Julie Lemieux, Centre Hospitalier Universitaire de Québec, Quebec City, Quebec; Michael D. Brundage, Cancer Centre of Southeastern Ontario at Kingston General Hospital; Wendy R. Parulekar, Kate Whelan, and Dongsheng Tu, Canadian Cancer Trials Group, Kingston; Kathleen I. Pritchard, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto; Timothy J. Whelan, McMaster University and Juravinski Cancer Centre at Hamilton Health Sciences, Hamilton, Ontario, Canada; Paul E. Goss, Massachusetts General Hospital Cancer Center, Boston, MA; James N. Ingle, North Central Cancer Treatment Group, Mayo Clinic, Rochester, NY; Paul Celano; Greater Baltimore Medical Center, Baltimore, MD; Hyman Muss, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Julie Gralow, University of Washington, Seattle, WA; and Kathrin Strasser-Weippl, Wilhelminen Hospital, Vienna, Austria.
J Clin Oncol. 2018 Feb 20;36(6):563-571. doi: 10.1200/JCO.2017.75.7500. Epub 2018 Jan 12.
Purpose MA.17R was a Canadian Cancer Trials Group-led phase III randomized controlled trial comparing letrozole to placebo after 5 years of aromatase inhibitor as adjuvant therapy for hormone receptor-positive breast cancer. Quality of life (QOL) was a secondary outcome measure of the study, and here, we report the results of these analyses. Methods QOL was measured using the Short Form-36 (SF-36; two summary scores and eight domains) and menopause-specific QOL (MENQOL; four symptom domains) at baseline and every 12 months up to 60 months. QOL assessment was mandatory for Canadian Cancer Trials Group centers but optional for centers in other groups. Mean change scores from baseline were calculated. Results One thousand nine hundred eighteen women were randomly assigned, and 1,428 women completed the baseline QOL assessment. Compliance with QOL measures was > 85%. Baseline summary scores for the SF-36 physical component summary (47.5 for letrozole and 47.9 for placebo) and mental component summary (55.5 for letrozole and 54.8 for placebo) were close to the population norms of 50. No differences were seen between groups in mean change scores for the SF-36 physical and mental component summaries and the other eight QOL domains except for the role-physical subscale. No difference was found in any of the four domains of the MENQOL Conclusion No clinically significant differences were seen in overall QOL measured by the SF-36 summary measures and MENQOL between the letrozole and placebo groups. The data indicate that continuation of aromatase inhibitor therapy after 5 years of prior treatment in the trial population was not associated with a deterioration of overall QOL.
目的 MA.17R 是加拿大癌症研究组进行的一项 III 期随机对照试验,比较了来曲唑与安慰剂在芳香化酶抑制剂辅助治疗激素受体阳性乳腺癌 5 年后的疗效。生活质量(QOL)是该研究的次要终点,在此报告这些分析的结果。方法 使用简明健康状况调查问卷(SF-36;两个综合评分和八个领域)和绝经特异性生活质量问卷(MENQOL;四个症状领域)在基线和 60 个月内每 12 个月测量一次 QOL。加拿大癌症研究组中心的 QOL 评估是强制性的,而其他组的中心则是可选的。从基线计算 QOL 评估的平均变化分数。结果 1918 名女性被随机分配,其中 1428 名女性完成了基线 QOL 评估。QOL 测量的依从性>85%。SF-36 生理成分综合评分(来曲唑组为 47.5,安慰剂组为 47.9)和心理成分综合评分(来曲唑组为 55.5,安慰剂组为 54.8)的基线汇总评分接近 50 的人群正常值。在 SF-36 生理和心理成分综合评分以及其他八个 QOL 领域的平均变化评分方面,两组之间没有差异,除了角色身体子量表。在 MENQOL 的四个领域中,也没有发现差异。结论在 SF-36 综合评分和 MENQOL 测量的整体 QOL 方面,来曲唑组和安慰剂组之间没有观察到临床显著差异。数据表明,在试验人群中,在接受芳香化酶抑制剂治疗 5 年后继续使用该抑制剂不会导致整体 QOL 恶化。