Abstract
The aim of current study was to evaluate the changes of health-related quality of life (HRQoL) and its clinical, demographic and socioeconomic determinants during chemotherapy and 4 months follow-up in women with breast cancer using a repeated measures framework. A double blind cohort study was performed in 100 breast cancer patients given fluorouracil, doxorubicin and cyclophosphamide (FAC) or docetaxel, doxorubicin, cyclophosphamide (TAC) in south of Iran. HRQoL was assessed at baseline, end of chemotherapy and four months thereafter using the QLQ-C30 questionnaire from European Organization for Research and Treatment of Cancer (EORTC). Generalized estimating equations (GEE) was applied for statistical analysis. The mean of age at baseline was 48.5±10.6. 70% and 14% of patients were married and smokers, respectively, and 20% suffered from another disease besides breast cancer. The results of GEE showed that after control for baseline scores, the HRQoL significantly improved over time. Although, the patients in FAC group had higher scores than the TAC group, the differences also diminished over time. Smoking, marital status and having child affected some scales of HRQoL. None of other variables were significantly related to HRQoL. Although patients in TAC groups had lower level of HRQoL over 8 months follow up, they experienced faster improvement than the FAC group. This implies that in long-term, improvements in TAC group are higher than FAC. Having children was positively correlated with HRQoL. Generally, there were no demographic and socio-economic differences in HRQoL in these patients between the chemotherapeutic regimens.
Highlights
As the traditional end points are mainly concentrated on the biologic and physiologic outcomes, their ability in capturing the impact of interventions on patients’ health related-quality of life (HRQoL) has been questioned over last decades, especially for the chronic diseases (Lam et al, 2000)
The aim of current study was to evaluate the changes of health-related quality of life (HRQoL) and its clinical, demographic and socioeconomic determinants during chemotherapy and 4 months follow-up in women with breast cancer using a repeated measures framework
A double blind cohort study was performed in 100 breast cancer patients given fluorouracil, doxorubicin and cyclophosphamide (FAC) or docetaxel, doxorubicin, cyclophosphamide (TAC) in south of Iran
Summary
As the traditional end points are mainly concentrated on the biologic and physiologic outcomes, their ability in capturing the impact of interventions on patients’ health related-quality of life (HRQoL) has been questioned over last decades, especially for the chronic diseases (Lam et al, 2000). Breast cancer is one of these prevailing chronic conditions which adversely affects the HRQoL in the patients and has been the subject of many studies (Perry et al, 2007). Being in advanced stage of disease and affecting by disease at least one decade younger than their counterparts in developed countries translated the breast cancer to a serious health policy concern in the country (Harirchi et al, 2004; 2011). Docetaxel with doxorubicin and cyclophosphamide (TAC) and 5-fluorouracil, doxorubicin, cyclophosphamide (FAC) are used as adjuvant therapy in breast cancer. Results of previous study indicated that adjuvant therapy with TAC was associated with higher adverse effects, it significantly improved the rate of disease-free and overall survival in node-positive breast cancer (Martin et al, 2005a). A double blind cohort study was done to evaluate the effects of these adjuvant therapies on HRQoL in patients with node-positive breast cancer in Iran. To provide a better picture of changes in HRQoL during whole period of study and examine the effects of clinical, demographic and socio-economic characteristics on these changes, a multivariate repeated measures framework was applied in current study
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