Quality of life during chemotherapy, hormonotherapy or antiHER2 therapy of patients with advanced, metastatic breast cancer in clinical practice

Abstract

Introduction: Breast cancer is one of the most important health problems in the world. In recent years, this cancer has achieved a reduction in mortality, which is attributed to the introduction of mass screening and greater efficacy of post-operative treatment. Many patients with breast cancer have indications only for palliative therapy, but the impact of these methods on the quality of life of patients remains a subject of controversy. It remains unknown whether the progress in improving the quality of life in clinical trials also applies to patients treated as part of daily clinical practice. Data on the results of the impact of conducted therapies on the quality of life outside of clinical trials are scarce. Methods: The results of palliative chemotherapy and first-line hormonotherapy in 351 patients with advanced, metastatic breast cancer treated in the period from January 2010 to December 2016 in two centres were analysed. Results: The average age of patients was 62 ± 9.8 years; 139 patients received chemotherapy, 91-therapy containing trastuzumab, and 121-hormone therapy. A partial response was obtained in 111 patients (32%), stabilization in 150 (43%), and in 90 patients (26%) progression. Median survival time in the whole group of patients was 36 months. Chemotherapy compared to trastuzumab and hormonotherapy was associated with greater total toxicity (p = 0.03). There was a significant relationship between the type of therapy (hormonotherapy, chemotherapy, targeted therapy) and the general average quality of women's life measured with the EORC-QLQ-C30 questionnaire. In addition, a statistically significant difference was found in some somatic complaints (the scale of QLQ-BR23 symptoms) depending on the type of therapy performed. The lowest intensity of complaints was reported by patients during hormonotherapy, then during targeted therapy, and the largest during chemotherapy. Conclusions: There is no effect of chemotherapy on the overall quality of life. Hormone therapy and trastuzumab therapy improved the quality of life of the treated patients in clinical practice.

Impact of anticancer therapy on the quality of life of Sudanese patients with breast cancer at Khartoum oncology hospital

“…In QLQ-BR-23 symptoms scale, a marked signi cant level of symptomatology (systemic side effects, arm symptoms and being upset by hair loss) was observed in patients taking conventional chemotherapy than patients on hormonal or HER2-targeted therapies. Greater toxicity of chemotherapy in comparison with hormone therapy is in accordance with literature data [44]. Osoba et al, demonstrated that trastuzumab does not adversely affect QOL of patients [45].…”

Quality of Life of Cancer Patients Treated with Chemotherapy

“…The vast majority of respondents (88%) described their health condition as bad, and the disease limited the social activity of 70% of patients. In the study population, the mean general quality of life before treatment was 60.92 and, after treatment, was 58.20 [ 41 ]. The results of this study are supported by Gandhi et al [ 42 ], who conducted a cohort study of 100 patients suffering from multiple symptoms such as pain, insomnia, loss of appetite and fatigue.…”

Transition to exclusive palliative care for women with breast cancer

“…Although systemic therapy with a palliative objective is the basis for the treatment of women with advanced breast cancer, it is necessary to recognize the moment when it should be contraindicated. As most oncologists do not use, in practice, clinical criteria that can guide decision-making in favor of therapeutic proportionality, beneficence and non-maleficence, women may be susceptible to therapeutic futility and worsening quality of life (12)(13) .…”