Lambert-Obry V, Gouault-Laliberté A, Castonguay A, Zanotti G, Tran T, Mates M, Lemieux J, Chabot P, Prady C, Couture F, Lachaine J
PeriPharm Inc., Montreal, QC.
Pfizer Inc., New York, NY, U.S.A.
Curr Oncol. 2018 Aug;25(4):e282-e290. doi: 10.3747/co.25.3765. Epub 2018 Aug 14.
Advanced breast cancer (abc) represents a substantial burden for patients and caregivers. In the present study, we aimed to estimate quality of life (qol), utility, productivity loss, pain, health care resource utilization, and costs for patients with abc, and qol, utility, and productivity loss for their caregivers.
This multicentre prospective non-interventional study was conducted in Canada. Eligible participants were postmenopausal women with estrogen receptor-positive, her2-negative unresectable abc and their caregivers. Validated questionnaires were used to measure qol, utility, productivity loss, and pain. Patients and caregivers were classified into 4 health states typically used in oncology economic modelling: first-line progression-free (1l-pf), first-line progressive disease (1l-pd), second- or subsequent-line progression-free (≥2l-pf), and second- or subsequent-line progressive disease (≥2l-pd).
Most patients and caregivers accepted to participate, with total recruitment of 202 patients and 78 caregivers. Compared with patients in pf, patients in pd had lower mean qol scores (52.9 ± 29.9 for 1l-pd vs. 68.2 ± 23.2 for 1l-pf, and 54.0 ± 23.6 for ≥2l-pd vs. 66.0 ± 22.1 for ≥2l-pf), lower mean utility values (0.64 ± 0.22 for 1l-pd vs. 0.73 ± 0.20 for 1l-pf, and 0.65 ± 0.25 for ≥2l-pd vs. 0.74 ± 0.18 for ≥2l-pf), and greater productivity loss (39.4 ± 27.7 for 1l-pd vs. 27.5 ± 30.1 for 1l-pf, and 37.6 ± 29.2 for ≥2l-pd vs. 32.0 ± 29.0 for ≥2l-pf). Compared with caregivers of patients in pf, caregivers of patients in pd had lower qol scores and utility values, and greater productivity loss.
Study results indicate that, for patients and caregivers, pd health states are associated with a deterioration of qol and utility and a decrease in productivity in both 1l and ≥2l.
晚期乳腺癌(ABC)给患者及其照料者带来了沉重负担。在本研究中,我们旨在评估ABC患者的生活质量(QoL)、效用、生产力损失、疼痛、医疗资源利用和成本,以及其照料者的QoL、效用和生产力损失。
这项多中心前瞻性非干预性研究在加拿大进行。符合条件的参与者为绝经后雌激素受体阳性、人表皮生长因子受体2阴性不可切除ABC患者及其照料者。使用经过验证的问卷来测量QoL、效用、生产力损失和疼痛。患者和照料者被分为肿瘤学经济模型中通常使用的4种健康状态:一线无进展(1L-PF)、一线疾病进展(1L-PD)、二线或后续线无进展(≥2L-PF)和二线或后续线疾病进展(≥2L-PD)。
大多数患者和照料者同意参与,共招募了202名患者和78名照料者。与处于PF状态的患者相比,处于PD状态的患者平均QoL得分较低(1L-PD为52.9±29.9,1L-PF为68.2±23.2;≥2L-PD为54.0±23.6,≥2L-PF为66.0±22.1),平均效用值较低(1L-PD为0.64±0.22,1L-PF为0.73±0.20;≥2L-PD为0.65±0.25,≥2L-PF为0.74±0.18),生产力损失更大(1L-PD为39.4±27.7,1L-PF为27.5±30.1;≥2L-PD为37.6±29.2,≥2L-PF为32.0±29.0)。与处于PF状态患者的照料者相比,处于PD状态患者的照料者QoL得分和效用值较低,生产力损失更大。
研究结果表明,对于患者及其照料者而言,PD健康状态与1L和≥2L的QoL和效用恶化以及生产力下降相关。