Quality of life after preoperative radio-/chemotherapy in locally advanced breast cancer patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12083-e12083 ◽  
Author(s):  
Christiane Matuschek ◽  
Carolin Nestle-Kraemling ◽  
Sylvia Wollandt ◽  
Vanessa Speer ◽  
Edwin Boelke ◽  
...  

e12083 Background: Preoperative radiotherapy and chemoradiotherapy (PRT/PCRT) represents an increasingly used clinical strategy in different tumor sites. However, concerns regarding a possible unfavorable influence on the clinical outcome still exist. The aim of the current study was to examine the long-term global health status in our series of LABC patients treated with PRT/PCRT followed by breast-conserving surgery (BCS) or mastectomy (ME). Methods: Of the 315 patients treated with PRT/PCRT in the years 1991 and 1999, 203 patients were still alive at long-term follow up of mean 17.7 years (range 14-21). Thirty-seven patients were lost to follow up and 58 patients refused to be contacted, which resulted in 107 patients (64 patients after BCS and 43 after mastectomy) being available and willing to undergo further clinical assessment. PRT/PCRT consisted of external beam radiation therapy (EBRT) with 50 Gy (5 × 2 Gy/week) to the breast and the supra-/ infraclavicular lymph nodes combined with a consecutive electron boost or (in case of BCS) a 10-Gy interstitial brachytherapy boost with Ir-192 prior to EBRT. Overall, chemotherapy was administered either prior to RT or concomitantly in the majority of patients. Quality of life (QoL) was assessed by EORTC QLQ-C30 questionnaires for overall QoL and EORTC QLQ-BR23 for breast-specific QoL. Results are reported using functional scales (body image, sexual functioning, sexual enjoyment, and future perspective) and symptom-related items (systemic therapy side effects, breast symptoms, arm symptoms, and upset by hair loss). The results were compared to a published reference cohort of n=2028 healthy adults (16-92 years), including n=1139 women (age 16-92 years). EORTC QLQ-C30 functional scales were also analyzed between different subgroups including an age-matched analysis with a two sided paired t-test. Results: In comparison with this healthy control group of 1139 women, we did not detect any significant differences for the functional scales measured by physical function, emotional well-being, cognitive, and social function as well as the symptom scales: fatigue, nausea, vomiting, pain, diarrhea and financial difficulties for both groups. However, significant inferior scores were found in the present study group regarding obstipation (p=0.013), loss of appetite (0.038), sleeping disorder (p=0.01) and dyspnoe (p=0.01). Conclusions: Taken together, retrospective as well as prospective data underline the feasibility of preoperative radiotherapy in breast cancer.

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2268-2268
Author(s):  
Sylvia Faict ◽  
Nathan De Beule ◽  
Ann De Becker ◽  
Karel Fostier ◽  
Fabienne Trullemans ◽  
...  

Abstract Background Autologous stem cell transplantation (ASCT) is a frequent treatment option for various types of lymphoma. Few studies have addressed the occurrence of long-term morbidity and the quality of life (QoL) after ASCT. We analysed the overall survival (OS), the QoL and the impact of comorbidities before and after transplant in a consecutive cohort of lymphoma patients. Methods Patients transplanted in our center between 2003 and 2013 and with a minimum follow-up of 1 year were included. Survival was analysed by Kaplan-Meier methodology and the impact of prognostic factors was examined by standard multivariate analysis. Patients were inquired to complete the Self-reported Comorbidity Questionnaire (SCQ) as well as the EORTC QLQ-C30. Results of questionnaires were compared to a healthy reference population. Results A total of 85 lymphoma patients were identified with a median follow-up period of 76 months. The estimated OS probability was 62,7% (S.E. 5,5%) at 5 years and 60,8% (S.E. 5,6%) at 10,9 years. Indicators of a poor prognosis at time of transplantation were: age ≥ 60 years, high-intermediate to high-risk IPI for NHL and HCT-comorbidity index ≥ 3. Of long-term (> 1 year) survivors 40 completed the EORTC QLQ-C30. They experienced lower cognitive and social functioning and reported more fatigue, dyspnea and financial difficulties, when compared to the reference population. A small proportion of patients reported significant complaints related to pain (22,5%) and fatigue (10%). Very long-term survivors (over 5 years post ASCT) had a better physical and role functioning, with less fatigue, dyspnea, insomnia and loss of appetite as compared to patients who were transplanted more recently. Patients with more self-reported comorbidities post-ASCT did significantly worse in terms of QoL after transplantation. They experienced worse physical, role, cognitive and social functioning, and had more complaints about fatigue, pain, dyspnea, diarrhea and insomnia. Conclusion The presence of comorbidities pre-ASCT, as determined by HCT-CI >3, was associated with a worse OS. Surprisingly, the overall long-term impact of ASCT on the QOL was limited with adverse effects only related to cognitive and social functions. These negative consequences also decreased over time. Finally, the occurrence of comorbidities after transplantation was associated with worse QoL. Disclosures No relevant conflicts of interest to declare.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3808-3808
Author(s):  
Silke Andresen ◽  
Juliane Brandt ◽  
Sascha Dietrich ◽  
Marie-Luise Memmer ◽  
Anthony D. Ho ◽  
...  

Abstract Abstract 3808 Introduction: High-dose chemotherapy (HDCT) followed by peripheral blood stem cell transplantation (PBSCT) is frequently applied in eligible patients with relapsed or refractory follicular lymphoma (FL). The toxicity of HDCT, however, might manifest itself in the respective patients' reduced quality of life (QoL). In this study we investigated the QoL of long term survivors after HDCT in comparison with patients after conventional chemotherapy and the healthy German population. Patients and Methods: QoL was evaluated with the standardized questionnaires EORTC QLQ-C30 and EQ-5D. A total of 124 patients with FL were included in the study. 63 patients (29 female) with a median age of 60.4 (range 41–80) received HDCT with PBSCT between 1992 and 2002. This group was compared with 61 patients (38 female) with a median age of 62.9, range 31–81) who were treated with Rituxmab and CHOP chemotherapy and supplementary radiation in our institution. 55 patients of 63 (88%) of the HDCT group and 25 of 61 (41%) patients of the conventional group were in continuous complete remission (CR). Median follow-up for the HDCT group is 9 years and for the conventional chemotherapy group it is 4.4 years. In addition, QoL of the patients was compared to QoL of healthy people on the basis of two studies about the general health status of the German population (R. Schwarz and A. Hinz: “Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population,” European Journal of Cancer 37 [2001]: 1345–1351; H. H. König et al.: “Health Status of the German Population: Results of a Representative Survey Using the EuroQoL Questionnaire,” Gesundheitswesen 67 [2005]: 173–182). Results: In the HDCT group, the results of the questionnaires show a reduced QoL compared to the healthy population. Regarding the three main categories of the EORTC QLQ-C30, the mean sum score for global health state (ghs) is 71.38, for functional state (fs) 78.38 and for symptomatic state (ss) 18.60 (the ideal score being 100.00 for the first two items and 0.00 for the latter). The mean value for EQ-5D is 0.911 (ideal value: 1.000) and that for VAS is 75.52 (ideal value: 100.00). The one sample t-test evaluation shows that the decrease in QoL is significant with p<0.05 in four of five of the subcategories of the functional state; six of the nine subcategories of the symptomatic state, namely fatigue, dyspnoea, insomnia, constipation, diarrhoea and financial difficulties. Patients who received conventional chemotherapy (ghs: 67.04; fs: 70.49; ss: 25.01) also showed a reduced QoL compared to the healthy population in all of the three main categories of the EORTC-QLQ-C30, in particular in the category of functional and symptomatic state. These differences were statistically significant in all subcategories of the functional state namely physical,-role,-emotional,-cognitive,- and social functioning (p=0.001). The differences of the symptomatic state were statistically significant in seven of nine subcategories, namely fatigue, pain, dyspnoea, insomnia, constipation, diarrhea and financial difficulties. When QoL of the HDCT group and the conventional therapy group were compared, there were significant differences in favor of the HDCT group only in the functional subcategory social functioning (p=0.04) and the symptomatic subcategory pain (p=0.01), with no significant differences in all other categories. In the EQ-5D questionnaire, we found a reduced QoL in patients after conventional chemotherapy compared to HDCT patients (p=0.05) and healthy people (p=0.02). Conclusions: In this long term follow up study, we found a reduced QoL in FL patients after conventional chemotherapy as well as after HDCT compared to the healthy population. There was a tendency of a better QoL in patients of the HDCT group compared to patients of the conventional chemotherapy group, maybe due to a higher proportion of patients in CR or a longer follow up period in the HDCT group. We conclude that the negative impact of both HDCT and conventional therapy on QoL of patients with follicular lymphoma should not be underestimated and should lead to the development of less toxic therapy strategies. Disclosures: No relevant conflicts of interest to declare.


2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
E Jezerskyte ◽  
L M Saadeh ◽  
E R C Hagens ◽  
M A G Sprangers ◽  
L Noteboom ◽  
...  

Abstract Aim The aim of this study was to evaluate long-term HR-QoL in patients undergoing transhiatal versus transthoracic esophagectomy in a tertiary referral center. Background & Methods Treatment of esophageal cancers is challenging. Besides (neo)adjuvant chemo(radio)therapy different surgical approaches are possible such as transhiatal (THE) or transthoracic esophagectomy (TTE) with a cervical or intrathoracic anastomosis. Studies have been performed to establish evidence which is the preferred procedure in terms of postoperative morbidity, survival and short- and long-term health-related quality of life (HR-QoL). All patients after THE or TTE for distal esophageal or gastroesophageal junction carcinoma performed between 2003 and 2016 received EORTC QLQ-C30 and EORTC QLQ-OG25 questionnaires. All questionnaires with a follow-up of more than two years after surgery were analysed. Three HR-QoL domains were chosen as primary endpoints: problems with eating, reflux and nausea and vomiting. The secondary endpoints were the remaining HR-QoL domains, postoperative complications and pathology results. The results were corrected for possible confounders such as age and gender. Results The questionnaire response rate was 47.6%, with 56 patients in the THE group and 134 in the TTE group. The mean age was 63.5 years and a median follow-up of 3.7 years (range 24-137 months) was reached. No significant difference was found in any of the HR-QoL domains or postoperative complications between the two groups. Significantly more lymph nodes were resected in the TTE group (p<0.001). No difference was found in the lymph node metastases or radicality of surgery between the two groups. Conclusion After a long follow-up of more than two years no differences in HR-QoL or postoperative complications were found between patients with distal esophageal or gastroesophageal junction carcinoma undergoing THE or TTE esophagectomy. Based on this study we conclude that long-term quality of life should not influence the decision making for surgical approach between THE and TTE esophagectomy.


2020 ◽  
Vol 66 (1) ◽  
Author(s):  
Monique Binotto ◽  
Gilberto Schwartsmann

Introdução: O câncer de mama pode alterar a qualidade de vida relacionada à saúde das pacientes. Objetivo: Compreender o impacto da quimioterapia para câncer de mama na qualidade de vida relacionada à saúde de pacientes. Método: Trata-se de uma revisão integrativa da literatura, compreendendo artigos publicados entre 2007 e 2019, disponíveis nas bases de dados PubMed, LILACS e SciELO. Analisaram-se 25 artigos na íntegra. Resultados: Os questionários mais frequentemente utilizados nos estudos foram o European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) e o módulo complementar European Organization for Research and Treatment of Cancer Breast Cancer-specific Quality of Life Questionnaire (EORTC QLQ-BR23). Em relação às alterações da qualidade de vida, a saúde global diminui durante a quimioterapia, mas pode melhorar após o término do tratamento. O aumento dos sintomas é relatado em diversos estudos e prejudicou a qualidade de vida relacionada à saúde das pacientes. Entretanto, os sintomas diminuem após o término da quimioterapia, exceto para algumas escalas. As escalas de imagem corporal, função sexual e funcionamento físico pioram ao longo do tratamento. A qualidade de vida mental/psicológica tem oscilações durante o tratamento, assim como a escala sobre as relações sociais. Conclusão: A qualidade de vida relacionada à saúde de mulheres com câncer de mama é afetada negativamente pelo tratamento quimioterápico, expressando maior impacto nas escalas de sintomas.


2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii12-ii13
Author(s):  
S M Keshwara ◽  
A I Islim ◽  
C P Millward ◽  
C S Gillespie ◽  
G E Richardson ◽  
...  

Abstract BACKGROUND Long-term Health-Related Quality of Life (HRQoL) is an important measure of patient wellbeing. There is a paucity of studies evaluating HRQoL in meningioma patients. MATERIAL AND METHODS Cross-sectional study of adult patients with an incidental or symptomatic intracranial meningioma. Patients with less than 5 years of follow-up, a history of craniospinal radiation or neurofibromatosis type 2 were excluded. HRQoL was evaluated with SF-36, EORTC QLQ-C30 and EORTC QLQ-BN20 questionnaires. Outcome determinants were evaluated using a multi-variable linear regression analysis, adjusted for patient, tumour and treatment characteristics, and duration of follow-up. RESULTS 699 patients were invited to participate and 246 responded: 118 (48%) had an incidental meningioma. Mean age at diagnosis was 56.8 years (SD=13) and 81% were female. Median time from diagnosis to completion of questionnaire was 8.5 years (IQR 6.8–11.5). During follow-up, 158 patients (64.2%) had at least one operation for their meningioma and 47 patients (19.1%) had radiotherapy. Of those operated, 126 (79.7%) had WHO grade 1 and 24 (15.2%) had grade 2 meningiomas. Compared to normative population values, meningioma patients reported a worse SF-36 general health score (mean 61.9 vs 56.5, P=0.003) but a similar QLQ-C30 global health score (mean 62.3 vs 65.8, P=0.039), worse SF-36 and QLQ-C30 physical functioning scores (mean 74.1 vs 64.6, P&lt;0.001 and mean 81.8 vs 76.5, P=0.007) and similar SF-36 and QLQ-C30 emotional health scores (mean 72.2 vs 70.9, P=0.367 and mean 71.0 vs 71.9, P=0.960). QLQ-C30 cognitive functioning was worse (mean 80.5 vs 71.4, P&lt;0.001). Compared to the meningioma literature, QLQ-BN20 seizure burden was similar (mean 2.0 vs 1.6, P=0.760). A worse performance status at diagnosis was associated with an inferior QLQ-C30 global health score (β-coefficient=-4.9 [95% CI -9.1-(-)0.6] P=0.024). Number of surgeries was significantly associated with a worse QLQ-C30 cognitive functioning score (β-coefficient=-7.0 [95% CI -13.2-(-)0.9], P=0.025). Anti-epileptic drug use was associated with a significantly worse QLQ-C30 emotional health score (β-coefficient=-10.9 [95% CI -21.7-(-)0.01], P=0.050). CONCLUSION Meningioma patients have long-term HRQoL impairments affecting their physical and cognitive functions. An understanding that multiple surgeries affects cognitive function, and the need for anti-epileptic drugs equate to poorer emotional health, could help target appropriate therapies and support in the future.


2021 ◽  
Author(s):  
GanBin Li ◽  
Tao Yu ◽  
Hao-Yu Zhang ◽  
Zhen-Jun Wang ◽  
Guang-Hui Wei ◽  
...  

Abstract Background: Emergence surgery (ES) and self-expanding metallic stents (SEMS) are traditional approaches for complete obstructing left-sided colon cancer. A strategy of “stents-chemotherapy-surgery” was applied in our center recently. Studies assessing the anal function and quality of life of patients with complete obstructing left-sided colon cancer are still lacking.Methods: Patients with complete obstructing left-sided colon cancer were included, and three treatment strategies were used, including ES, SEMS, and SEMS followed by neoadjuvant chemotherapy (NAC) for patients with complete obstructing left-sided colon cancer. The Wexner, Vaizey, and low anterior resection syndrome (LARS) scores were used to assess anal function and the EORTC QLQ C30 score was used to assess quality of life. Logistic regression analysis was used to detect risk factors affecting short-term anal function of patients.RESULTS: The Wexner scores were similar among the groups during the follow-up period. The Vaizey (H=18.415, P=0.001) and LARS scores (H=3.660, P=0.04) both revealed that anal function among patients receiving SEMS and NACwas significantly better than patients who underwent ES at the 1-month post-operative follow-up evaluation; no significant difference existed at the 6- and 12-month follow-up evaluations. The EORTC QLQ C30 score revealed that social function of patients receiving SEMS and NAC was also significantly better than patients undergoing ES (H=7.035, P=0.03). Logistic regression analysis suggested that a one-stage stoma in an emergent setting is an independent risk factor for short-term reduction of anal function among patients with complete obstructing left-sided colon cancer (OR=5.238, 95% CI: 1.569~17.484, P=0.007).Conclusion: Compared to ES, SEMS might be able to improve the quality of life and short-term anal function in patients with complete obstructing left-sided colon cancer.


2014 ◽  
Vol 1 (1) ◽  
pp. 22 ◽  
Author(s):  
TanMay Leng ◽  
SeowGek Ching ◽  
DahlianaBinte Idris ◽  
TeoLee Wah ◽  
LohSoon Yue ◽  
...  

Author(s):  
Rieneke T. Lugtenberg ◽  
◽  
Stefanie de Groot ◽  
Ad A. Kaptein ◽  
Maarten J. Fischer ◽  
...  

Abstract Purpose In the phase II DIRECT study a fasting mimicking diet (FMD) improved the clinical response to neoadjuvant chemotherapy as compared to a regular diet. Quality of Life (QoL) and illness perceptions regarding the possible side effects of chemotherapy and the FMD were secondary outcomes of the trial. Methods 131 patients with HER2-negative stage II/III breast cancer were recruited, of whom 129 were randomly assigned (1:1) to receive either a fasting mimicking diet (FMD) or their regular diet for 3 days prior to and the day of neoadjuvant chemotherapy. The European Organisation for Research and Treatment of Cancer (EORTC) questionnaires EORTC-QLQ-C30 and EORTC-QLQ-BR23; the Brief Illness Perception Questionnaire (BIPQ) and the Distress Thermometer were used to assess these outcomes at baseline, halfway chemotherapy, before the last cycle of chemotherapy and 6 months after surgery. Results Overall QoL and distress scores declined during treatment in both arms and returned to baseline values 6 months after surgery. However, patients’ perceptions differed slightly over time. In particular, patients receiving the FMD were less concerned and had better understanding of the possible adverse effects of their treatment in comparison with patients on a regular diet. Per-protocol analyses yielded better emotional, physical, role, cognitive and social functioning scores as well as lower fatigue, nausea and insomnia symptom scores for patients adherent to the FMD in comparison with non-adherent patients and patients on their regular diet. Conclusions FMD as an adjunct to neoadjuvant chemotherapy appears to improve certain QoL and illness perception domains in patients with HER2-negative breast cancer. Trialregister ClinicalTrials.gov Identifier: NCT02126449.


2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Diriba Alemayehu Gadisa ◽  
Esayas Tadesse Gebremariam ◽  
Getnet Yimer Ali

Abstract Background Breast cancer is the most common cancer among women and it affects quality of life of those women. So far, the two most frequently used tools for assessing health related quality of life in breast cancer patients, EORTC QLQ-C30 and EORTC QLQ-BR23 modules, were not validated in Ethiopia. Hence, the present study aimed to assess the psychometric properties of the tools among Ethiopian breast cancer patients. Methods Institutional based longitudinal study was conducted from January 1 to May 1, 2017 GC at only nationwide oncology center, Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. A total of 146 patients who visited the facility during that period, with no missing quality of life data, were selected for analysis. The psychometric properties of the EORTC QLQ-C30 and EORTC QLQ-BR23 were evaluated in terms of reliability, convergent, divergent, construct and clinical validity using SPSS version 22. Results Satisfactory internal consistency reliability (Cronbach’s α coefficients > 0.7) was confirmed, except for cognitive function (α = 0.516) of EORTC QLQ-C30 and body image (α = 0.510) of EORTC QLQ-BR23. Multiple-trait scaling analysis demonstrated a good convergent and divergent validity. No scaling errors were observed. Most items in EORTC QLQ-BR23 possessed a weak or no correlation with its own dimension in EORTC QLQ-C30 (r < 0.4) except with some of symptom scales. A statistically significant chemotherapy induced quality of life scores changes (P ≤ 0.05) were observed in all dimensions of both instruments between baseline and the end of first cycle chemotherapy, except for body image (P = 0.985) and sexual enjoyment (P = 0.817) of EORTC QLQ-BR23, indicating clinical validity. Conclusion Amharic version of the EORTC QLQ-C30 and EORTC QLQ-BR23 modules are valid and adequately reliable tool and can be used for clinical and epidemiological cancer researches to study the health related quality of life (HRQoL) of women with breast cancer in Ethiopia.


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