Department of Oncology, Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal.
Department of Oncology, Independent Patient Advocate, Amman, Jordan.
Oncologist. 2023 Oct 3;28(10):856-865. doi: 10.1093/oncolo/oyad207.
Quality of life (QOL) is a critical factor in decision-making for advanced breast cancer (ABC). There is a need to improve how QOL and treatment-related side effects (SEs) that impact it are clinically assessed. We examined healthcare professionals' (HCPs') and patients' perspectives on the importance of QOL discussions and the impact of SEs on QOL in clinical settings.
A cross-sectional online survey was conducted (7/2020-5/2021) among oncologists, nurses, and patients with HR+/HER2- ABC in 7 countries.
The survey was completed by 502 HCPs and 467 patients. Overall, 88% of oncologists and 49% of patients recalled QOL discussions at follow-up. In the first- through fourth-line (1L, 2L, 3L, and 4L) settings, respectively, 48%, 57%, 79%, and 85% of oncologists reported QOL was very important; 73% and 45% of patients receiving 1L and 2L treatment and 40% receiving 3L+ treatment indicated QOL was important. Patients reported that insomnia, anxiety, back pain, fatigue, diarrhea, hot flashes, low sexual interest, and loss of appetite had a moderate/severe impact on QOL. Of patients experiencing certain SEs, ≥64% did not discuss them with HCPs until there was a moderate/severe impact on QOL. In patients receiving a CDK4/6 inhibitor, SEs, including insomnia, diarrhea, back pain, and fatigue, had a moderate/severe impact on QOL.
This survey discovered disconnects between HCPs and patients with ABC on the importance of QOL discussions and the impact of SEs on QOL. These data support the use of ABC-specific QOL questionnaires that closely monitor SEs impacting QOL.
生活质量（QOL）是晚期乳腺癌（ABC）决策的关键因素。需要改进如何在临床评估中评估 QOL 和影响 QOL 的治疗相关副作用（SEs）。我们研究了医疗保健专业人员（HCPs）和患者对 QOL 讨论的重要性以及 SEs 对临床环境中 QOL 的影响的看法。
在 7 个国家/地区，对 HR+/HER2-ABC 的肿瘤学家、护士和患者进行了横断面在线调查（2020 年 7 月至 2021 年 5 月）。
调查完成后，共有 502 名 HCPs 和 467 名患者接受了调查。总体而言，88%的肿瘤学家和 49%的患者在随访时回忆起 QOL 讨论。在一线至四线（1L、2L、3L 和 4L）环境中，分别有 48%、57%、79%和 85%的肿瘤学家报告 QOL 非常重要；接受 1L 和 2L 治疗的 73%和 45%的患者以及接受 3L+治疗的 40%的患者表示 QOL 很重要。患者报告说，失眠、焦虑、背痛、疲劳、腹泻、热潮红、性欲低下和食欲不振对 QOL 有中度/重度影响。在经历某些 SEs 的患者中，≥64%的患者直到 SEs 对 QOL 产生中度/重度影响时才与 HCPs 讨论这些 SEs。在接受 CDK4/6 抑制剂治疗的患者中，SEs，包括失眠、腹泻、背痛和疲劳，对 QOL 有中度/重度影响。
这项调查发现，ABC 患者和 HCPs 在 QOL 讨论的重要性和 SEs 对 QOL 的影响方面存在脱节。这些数据支持使用专门针对 ABC 的 QOL 问卷，密切监测影响 QOL 的 SEs。
