Abstract
BackgroundEstimating quality of life (QoL) in patients with breast cancer is of importance in assessing treatment outcomes. Adjuvant endocrine therapy is widely used for hormone receptor-positive (HR+) early-stage breast cancer (EBC), and evidence suggests that aromatase inhibitors (AIs) may improve QoL for these patients. This study evaluated QoL in postmenopausal Chinese patients with HR+ EBC taking AIs.MethodsThis was a prospective, multicenter, and observational study that had no intent to intervene in the current treatment of recruited patients. Eligible patients were recruited within 7 days of beginning adjuvant treatment with AIs. The Functional Assessment of Cancer Therapy-Breast (FACT-B) scale was used to evaluate the patients’ QoL. Data were collected at baseline and at 6, 12, 18, and 24 months.ResultsFrom June 2010 to October 2013, a total of 494 patients with HR+ EBC were recruited from 21 centers. There was a 7.51-point increase in the patients’ mean FACT-B trial outcome index (TOI), from 90.69 at baseline to 98.72 at 24 months (P < .0001). The mean TOI scores at baseline, 6, 12, and 18 months were 90.69, 94.36, 97.71, and 96.75, respectively (P < .0001, for all). The mean (FACT-B) emotional well-being subscale scores at baseline, 6, 12, 18, and 24 months were 16.32, 16.55, 17.34 (P < .0001), 17.47 (P < .0001), and 17.85 (P < .0001), respectively, and social well-being scores were 18.61, 19.14 (P < .04), 19.35 (P < .008), 18.32, and 18.40, respectively. In the mixed model, baseline TOI, clinical visits, prior chemotherapies, age group, and axillary lymph-node dissection presented statistically significant effects on the change of FACT-B TOI and FACT-B SWB, whereas only baseline TOI, clinical visits, and prior chemotherapies presented statistically significant effects on the change of FACT-B EWB. FACT-B TOI, being the most pertinent and precise indicator of patient-reported QoL, demonstrated significant changes reflecting clinical benefit of adjuvant AIs endocrine therapy in the QoL of HR + EBC patients.ConclusionsThe study demonstrated significant improvements in the long-term QoL of postmenopausal Chinese patients with HR+ EBC at 6, 12, 18, and 24 months after starting treatment with AIs. The current study indicates improved long-term QoL with AI adjuvant treatment, which will aid clinicians in optimizing treatment to yield effective healthcare outcomes.Trial registrationClinicaltrials.gov NCT01144572
Highlights
Estimating quality of life (QoL) in patients with breast cancer is of importance in assessing treatment outcomes
The current study indicates improved long-term QoL with Aromatase inhibitor (AI) adjuvant treatment, which will aid clinicians in optimizing treatment to yield effective healthcare outcomes
Patient disposition From June 2010 to October 2013, a total of 494 patients were enrolled in the study; of these patients, 453 (91.7 %) completed the study and 41 (8.3 %) prematurely discontinued from the study as a result of loss to followup (5.1 %), disease relapse/progression (1.2 %), failure to adhere to inclusion/exclusion criteria (0.6 %), voluntarily discontinuation (0.4 %), cessation of AI therapy (0.4 %) and other (0.6 %)
Summary
Estimating quality of life (QoL) in patients with breast cancer is of importance in assessing treatment outcomes. Adjuvant endocrine therapy is widely used for hormone receptor-positive (HR+) early-stage breast cancer (EBC), and evidence suggests that aromatase inhibitors (AIs) may improve QoL for these patients. Previous researches suggested that treatment of patients with early-stage breast cancer (EBC) with third-generation AIs (e.g., anastrozole, letrozole, and exemestane) may improve their QoL [6,7,8,9]. This therapy is associated with persistent side effects and toxicity, which lead to negatively impact the patient’s QoL [10]
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