Impact of Adjuvant Endocrine Therapy on Quality of Life and Symptoms: Observational Data Over 12 Months From the Mind-Body Study
Impact of Adjuvant Endocrine Therapy on Quality of Life and Symptoms: Observational Data Over 12 Months From the Mind-Body Study
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DOI：
10.1200/jco.2015.64.3866
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发表时间：
2016-03-10
影响因子：
45.3
通讯作者：
Crespi, Catherine M.
中科院分区：
文献类型：
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作者：
Ganz, Patricia A.;Petersen, Laura;Crespi, Catherine M.
研究对象与方法心身研究(MBS)观察性队列研究参与者提供了自我报告的身心健康、与内分泌治疗相关的症状、抑郁、疲劳以及在入选时(在接受内分泌治疗前)、6个月和12个月后获得的数据。使用线性混合模型比较了三组患者(无ET、芳香酶抑制剂[AI]或他莫昔芬)的结局变量的纵向轨迹。结果在186名启动ET的女性中，三分之二的患者在AI和他莫昔芬之间平均分配，在基线或协变量调整分析中，各组之间的自我报告测量没有显著差异。身体健康得分最初低于正常水平，并随着时间的推移而改善，但人工智能组在12个月时得分明显较低(P=0.05)；心理健康得分在正常范围内，每组相似，并且不随时间变化。与无ET组相比，无ET组的症状严重程度稳定或下降，而ET组往往随着时间的推移而加重，AI组在一个或两个随访时间点报告了更严重的肌肉骨骼(P=.02)、潮热(P=.02)和认知问题(P=.006)。他莫昔芬组潮热(P=.002)、认知问题(P=.016)和膀胱问题(P=.02)的发生率均高于非ET组。结论应注意ET相关症状负担的增加，并应更好地处理患者报告的结果。(C)2016年度美国临床肿瘤学会
PurposeTo examine patterns of health and symptoms associated with the initiation of adjuvant endocrine therapy (ET) for primary breast cancer treatment.Patients and MethodsThe mind-body study (MBS) observational cohort participants provided self-reported data on physical and mental health, ET-related symptoms, as well as depression, fatigue, and sleep obtained at enrollment (after primary treatment, prior to initiation of ET) and 6 and 12 months later. Longitudinal trajectories of outcome variables among three patient groups (no ET, aromatase inhibitor [AI], or tamoxifen) were compared by using linear mixed models.ResultsTwo-thirds of the 186 women initiated ET, which was evenly split between AI and tamoxifen, and no significant differences were observed in self-reported measures among the groups at baseline or in covariate-adjusted analyses. Physical health scores were below normative levels initially and improved over time, but the AI group had a significantly lower score at 12 months (P=.05); mental health scores were within the normal range, were similar in each group, and did not change over time. The no-ET group showed either stable or declining symptom severity, whereas the ET groups often showed increased severity over time, and the AI group reported more severe musculoskeletal (P=.02), hot flash (P=.02), and cognitive problems (P=.006) at one or both of the follow-up time points compared with the no-ET group. The tamoxifen group had higher levels of hot flashes (P=.002), cognitive problems (P=.016), and bladder problems (P=.02) than the noET group.ConclusionAttention should be given to the increased symptom burden associated with ET, and better efforts should be made to address patient-reported outcomes. (C) 2016 by American Society of Clinical Oncology