Ghosh Suman, Wadasadawala Tabassum, Mohanty Sanjay, Sarin Rajiv, Parmar Vani, Gupta Sudeep
Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
International Institute for Population Sciences, Mumbai, India.
JCO Glob Oncol. 2025 Apr;11:e2400507. doi: 10.1200/GO-24-00507. Epub 2025 Apr 18.
Breast cancer (BC) is the most common malignancy among women in India and globally. Given the high survivorship, understanding the evolution of health-related quality of life (HRQoL) is crucial, yet comprehensive longitudinal studies from India are lacking.
This prospective observational study included 500 patients with BC registered between June 2019 and March 2022. HRQoL was assessed at pretreatment, treatment completion, and 6-month follow-up using European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30, EORTC-QLQ-BR-23, and EQ-5D-5L tools. A linear mixed-effects model analyzed HRQoL trajectories and predictors.
The median patient age was 46 years, with 60.8% presenting with locally advanced disease; all patients underwent multimodal therapy, comprising surgery (57% mastectomy), chemotherapy (95%), and radiotherapy (RT; 77%). Pretreatment global QoL scores were influenced by age (younger fared better, = .003), stage ( = .027), and social displacement ( = .038). Longitudinal assessment revealed a small decline in global QoL (-2.1) and EQ-VAS (-1.9), along with meaningful improvements in social (+12.8), cognitive (+4.3), and role function (+7.3). Symptom burden significantly decreased, except for deterioration in body image (-7) and sexual enjoyment (-16). Younger patients had slower recovery in physical ( = .003) and social function ( = .05), while school education and financial independence positively influenced QoL variation. Social displacement affected trajectories of QoL ( = .017), role ( = .032), and social function ( = .024). Extent of surgery and RT did not affect overall HRQoL trends, although RT recipients reported more fatigue ( = .029).
To our knowledge, this is the first longitudinal HRQoL study in Indian patients with BC, showing significant improvement in most functional domains at early survivorship. Sociodemographic factors, such as age, social displacement, education, and financial independence, rather than treatment modalities, were stronger predictors of HRQoL. Longer follow-up is needed for a more comprehensive assessment.
乳腺癌（BC）是印度及全球女性中最常见的恶性肿瘤。鉴于其高生存率，了解健康相关生活质量（HRQoL）的演变至关重要，但印度缺乏全面的纵向研究。
这项前瞻性观察性研究纳入了2019年6月至2022年3月期间登记的500例BC患者。使用欧洲癌症研究与治疗组织（EORTC）-QLQ-C30、EORTC-QLQ-BR-23和EQ-5D-5L工具在治疗前、治疗完成时和6个月随访时评估HRQoL。采用线性混合效应模型分析HRQoL轨迹和预测因素。
患者中位年龄为46岁，60.8%为局部晚期疾病；所有患者均接受了多模式治疗，包括手术（57%为乳房切除术）、化疗（95%）和放疗（RT；77%）。治疗前的总体生活质量评分受年龄（年龄越小情况越好，P = 0.003）、分期（P = 0.027）和社会流离失所状况（P = 0.038）影响。纵向评估显示总体生活质量略有下降（-2.1）和EQ-VAS评分下降（-1.9），同时社会功能（+12.8）、认知功能（+4.3）和角色功能（+7.3）有显著改善。症状负担显著减轻，但身体形象（-7）和性快感（-16）有所恶化。年轻患者身体功能（P = 0.003）和社会功能（P = 0.05）恢复较慢，而学校教育和经济独立对生活质量变化有积极影响。社会流离失所状况影响生活质量（P = 0.017）、角色功能（P = 0.032）和社会功能（P = 0.024）的轨迹。手术范围和放疗未影响总体HRQoL趋势，尽管接受放疗的患者报告有更多疲劳感（P = 0.029）。
据我们所知，这是印度BC患者的第一项纵向HRQoL研究，显示早期生存阶段大多数功能领域有显著改善。社会人口学因素，如年龄、社会流离失所状况、教育和经济独立，而非治疗方式，是HRQoL更强的预测因素。需要更长时间的随访进行更全面的评估。
