Patient-reported predictors of early treatment discontinuation: treatment-related symptoms and health-related quality of life among postmenopausal women with primary breast cancer randomized to anastrozole or exemestane on NCIC Clinical Trials Group (CCTG) MA.27 (E1Z03).
Patient-reported predictors of early treatment discontinuation: treatment-related symptoms and health-related quality of life among postmenopausal women with primary breast cancer randomized to anastrozole or exemestane on NCIC Clinical Trials Group (CCTG) MA.27 (E1Z03).
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DOI：
10.1007/s10549-018-4713-2
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发表时间：
2018-06
影响因子：
3.8
通讯作者：
Cella D
中科院分区：
文献类型：
--
作者：
Wagner LI;Zhao F;Goss PE;Chapman JW;Shepherd LE;Whelan TJ;Mattar BI;Bufill JA;Schultz WC;LaFrancis IE;Nagargoje GG;Vemuri R;Nikcevich DA;Sledge GW;Cella D
芳香化酶抑制剂是绝经后妇女乳腺癌依赖性早期乳腺癌最常用的辅助内分泌治疗。在加拿大癌症试验组（CCTG）MA.27参与者中，阿那曲唑和阿司美坦的5年无事件生存率相当。这项伴随研究检查了随机接受阿那曲唑或阿司美坦治疗的绝经后妇女中患者报告的治疗相关症状（TRS）和健康相关生活质量（HRQL）的差异。MA：27名随机接受5年阿那曲唑（1 mg/天，n=371，A组）或阿司美坦（25 mg/天，n =315，E组）治疗的受试者（N = 686，共7，576名）完成了56项癌症治疗功能评估-内分泌症状（FACT-ES）问卷，以评估TRS和HRQL。在基线、3、6、12和24个月时完成FACT-ES。在任何时间点，治疗组之间均未观察到测量TRS和HRQL的FACT-ES中位评分的显著差异。在3、6、12和24个月时，TRS较基线的变化具有统计学显著性。两组的HRQL随时间推移保持稳定。TRS负荷越大，HRQL越差（系数= 0.57，p<0.001）。20%的患者在第24个月停止AI治疗，32%的患者在第4年停止AI治疗。在两组中，在开始研究治疗前报告更多副作用困扰的患者在完成方案治疗前停止治疗的风险更高（风险比[HR] =1.29，95% CI：1.08-1.55，P=0.01）。阿那曲唑和阿司美坦之间的TRS和HRQL相当。TRS对HRQL有负面影响。报告在开始AI之前受到治疗副作用困扰的女性提前停止治疗的风险增加。
Aromatase inhibitors are the most commonly prescribed adjuvant endocrine therapy for hormone-dependent early breast cancer in postmenopausal women. Among Canadian Cancer Trials Group (CCTG) MA.27 participants, anastrozole and exemestane had comparable 5-year event-free survival. This companion study examined differences in patient-reported treatment-related symptoms (TRS) and health-related quality of life (HRQL) among postmenopausal women randomized to anastrozole or exemestane. MA.27 participants (N = 686, of 7,576) randomized to 5-years of anastrozole (1mg/day, n=371, arm A) or exemestane (25 mg/day, n=315, arm E) completed the 56-item Functional Assessment of Cancer Therapy-Endocrine Symptoms (FACT-ES) questionnaire to assess TRS and HRQL. The FACT-ES was completed at baseline, 3, 6, 12 and 24 months. No significant differences in FACT-ES median scores measuring TRS and HRQL were observed between treatment arms at any time-point. Change in TRS from baseline was statistically significant at 3, 6, 12 and 24 months. HRQL was stable over time in both arms. Greater TRS burden was associated with poorer HRQL (coefficient= 0.57, p<0.001). Twenty percent of patients discontinued AI therapy by month 24 and 32% discontinued AIs at 4 years. In both arms, patients reporting more side-effect bother prior to initiating study treatment had a higher risk of discontinuing treatment before completing protocol therapy (hazard ratio [HR] =1.29, 95% CI: 1.08-1.55, P=0.01). TRS and HRQL were comparable between anastrozole and exemestane. TRS negatively affect HRQL. Women who report being bothered by treatment side effects prior to initiating an AI are at increased risk for early treatment discontinuation.
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影响因子：
2
作者：
SCHLUCHTER, MD
通讯作者：
SCHLUCHTER, MD
影响因子：
45.3
作者：
Goss, Paul E.;Ingle, James N.;Shepherd, Lois E.
通讯作者：
Shepherd, Lois E.
影响因子：
45.3
作者：
Coates, Alan S.;Keshaviah, Aparna;Goldhirsch, Aron
通讯作者：
Goldhirsch, Aron
影响因子：
45.3
作者：
Dowsett, Mitch;Cuzick, Jack;Peto, Richard
通讯作者：
Peto, Richard
DOI：
10.1093/jee/39.2.269
发表时间：
1945-01-01
期刊：
BIOMETRICS BULLETIN
影响因子：
--
作者：
WILCOXON, F
通讯作者：
WILCOXON, F