Cao Ayong, Zhang Jin, Liu Xiaoan, Wu Weizhu, Liu Yinhua, Fan Zhimin, Zhang Anqin, Zhou Tianning, Fu Peifen, Wang Shu, Ouyang Quchang, Tang Jinhai, Jiang Hongchuan, Zhang Xiaohua, Pang Da, He Jianjun, Shi Linxiang, Wang Xianming, Sheng Yuan, Mao Dahua, Shao Zhimin
Department of Breast Surgery, Fudan University Shanghai Cancer Center, No. 270 Dongan Road, Xuhui District, Shanghai, 200032, China.
Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China.
Health Qual Life Outcomes. 2016 Mar 24;14:51. doi: 10.1186/s12955-016-0446-2.
Estimating quality of life (QoL) in patients with breast cancer is of importance in assessing treatment outcomes. Adjuvant endocrine therapy is widely used for hormone receptor-positive (HR+) early-stage breast cancer (EBC), and evidence suggests that aromatase inhibitors (AIs) may improve QoL for these patients. This study evaluated QoL in postmenopausal Chinese patients with HR+ EBC taking AIs.
This was a prospective, multicenter, and observational study that had no intent to intervene in the current treatment of recruited patients. Eligible patients were recruited within 7 days of beginning adjuvant treatment with AIs. The Functional Assessment of Cancer Therapy-Breast (FACT-B) scale was used to evaluate the patients' QoL. Data were collected at baseline and at 6, 12, 18, and 24 months.
From June 2010 to October 2013, a total of 494 patients with HR+ EBC were recruited from 21 centers. There was a 7.51-point increase in the patients' mean FACT-B trial outcome index (TOI), from 90.69 at baseline to 98.72 at 24 months (P < .0001). The mean TOI scores at baseline, 6, 12, and 18 months were 90.69, 94.36, 97.71, and 96.75, respectively (P < .0001, for all). The mean (FACT-B) emotional well-being subscale scores at baseline, 6, 12, 18, and 24 months were 16.32, 16.55, 17.34 (P < .0001), 17.47 (P < .0001), and 17.85 (P < .0001), respectively, and social well-being scores were 18.61, 19.14 (P < .04), 19.35 (P < .008), 18.32, and 18.40, respectively. In the mixed model, baseline TOI, clinical visits, prior chemotherapies, age group, and axillary lymph-node dissection presented statistically significant effects on the change of FACT-B TOI and FACT-B SWB, whereas only baseline TOI, clinical visits, and prior chemotherapies presented statistically significant effects on the change of FACT-B EWB. FACT-B TOI, being the most pertinent and precise indicator of patient-reported QoL, demonstrated significant changes reflecting clinical benefit of adjuvant AIs endocrine therapy in the QoL of HR + EBC patients.
The study demonstrated significant improvements in the long-term QoL of postmenopausal Chinese patients with HR+ EBC at 6, 12, 18, and 24 months after starting treatment with AIs. The current study indicates improved long-term QoL with AI adjuvant treatment, which will aid clinicians in optimizing treatment to yield effective healthcare outcomes.
Clinicaltrials.gov NCT01144572.
评估乳腺癌患者的生活质量(QoL)对于评估治疗效果至关重要。辅助内分泌治疗广泛应用于激素受体阳性(HR+)早期乳腺癌(EBC)患者,有证据表明芳香化酶抑制剂(AIs)可能改善这些患者的生活质量。本研究评估了服用AIs的绝经后中国HR+ EBC患者的生活质量。
这是一项前瞻性、多中心观察性研究,无意干预招募患者的当前治疗。符合条件的患者在开始使用AIs进行辅助治疗的7天内被招募。使用癌症治疗功能评估-乳腺癌(FACT-B)量表评估患者的生活质量。在基线以及6、12、18和24个月时收集数据。
2010年6月至2013年10月,共从21个中心招募了494例HR+ EBC患者。患者的平均FACT-B试验结果指数(TOI)增加了7.51分,从基线时的90.69增加到24个月时的98.72(P <.0001)。基线、6、12和18个月时的平均TOI得分分别为90.69、94.36、97.71和96.75(所有P <.0001)。基线、6、12、18和24个月时FACT-B情绪健康子量表的平均得分分别为16.32、16.55、17.34(P <.0001)、17.47(P <.0001)和17.85(P <.0001),社会健康得分分别为18.61、19.14(P <.04)、19.35(P <.008)、18.32和18.40。在混合模型中,基线TOI、临床就诊次数、既往化疗、年龄组和腋窝淋巴结清扫对FACT-B TOI和FACT-B社会健康状况(SWB)的变化有统计学显著影响,而只有基线TOI、临床就诊次数和既往化疗对FACT-B情绪健康状况(EWB)的变化有统计学显著影响。FACT-B TOI作为患者报告的生活质量最相关和精确的指标,显示出显著变化,反映了辅助AIs内分泌治疗对HR+ EBC患者生活质量的临床益处。
该研究表明,绝经后中国HR+ EBC患者在开始使用AIs治疗后的6、12、18和24个月,长期生活质量有显著改善。当前研究表明AI辅助治疗可改善长期生活质量,这将有助于临床医生优化治疗以产生有效的医疗保健结果。
Clinicaltrials.gov NCT01144572。