晚期转移性乳腺癌患者在临床实践中接受化疗、激素治疗或抗 HER2 治疗期间的生活质量。
Quality of life during chemotherapy, hormonotherapy or antiHER2 therapy of patients with advanced, metastatic breast cancer in clinical practice.
机构信息
Pomeranian Oncology Center, Gdynia, Poland.
Department of Oncology, Pomeranian Hospitals in Wejherowo, Powstania Styczniowego 1, Gdynia, Poland.
出版信息
Health Qual Life Outcomes. 2020 May 12;18(1):134. doi: 10.1186/s12955-020-01389-x.
INTRODUCTION
Breast cancer is one of the most important health problems in the world. In recent years, this cancer has achieved a reduction in mortality, which is attributed to the introduction of mass screening and greater efficacy of post-operative treatment. Many patients with breast cancer have indications only for palliative therapy, but the impact of these methods on the quality of life of patients remains a subject of controversy. It remains unknown whether the progress in improving the quality of life in clinical trials also applies to patients treated as part of daily clinical practice. Data on the results of the impact of conducted therapies on the quality of life outside of clinical trials are scarce.
METHODS
The results of palliative chemotherapy and first-line hormonotherapy in 351 patients with advanced, metastatic breast cancer treated in the period from January 2010 to December 2016 in two centres were analysed.
RESULTS
The average age of patients was 62 ± 9.8 years; 139 patients received chemotherapy, 91 - therapy containing trastuzumab, and 121 - hormone therapy. A partial response was obtained in 111 patients (32%), stabilization in 150 (43%), and in 90 patients (26%) progression. Median survival time in the whole group of patients was 36 months. Chemotherapy compared to trastuzumab and hormonotherapy was associated with greater total toxicity (p = 0.03). There was a significant relationship between the type of therapy (hormonotherapy, chemotherapy, targeted therapy) and the general average quality of women's life measured with the EORC-QLQ-C30 questionnaire. In addition, a statistically significant difference was found in some somatic complaints (the scale of QLQ-BR23 symptoms) depending on the type of therapy performed. The lowest intensity of complaints was reported by patients during hormonotherapy, then during targeted therapy, and the largest during chemotherapy.
CONCLUSIONS
There is no effect of chemotherapy on the overall quality of life. Hormone therapy and trastuzumab therapy improved the quality of life of the treated patients in clinical practice.
简介
乳腺癌是全球最重要的健康问题之一。近年来，由于采用了大规模筛查和提高术后治疗效果，乳腺癌死亡率有所下降。许多乳腺癌患者仅需要姑息治疗，但这些方法对患者生活质量的影响仍存在争议。目前尚不清楚临床试验中提高生活质量的进展是否也适用于作为日常临床实践一部分接受治疗的患者。关于临床试验之外进行的治疗对生活质量影响的结果数据稀缺。
方法
分析了 2010 年 1 月至 2016 年 12 月期间在两个中心接受晚期转移性乳腺癌姑息化疗和一线激素治疗的 351 例患者的结果。
结果
患者的平均年龄为 62±9.8 岁；139 例患者接受化疗，91 例接受曲妥珠单抗治疗，121 例接受激素治疗。111 例（32%）患者获得部分缓解，150 例（43%）患者疾病稳定，90 例（26%）患者疾病进展。全组患者的中位生存时间为 36 个月。与曲妥珠单抗和激素治疗相比，化疗的总毒性更大（p=0.03）。治疗方法（激素治疗、化疗、靶向治疗）与 EORC-QLQ-C30 问卷测量的女性生活质量总体平均分之间存在显著关系。此外，根据所进行的治疗方法，在某些躯体抱怨（QLQ-BR23 症状量表）方面发现了具有统计学意义的差异。接受激素治疗的患者报告的抱怨强度最低，其次是接受靶向治疗的患者，接受化疗的患者抱怨强度最大。
结论
化疗对总体生活质量没有影响。激素治疗和曲妥珠单抗治疗改善了临床实践中接受治疗的患者的生活质量。
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