Please use this identifier to cite or link to this item: http://hdl.handle.net/1959.13/43418

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Title
Quality of life and quality-adjusted survival (Q-TWiST) in patients receiving dose-intensive or standard dose chemotherapy for high-risk primary breast cancer
Author/Creator
Bernhard, J.;  Zahrieh, D.;  Green, M. D.;  Colleoni, M.;  Gelber, R. D.;  Castiglione-Gertsch, M.;  Price, K. N.;  Goldhirsch, A.;  Coates, A. S.;  Zhang, J. J.;  Martinelli, G.;  Basser, R.;  Hurny, C.;  Forbes, J. F.;  Aebi, S.;  Yeo, W.;  Thurlimann, B.
Institution
The University of Newcastle. Faculty of Health, School of Medicine and Public Health
Description
Quality of life ( QL) is an important consideration when comparing adjuvant therapies for early breast cancer, especially if they differ substantially in toxicity. We evaluated QL and Q-TWiST among patients randomised to adjuvant dose-intensive epirubicin and cyclophosphamide administered with filgrastim and progenitor cell support ( DI-EC) or standard-dose anthracycline-based chemotherapy ( SD-CT). We estimated the duration of chemotherapy toxicity ( TOX), time without disease symptoms and toxicity ( TWiST), and time following relapse ( REL). Patients scored QL indicators. Mean durations for the three transition times were weighted with patient reported utilities to obtain mean Q-TWiST. Patients receiving DI-EC reported worse QL during TOX, especially treatment burden (month 3: P<0.01), but a faster recovery 3 months following chemotherapy than patients receiving SD-CT, for example, less coping effort (P<0.01). Average Q-TWiST was 1.8 months longer for patients receiving DI-EC (95% CI,-2.5 to 6.1). Q-TWiST favoured DI-EC for most values of utilities attached to TOX and REL. Despite greater initial toxicity, quality-adjusted survival was similar or better with dose-intensive treatment as compared to standard treatment. Thus, QL considerations should not be prohibitive if future intensive therapies show superior efficacy.
Relation
British Journal of Cancer Vol. 98, Issue 1, p. 25-33
Publisher Link
http://dx.doi.org/10.1038/sj.bjc.6604092
Date
2008
Publisher
Nature Publishing Group
Keyword(s)
breast cancer;  adjuvant chemotherapy;  quality of life;  adaptation;  quality-adjusted survival
Resource Type
journal article
Identifier
http://hdl.handle.net/1959.13/43418
Identifier
ISSN:0007-0920
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Subject
"British Journal of Cancer"
 
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