Impact of adjuvant therapy on quality of life in women with node-positive operable breast cancer

Quantifying trade-offs: quality of life and quality-adjusted survival in a randomised trial of chemotherapy in postmenopausal patients with lymph node-negative breast cancer

“…After completing chemotherapy, QL scores rapidly improved as found in our previous trials (Hürny et al, 1996b;The International Breast Cancer Study Group, 2001) and in an adjuvant trial by the Eastern Cooperative Oncology Group with a more comprehensive QL questionnaire (Fairclough et al, 1999). Contrary to our hypothesis, patients' perception of chemotherapy was not affected by the ER status of their tumour.…”

“…We predicted worse QL during chemotherapy (month 3) but no residual effects among treatment groups after completion of chemotherapy (Hürny et al, 1996b). A clinically meaningful difference was defined based on our previous observations of the coping indicator in postmenopausal patients with lymph nodepositive breast cancer (Hürny et al, 1996b), as the ratio of the average change between baseline and month 3 in patients with Tam alone vs those with three initial cycles CMF followed by Tam (ratio ¼ 3.37; not shown in the original article).…”

“…A clinically meaningful difference was defined based on our previous observations of the coping indicator in postmenopausal patients with lymph nodepositive breast cancer (Hürny et al, 1996b), as the ratio of the average change between baseline and month 3 in patients with Tam alone vs those with three initial cycles CMF followed by Tam (ratio ¼ 3.37; not shown in the original article). We chose to use the ratio instead of the absolute difference in scores because the baseline scores in the present trial were better than those of the earlier trial, which involved women with node-positive disease.…”

“…For baseline analysis and tests for heterogeneity among treatment groups at each time point, we used the square roots of the scores (Hürny et al, 1996b) because this transformation approximated a normal distribution and was effective in stabilising the variances for all indicators. The figures however show the results in the original scores from 0 to 100.…”

“…The objective of the QL analysis was an extension of our earlier findings on the impact of adjuvant therapy on QL (Hürny et al, 1996b). Presence, duration, timing and anticipation of chemotherapy had a measurable effect on patients' QL, but patients' psychological adaptation was found to be more important for their QL than cytotoxic side effects.…”