HRQOL alongside BC treatment measures are lacking. We aimed to develop a 10-year mortality risk score based on a priori chosen treatment and HRQOL variables. Methods: We studied 660 women ≥65-years old diagnosed with stage I-IIIA primary breast cancer in years 1997-1999. Data from medical and psychosocial domains were collected over 10 years from interviews, medical records, and death indexes. BC treatment variables included receipt of definitive locoregional surgery +/- radiation, chemotherapy, and tamoxifen. HRQOL variables included physical function [10-item Physical Function Index (PFI-10) from the Medical Outcomes Study Short Form-36 (MOS SF-36)]; mental health [5-item Mental Health Index (MHI-5) from the MOS SF-36]; and social support [8-item modified MOS Social Support Scale (mMOS-SSS)]. We used penalized logistic regression models to develop a 10-year mortality risk score, and investigated its discrimination (c-statistic) and calibration (observed versus predicted mortality using the Hosmer-Lemeshow (HL) test). Results: Mortality though 10-years of follow-up was 34.8% (230 of 660 women). The c-statistic of a risk score using only age, number of comorbidities, stage of BC, and BC treatment was 0.71. The c-statistic increased to 0.74 with the addition of HRQOL measures and showed good calibration (p = 0.72 from HL test). Physical function and mental health had strong independent associations with mortality (women with high PFI-10: OR 0.63, 95% CI 0.43, 0.92; women with high MHI-5: OR 0.57, 95% CI 0.39, 0.85). Conclusions: In older early stage breast cancer survivors, our risk score combining HRQOL with treatment measures showed good discrimination and calibration. HRQOL is independently associated with 10-year mortality and adds predictive ability to age, comorbidity, stage of BC, and BC treatment.

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Health-related quality of life of early-stage breast cancer patients after different radiotherapy regimens

Breast Cancer Research and Treatment ◽

10.1007/s10549-021-06314-4 ◽

2021 ◽

Author(s):

Daphne H. M. Jacobs ◽

Ramona K. Charaghvandi ◽

Nanda Horeweg ◽

John H. Maduro ◽

Gabrielle Speijer ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Early Stage ◽

Early Stage Breast Cancer ◽

Breast Irradiation ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Over Time

Abstract Purpose To evaluate and compare health-related quality of life (HRQL) of women with early-stage breast cancer (BC) treated with different radiotherapy (RT) regimens. Methods Data were collected from five prospective cohorts of BC patients treated with breast-conserving surgery and different RT regimens: intraoperative RT (IORT, 1 × 23.3 Gy; n = 267), external beam accelerated partial breast irradiation (EB-APBI, 10 × 3.85 Gy; n = 206), hypofractionated whole breast irradiation(hypo-WBI, 16 × 2.67 Gy; n = 375), hypo-WBI + boost(hypo-WBI-B, 21–26 × 2.67 Gy; n = 189), and simultaneous WBI + boost(WBI-B, 28 × 2.3 Gy; n = 475). Women ≥ 60 years with invasive/in situ carcinoma ≤ 30 mm, cN0 and pN0-1a were included. Validated EORTC QLQ-C30/BR23 questionnaires were used to asses HRQL. Multivariable linear regression models adjusted for confounding (age, comorbidity, pT, locoregional treatment, systemic therapy) were used to compare the impact of the RT regimens on HRQL at 12 and 24 months. Differences in HRQL over time (3–24 months) were evaluated using linear mixed models. Results There were no significant differences in HRQL at 12 months between groups except for breast symptoms which were better after IORT and EB-APBI compared to hypo-WBI at 12 months (p < 0.001). Over time, breast symptoms, fatigue, global health status and role functioning were significantly better after IORT and EB-APBI than hypo-WBI. At 24 months, HRQL was comparable in all groups. Conclusion In women with early-stage breast cancer, the radiotherapy regimen did not substantially influence long-term HRQL with the exception of breast symptoms. Breast symptoms are more common after WBI than after IORT or EB-APBI and improve slowly until no significant difference remains at 2 years posttreatment.

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Investigating Associations Between Health-Related Quality of Life and Endocrine Therapy Underuse in Women With Early-Stage Breast Cancer

Journal of Oncology Practice ◽

10.1200/jop.2016.018630 ◽

2017 ◽

Vol 13 (5) ◽

pp. e463-e473 ◽

Cited By ~ 3

Author(s):

Laura C. Pinheiro ◽

Stephanie B. Wheeler ◽

Katherine E. Reeder-Hayes ◽

Cleo A. Samuel ◽

Andrew F. Olshan ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Endocrine Therapy ◽

Early Stage ◽

Health Related Quality ◽

Logistic Regression Models ◽

Increased Risk ◽

Related Quality ◽

Health Related

Purpose: Endocrine therapy (ET) underuse puts women at increased risk for breast cancer (BC) recurrence. Our objective was to determine if health-related quality of life (HRQOL) subgroups were associated with underuse. Methods: Data came from the third phase of the Carolina Breast Cancer Study. We included 1,599 women with hormone receptor–positive BC age 20 to 74 years. HRQOL was measured, on average, 5 months postdiagnosis. Subgroups were derived using latent profile (LP) analysis. Underuse was defined as not initiating or adhering to ET by 36 months postdiagnosis. Multivariable logistic regression models estimated adjusted odds ratios (ORs) between HRQOL LPs and underuse. The best HRQOL LP was the reference. Chemotherapy- and race-stratified models were estimated, separately. Results: Initiation analyses included 953 women who had not begun ET by their 5-month survey. Of these, 154 never initiated ET. Adherence analyses included 1,114 ET initiators, of whom 211 were nonadherent. HRQOL was not significantly associated with noninitiation, except among nonchemotherapy users, with membership in the poorest LP associated with increased odds of noninitiation (adjusted OR, 5.5; 95% CI, 1.7 to 17.4). Membership in the poorest LPs was associated with nonadherence (LP1: adjusted OR, 2.2; 95% CI, 1.2 to 4.0 and LP2: adjusted OR,1.9; 95% CI, 1.1 to 3.6). Membership in the poorest LP was associated with nonadherence among nonchemotherapy users (adjusted OR, 2.1; 95% CI, 1.2 to 5.1). Conclusion: Our results suggest women with poor HRQOL during active treatment may be at increased risk for ET underuse. Focusing on HRQOL, a modifiable factor, may improve targeting of future interventions early in the BC continuum to improve ET initiation and adherence and prevent BC recurrence.

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Association of p-phenylenediamine exposure with alterations of pulmonary function, pruritus and health-related quality of life in hair dye manufacturer workers: a cross-sectional study

10.21203/rs.3.rs-19200/v1 ◽

2020 ◽

Author(s):

ming zhang ◽

Lin Fan ◽

Meibian Zhang ◽

Baofeng Liu ◽

Qiang Zeng

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Pulmonary Function ◽

Exposed Group ◽

Health Related Quality ◽

Hair Dye ◽

Sf 36 ◽

Related Quality ◽

Health Related

Abstract Background p -Phenylenediamine (PPD) is a common component of hair dye, indicating the clinical characteristics of skin contact allergy and asthma with impaired pulmonary function. Howerver the adverse effects of PPD occupational exposure was rarely mentioned. The purpose of this study was to explore the PPD-induced pulmonary function, pruritus and health-related quality of life (HRQOL) of industrial workers of hair dye. Methods We recruited 124 workers from a hair dye manufacturer exposed to PPD. Individual PPD exposure and pulmonary function of workers were measured. The quality of life and subjective pruritus of workers was also assessed by SF-36 and VAS of pruritus, respectively. Results In the high PPD-exposed group, FVC% (percentage of forced vital capacity) was higher, while FEV1/FVC% (ratio percentage of forced expiratory volume) was lower than that in the low PPD-exposed group ( P <0.05). In terms of the HRQOL, the scores of mental health and vitality of the high PPD-exposed group were the lowest of all groups ( P <0.05), while the score of VAS was significantly higher than that of other two groups ( P <0.001). PPD levels were negatively correlated with vitality and mental health ( P <0.01). Higher PPD exposure level was correlated with a significantly higher VAS level (OR 9.394; 95%CI: 1.710, 51.622; P =0.010). The structural equation model provided a good fit to the data (χ2/df =1.607, GFI =0.901, AGFI =0.934, RMSEA =0.007, IFI =0.977, CFI =0.960, PGFI =0.615). And showed that PPD exposed level have positive effects on VAS level (β = 0.213, P <0.001). Then PPD exposed level partly via lack total score of SF-36 (β = -0.465, P =0.002); on negative effects on VAR level (β = -0.110, P <0.001). Conclusion Occupational PPD exposure might be associated with pulmonary function impairment, poor HRQOL, and subjective pruritus of workers.

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Multiple Predictors of Health-Related Quality of Life in Early Stage Breast Cancer. Data from a Year Follow-up Study Compared with the General Population

Quality of Life Research ◽

10.1007/s11136-005-4344-z ◽

2005 ◽

Vol 14 (8) ◽

pp. 1813-1823 ◽

Cited By ~ 110

Author(s):

Inger Schou ◽

Øivind Ekeberg ◽

Leif Sandvik ◽

Marianne J. Hjermstad ◽

Cornelia M. Ruland

Keyword(s):

Breast Cancer ◽

Early Stage ◽

Health Related Quality ◽

Breast Cancer Data ◽

Cancer Data ◽

Follow Up Study ◽

Related Quality ◽

Health Related

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Health related quality of life of survivors of trauma six months after discharge

South African Journal of Physiotherapy ◽

10.4102/sajp.v69i1.366 ◽

2013 ◽

Vol 69 (1) ◽

Cited By ~ 4

Author(s):

J. Schneiderman ◽

H. Van Aswegen ◽

P. Becker

Keyword(s):

Quality Of Life ◽

Physical Function ◽

General Health ◽

Mental Component Summary Score ◽

Trauma Survivors ◽

Health Related Quality ◽

Sf 36 ◽

Related Quality ◽

Health Related

To investigate the health-related quality of life (HRQOL) of survivors of major trauma at six months following discharge, using two popular HRQOL tools. A cross-sectional study was done on adult trauma survivors in Johannesburg. Subjects completed the EQ-5D and SF-36 HRQOL questionnaires. Additional demographic and clinical data were collected. The majority of subjects reported some problems in usual activities and pain/discomfort as measured with the EQ-5D at six months. The mean EQ-5D VAS was 68 (±26.1). lowest scores were reported in the role physical (44.6 ± 41.6) and role emotional (44.1 ± 45.4) domains of the SF-36. mean SF-36 physical component summary (PCS) score (62.1 ± 27.8) was higher than mental component summary score (58.7 ±20.1). EQ-5D VAS was found to be moderately correlated with age (r=-0.4; p=0.05). A negative correlation was found between SF-36 physical function score and ICU length of stay (LOS), hospital LOS and age (r=-0.4 (p=0.03), -0.4 (p=0.03) and -0.6 (p=0.00) respectively). Statistical significance was observed in the correlation between age and SF-36 general health domain (r=-0.4; p=0.02) as well as age and PCS score (r=-0.5; p=0.01). Trauma survivors in Johannesburg experience limitations in specific emotional and physical domains of HRQOL at six months after discharge. Age was associated with the level of self-rated health as well as limitations in general health and physical function. ICU and hospital LOS were associated with limitations in physical function. There is a need for physical and psychological rehabilitation after discharge from trauma intensive care.

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