Prospective Exploratory Analysis of the Association Between Tumor Response, Quality of Life, and Expenditures Among Patients Receiving Paclitaxel Monotherapy for Refractory Metastatic Breast Cancer

Modi, Shanu; Panageas, Katherine S.; Duck, Elaine; Bach, Ariadne M.; Weinstock, Nancy; Dougherty, James; Cramer, Laura D.; Hudis, Clifford A.; Norton, Larry; Seidman, Andrew D.

doi:10.1200/jco.2002.08.057

Cited by 25 publications

(17 citation statements)

References 22 publications

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“…Also objective tumor progression was not correlated with deterioration of QOL during chemotherapy, except for social functioning. Using another questionnaire, Modi et al [6] found that tumor response was significantly associated with early improvement in QOL score in refractory breast cancer. Several limitations are noted in this study.…”

Section: Discussionmentioning

confidence: 99%

Changes in quality of life during palliative chemotherapy for solid cancer

Bang

Park

Kang

et al. 2005

Support Care Cancer

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Section: Discussionmentioning

confidence: 99%

Changes in quality of life during palliative chemotherapy for solid cancer

Bang

Park

Kang

et al. 2005

Support Care Cancer

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“…Plus récemment, dans une étude sur 50 patientes déjà traitées pour leur cancer du sein métastatique et recevant une chimiothérapie par paclitaxel, les patientes répondeuses après deux cycles ont une amélioration signifi cative de la qualité de vie non retrouvée chez les patientes non répondeuses [40]. L'amélioration de la qualité de vie est parfois plus fré-quente que la réponse à la chimiothérapie.…”

Section: Taux De Réponse Réduction Des Symptômes Et Qualité De Vieunclassified

La décision d’arrêt de la chimiothérapie chez les patientes atteintes de cancer du sein métastatique

Bouleuc¹,

Chvetzoff²,

Favier³

et al. 2011

Oncologie

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La décision d'arrêt de la chimiothérapie chez les patientes atteintes de cancer du sein métastatique Groupe de travail : C. Bouleuc (oncologue-soins palliatifs), G. Chvetzoff (oncologue-soins palliatifs), L. Favier (oncologue médical), I. Krakowski (oncologue médical), P. Poulain (soins palliatifs), C. Tournigand (oncologue médical) La décision d'arrêt d'une chimiothérapie palliative en situation métastatique est un mélange complexe d'enjeux thérapeutiques, humains et éthiques. La qualifi cation même de « palliative » associée à la chimiothérapie fait débat entre les oncologues et les médecins de soins palliatifs. De manière un peu paradoxale, ce sont les oncologues qui revendiquent l'adjectif « palliatif » dès la première ligne de chimiothérapie au stade métastatique (c'est-à-dire dès que le but du traitement est un allongement de la durée de vie, même très prolongé, et/ou de la qualité de vie), alors que les médecins de soins palliatifs le repoussent aux ultimes lignes thérapeutiques. Recommandations GuidelinesFréquence de la prescription de chimiothérapie en fi n de vie La fréquence de la prescription de chimiothérapie palliative en phase terminale n'est pas négligeable. Dans une étude fi nlandaise, 20 % des patientes atteintes de cancer du sein métastatique reçoivent une chimiothérapie dans le dernier mois de vie [2]. Une autre étude effectuée en Amérique du Nord et en Australie retrouve un résultat similaire, 18 % de chimiothérapie dans les quatre dernières semaines et 8 % dans les deux dernières [31]. Dans une autre étude au Portugal, 37 % de patients atteints de tout type de cancer reçoi-vent une chimiothérapie dans le dernier mois de vie, dont 21 % dans les 15 derniers jours [6].

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“…4,5 Although a significant number of advanced cancer patients respond to first-line regimens, survival rates continue to remain fairly low, with the main outcome being largely palliative. 2,6,7 Nevertheless, it is becoming apparent that treatment may improve quality of life even if it does not lengthen it. 8 In today's treatment milieu, physicians face uncertainty as to whether palliative tumor reduction is worth the cost of potential negative symptom or quality of life disruption that often occur secondary to treatment toxicity.…”

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“…[1][2][3] However, progress has been incremental over several decades, and nevertheless the great majority of people with metastatic or recurrent cancer will die from their disease. 4,5 Although a significant number of advanced cancer patients respond to first-line regimens, survival rates continue to remain fairly low, with the main outcome being largely palliative.…”

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confidence: 99%

“…11 A similarly complex positive correlation may exist between palliative tumor reduction and patient-reported outcome improvement; however, to the best of our knowledge, the literature has never been formally reviewed. 2,7,12,13 The presumed correlation between tumor response and patient benefit is based on the hypothesis that symptoms are caused primarily by tumor burden. These symptoms would therefore be relieved when a tumor is made smaller with therapy, thereby improving symptom reports and health-related quality of life.…”

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Metaanalysis of the correlation between radiographic tumor response and patient‐reported outcomes

Victorson

Soni

Cella

2005

Cancer

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BACKGROUND The primary aim of the current study was to determine whether radiographic tumor response is associated with patient‐reported outcomes such as symptom response or health‐related quality of life. METHODS A metaanalysis was conducted of 21 available studies from 1995–2003 that provided data sufficient for examining the association between tumor response and patient‐reported outcomes, including symptom response and health‐related quality of life. A second aim was to examine the influence of possible moderating study variables on effect size variation. RESULTS As hypothesized, patient‐reported outcome improvement rates were most frequently associated with patients classified as a complete or partial response (CR/PR), followed by those with stable disease (SD) and progressive disease (PD). Moderate effect sizes were observed between the CR/PR and SD (effect size of 0.35) and CR/PR and PD categories (effect size of 0.43). A weak effect size was found between SD and PD (effect size of 0.16), raising concern over the meaningfulness of the SD category. No significant correlations were found between effect size and patient or study characteristics. Significant associations existed between treatment duration and age, study duration, survival, and symptom response rates, especially among PD patients. CONCLUSION Despite significant study‐to‐study heterogeneity, an important association exists in the correlation between tumor response and formal measures of change in patient‐reported outcomes. A better understanding of this relation would be enhanced if future reports included estimates of effect size in patient‐reported outcome change by tumor response category. Practical implications, limitations, and directions for future research are provided. Cancer 2006. © 2005 American Cancer Society.

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Prospective Exploratory Analysis of the Association Between Tumor Response, Quality of Life, and Expenditures Among Patients Receiving Paclitaxel Monotherapy for Refractory Metastatic Breast Cancer

Abstract: Patients with evidence of tumor response on paclitaxel had a QoL benefit not observed in nonresponders, and this response was associated with a trend for lower overall costs.

Cited by 25 publications

References 22 publications

Changes in quality of life during palliative chemotherapy for solid cancer

Changes in quality of life during palliative chemotherapy for solid cancer

La décision d’arrêt de la chimiothérapie chez les patientes atteintes de cancer du sein métastatique

Metaanalysis of the correlation between radiographic tumor response and patient‐reported outcomes

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