Nielsen Anders Winther Mølby, Kristensen Morten Horsholt, Offersen Birgitte Vrou, Alsner Jan, Zachariae Robert, Nielsen Hanne Melgaard
Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Department of Psychology and Behavioural Science, Aarhus University, Aarhus, Denmark.
Acta Oncol. 2021 Jan;60(1):78-86. doi: 10.1080/0284186X.2020.1834143. Epub 2020 Nov 4.
Survival rates for breast cancer (BC) are increasing, leading to growing interest in treatment-related late-effects. The aim of the present study was to explore late effects using Patient-Reported Outcome Measures in postmenopausal BC survivors in standard follow-up care. The results were compared to age- and gender-matched data from the general Danish population.
Postmenopausal BC survivors in routine follow-up care between April 2016 and February 2018 at the Department of Oncology, Aarhus University Hospital, Denmark were asked to complete the EORTC QLQ-C30 and BR23 questionnaires together with three items on neuropathy, myalgia, and arthralgia from the PRO-CTCAE. Patients were at different time intervals from primary treatment, enabling a cross-sectional study of reported late effects at different time points after primary treatment. The time intervals used in the analysis were year ≤1, 1-2, 2-3, 3-4, 4-5 and 5+. The QLQ-C30 results were compared with reference data from the general Danish female population. Between-group differences are presented as effect sizes (ESs) (Cohen's ).
A total of 1089 BC survivors participated. Compared with the reference group, BC survivors reported better global health status 2-3 and 4-5 years after surgery ( = 0.26) and physical functioning 2-3 years after (0.21). Poorer outcomes in BC survivors compared with the reference group were found for cognitive functioning (0-4 and 5+ years), fatigue (0-2 years), insomnia (1-3 years), emotional functioning (3-4 years), and social functioning (≤1 year after surgery) with ESs ranging from 0.20 to 0.41. For the remaining outcomes, no ESs exceeded 0.20.
Only small to medium ESs were found for better global health and physical functioning and poorer outcomes for cognitive functioning, fatigue, insomnia, emotional functioning, and social functioning in postmenopausal BC survivors, who otherwise reported similar overall health-related quality of life compared with the general Danish female population.
乳腺癌（BC）的生存率正在提高，这使得人们对治疗相关的晚期效应越来越感兴趣。本研究的目的是在标准随访护理中，使用患者报告结局量表来探索绝经后BC幸存者的晚期效应。将结果与来自丹麦普通人群的年龄和性别匹配数据进行比较。
2016年4月至2018年2月期间，丹麦奥胡斯大学医院肿瘤学系接受常规随访护理的绝经后BC幸存者被要求完成欧洲癌症研究与治疗组织（EORTC）QLQ-C30和BR23问卷，以及来自PRO-CTCAE的关于神经病变、肌痛和关节痛的三个项目。患者处于距初次治疗的不同时间间隔，从而能够对初次治疗后不同时间点报告的晚期效应进行横断面研究。分析中使用的时间间隔为≤1年、1 - 2年、2 - 3年、3 - 4年、4 - 5年和5年以上。将QLQ-C30结果与丹麦普通女性人群的参考数据进行比较。组间差异以效应大小（ESs）（科恩d值）表示。
共有1089名BC幸存者参与。与参考组相比，BC幸存者报告在术后2 - 3年和4 - 5年的总体健康状况更好（d = 0.26），术后2 - 3年的身体功能更好（0.21）。与参考组相比，BC幸存者在认知功能（0 - 4年和5年以上）、疲劳（0 - 2年）、失眠（1 - 3年）、情绪功能（3 - 4年）和社会功能（术后≤1年）方面的结果较差，效应大小范围为0.20至0.41。对于其余结果，效应大小均未超过0.20。
在绝经后BC幸存者中，仅发现全球健康状况和身体功能改善以及认知功能、疲劳、失眠、情绪功能和社会功能较差的效应大小为小到中等，除此之外，这些幸存者报告的总体健康相关生活质量与丹麦普通女性人群相似。
