Quality of life during chemotherapy, hormonotherapy or antiHER2 therapy of patients with advanced, metastatic breast cancer in clinical practice
Quality of life during chemotherapy, hormonotherapy or antiHER2 therapy of patients with advanced, metastatic breast cancer in clinical practice
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DOI：
10.1186/s12955-020-01389-x
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发表时间：
2020-05-12
影响因子：
3.6
通讯作者：
Baczkowska-Waliszewska, Zuzanna
中科院分区：
文献类型：
--
作者：
Adamowicz, Krzysztof;Baczkowska-Waliszewska, Zuzanna
前言乳腺癌是世界上最重要的健康问题之一。近年来，这种癌症的死亡率有所下降，这要归功于大规模筛查的引入和术后治疗的更大效果。许多乳腺癌患者只有姑息治疗的适应症，但这些方法对患者生活质量的影响仍然存在争议。目前尚不清楚在临床试验中改善生活质量的进展是否也适用于作为日常临床实践的一部分接受治疗的患者。方法对2010年1月至2016年12月在两个中心接受姑息化疗和一线激素治疗的351例晚期转移性乳腺癌患者的治疗结果进行分析。结果患者的平均年龄为629.8岁；139例患者接受了化疗，91例患者接受了曲妥珠单抗治疗，121例患者接受了激素治疗。部分缓解111例(32%)，稳定150例(43%)，进展90例(26%)。全组患者中位生存期为36个月。与曲妥珠单抗和激素治疗相比，化疗的总毒性更大(p=0.03)。治疗类型(激素治疗、化疗、靶向治疗)与EORC-QLQ-C30问卷测量的女性总体平均生活质量之间存在显著关系。此外，在一些躯体主诉(QLQ-BR23症状的量表)中发现了统计上的显著差异，这取决于所执行的治疗类型。患者在激素治疗期间的抱怨强度最低，其次是靶向治疗，化疗期间的抱怨强度最大。结论化疗对患者的总体生活质量没有影响。在临床实践中，激素治疗和曲妥珠单抗治疗改善了治疗患者的生活质量。
IntroductionBreast cancer is one of the most important health problems in the world. In recent years, this cancer has achieved a reduction in mortality, which is attributed to the introduction of mass screening and greater efficacy of post-operative treatment. Many patients with breast cancer have indications only for palliative therapy, but the impact of these methods on the quality of life of patients remains a subject of controversy. It remains unknown whether the progress in improving the quality of life in clinical trials also applies to patients treated as part of daily clinical practice. Data on the results of the impact of conducted therapies on the quality of life outside of clinical trials are scarce.MethodsThe results of palliative chemotherapy and first-line hormonotherapy in 351 patients with advanced, metastatic breast cancer treated in the period from January 2010 to December 2016 in two centres were analysed.ResultsThe average age of patients was 629.8years; 139 patients received chemotherapy, 91 - therapy containing trastuzumab, and 121 - hormone therapy. A partial response was obtained in 111 patients (32%), stabilization in 150 (43%), and in 90 patients (26%) progression. Median survival time in the whole group of patients was 36months. Chemotherapy compared to trastuzumab and hormonotherapy was associated with greater total toxicity (p =0.03). There was a significant relationship between the type of therapy (hormonotherapy, chemotherapy, targeted therapy) and the general average quality of women's life measured with the EORC-QLQ-C30 questionnaire. In addition, a statistically significant difference was found in some somatic complaints (the scale of QLQ-BR23 symptoms) depending on the type of therapy performed. The lowest intensity of complaints was reported by patients during hormonotherapy, then during targeted therapy, and the largest during chemotherapy.Conclusions p id=Par There is no effect of chemotherapy on the overall quality of life. Hormone therapy and trastuzumab therapy improved the quality of life of the treated patients in clinical practice.