Francis James, Baxter Mark, Giza Dana, Cheung Kwok-Leung, Parks Ruth
Nottingham Breast Cancer Research Centre, School of Medicine, Royal Derby Hospital Centre, University of Nottingham, Uttoxeter Road, Derby, DE22 3DT, UK.
Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland.
Drugs Aging. 2025 Jan;42(1):1-7. doi: 10.1007/s40266-024-01167-0. Epub 2024 Dec 13.
Breast cancer remains the most prevalent cancer worldwide, necessitating advancements in its management. Surgery remains the recommended primary treatment although neoadjuvant or adjuvant treatments, such as chemotherapy, may also be indicated. However, such medications confer a risk of toxicity, often resulting in dose reductions and hospitalisations. This morbidity is particularly pertinent within older patients, for whom their experience of breast cancer is already faced through the lens of unique challenges often including comorbidity, socioeconomic decline and limited support networks. Quality of life (QoL) assessments acknowledge the impact of diagnosis and treatment on patients' psychological, emotional and physical well-being. Multiple tools exist (each with their own strengths and weaknesses) ranging from the more comprehensive [such as the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)] to the more broadly focused [including the General Functional Assessment of Cancer Therapy (FACT-G)]. However, while such tools have existed for some time, there remains a gap in clinical guidance as to their integration, particularly within older patient cohorts. This article seeks to address these complexities in breast cancer decision-making by exploring how QoL assessment can best be utilised inform efficacy-tolerability trade-offs, and subsequently facilitate optimal patient-centred care.
乳腺癌仍然是全球最常见的癌症，因此其治疗方法需要不断改进。手术仍然是推荐的主要治疗方法，不过新辅助治疗或辅助治疗，如化疗，也可能会被采用。然而，这类药物存在毒性风险，常常导致剂量减少和住院治疗。这种发病率在老年患者中尤为突出，因为他们在面对乳腺癌时往往还面临着独特的挑战，包括合并症、社会经济状况下降以及支持网络有限等。生活质量（QoL）评估认识到诊断和治疗对患者心理、情感和身体健康的影响。有多种工具（每种都有其自身的优缺点），从更全面的工具[如欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30）]到更具广泛针对性的工具[包括癌症治疗通用功能评估（FACT-G）]。然而，尽管这类工具已经存在了一段时间，但在如何整合它们的临床指导方面仍然存在差距，尤其是在老年患者群体中。本文旨在通过探讨如何最好地利用生活质量评估来权衡疗效和耐受性，进而促进以患者为中心的最佳护理，来解决乳腺癌决策中的这些复杂问题。
