- 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
- 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.
- Relation
- British Journal of Cancer Vol. 98, Issue 1, p. 25-33
- Publisher Link
- http://dx.doi.org/10.1038/sj.bjc.6604092
- Publisher
- Nature Publishing Group
- Resource Type
- journal article
- Date
- 2008
- 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.
- Subject
- breast cancer; adjuvant chemotherapy; quality of life; adaptation; quality-adjusted survival
- Identifier
- http://hdl.handle.net/1959.13/43418
- Identifier
- uon:5531
- Identifier
- ISSN:0007-0920
- Language
- eng
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