From the Medical Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain.
Radiotherapeutic Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain.
Menopause. 2023 Jun 1;30(6):613-620. doi: 10.1097/GME.0000000000002178. Epub 2023 Apr 4.
In this article, the quality of life (QOL) of Spanish postmenopausal early-stage breast cancer patients who have finished endocrine therapy (ET), QOL changes after endocrine therapy cessation, and the differences between two endocrine therapy modalities (tamoxifen or aromatase inhibitor [AI]) are studied. More QOL information after endocrine therapy cessation is needed.
A prospective cohort study was performed. Participating in the study were 158 postmenopausal patients who had received tamoxifen or AI for 5 years. In some cases, endocrine therapy may have changed during those 5 years.Patients completed the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BR45 questionnaires at baseline, after 6 months, and after 1 year of follow-up. Patients older than 65 years also completed the QLQ-ELD14. Linear mixed-effect models were used to evaluate longitudinal changes in QOL and differences in QOL between endocrine therapy modalities.
QOL scores for the whole sample throughout follow-up were high (>80/100 points) in most QOL areas. Moderate limitations (>30 points) occurred in the QLQ-BR45 in sexual functioning and sexual enjoyment, future perspective, and joint symptoms. Moderate limitations also occurred in the QLQ-ELD14 in worries about others, maintaining purpose, joint stiffness, future worries, and family support. In those who had finished endocrine therapy, pain was reduced in all three assessments conducted during the 1-year follow-up period in both groups. Tamoxifen patients showed better QOL in functioning (role functioning, global QOL, financial impact), symptoms (pain), and emotional areas (future perspective and worries about others) than AI patients but worse QOL in skin mucosis symptoms.
The results of this study show that postmenopausal early-stage breast cancer patients adapted well to their disease and endocrine therapy treatment. QOL improvements in the 1-year follow-up period appeared in one key area: pain. Differences between endocrine therapy modalities suggested QOL was better in the tamoxifen group than in the AI group.
本文研究了完成内分泌治疗（ET）的西班牙绝经后早期乳腺癌患者的生活质量（QOL）、内分泌治疗停止后的 QOL 变化，以及两种内分泌治疗方式（他莫昔芬或芳香化酶抑制剂[AI]）之间的差异。需要更多关于内分泌治疗停止后的 QOL 信息。
进行了一项前瞻性队列研究。共有 158 名接受他莫昔芬或 AI 治疗 5 年的绝经后患者参与了研究。在某些情况下，这 5 年内可能会改变内分泌治疗。患者在基线时、治疗后 6 个月和 1 年随访时完成了欧洲癌症研究与治疗组织 EORTC QLQ-C30 和 QLQ-BR45 问卷。年龄大于 65 岁的患者还完成了 EORTC QLQ-ELD14。线性混合效应模型用于评估 QOL 的纵向变化和内分泌治疗方式之间的 QOL 差异。
在整个随访期间，整个样本的 QOL 评分在大多数 QOL 领域都很高（>80/100 分）。在 QLQ-BR45 的性功能和性享受、未来展望和关节症状方面，中度限制（>30 分）。在 EORTC QLQ-ELD14 中，担忧他人、保持目的、关节僵硬、未来担忧和家庭支持方面也存在中度限制。在内分泌治疗结束的患者中，两组在 1 年随访期间的所有三次评估中，疼痛均有所减轻。与 AI 患者相比，接受他莫昔芬治疗的患者在功能（角色功能、总体 QOL、经济影响）、症状（疼痛）和情绪（未来展望和担忧他人）方面的 QOL 更好，但在皮肤粘膜炎症状方面的 QOL 更差。
本研究结果表明，绝经后早期乳腺癌患者很好地适应了疾病和内分泌治疗。在 1 年随访期间，QOL 在一个关键领域得到了改善：疼痛。内分泌治疗方式之间的差异表明，他莫昔芬组的 QOL 优于 AI 组。
