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首页> 外文期刊>Journal of Clinical Oncology >Quality of life of older patients with early-stage breast cancer receiving adjuvant chemotherapy: A companion study to cancer and leukemia group B 49907
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Quality of life of older patients with early-stage breast cancer receiving adjuvant chemotherapy: A companion study to cancer and leukemia group B 49907

机译:接受辅助化疗的老年早期乳腺癌患者的生活质量:癌症和白血病B 49907组的一项伴随研究

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Purpose: A phase III trial (Cancer and Leukemia Group B CALGB-49907) was conducted to test whether older patients with early-stage breast cancer would have equivalent relapse-free and overall survival with capecitabine compared with standard chemotherapy. The quality of life (QoL) substudy tested whether capecitabine treatment would be associated with a better QoL than standard chemotherapy. Patients and Methods: QoL was assessed in 350 patients randomly assigned to either standard chemotherapy (cyclophosphamide, methotrexate, and fluorouracil [CMF] or doxorubicin and cyclophosphamide [AC]; n = 182) or capecitabine (n = 168). Patients were interviewed by telephone before treatment (baseline), midtreatment, within 1 month post-treatment, and at 12, 18, and 24 months postbaseline by using questionnaires from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30), a breast systemic adverse effects scale (EORTC BR23), and the Hospital Anxiety and Depression Scale (HADS). Results: Compared with patients who were treated with standard chemotherapy, patients who were treated with capecitabine had significantly better QoL, role function, and social function, fewer systemic adverse effects, less psychological distress, and less fatigue during and at the completion of treatment (P ≤ .005). Capecitabine treatment was associated with less nausea, vomiting, and constipation and with better appetite than standard treatment (P ≤ .004), but worse hand-foot syndrome and diarrhea (P < .005). These differences all resolved by 12 months. Conclusion: Standard chemotherapy was superior to capecitabine in improving relapse-free and overall survival for older women with early-stage breast cancer. Although capecitabine was associated with better QoL during treatment, QoL was similar for both groups at 1 year. The brief period of poorer QoL with standard treatment is a modest price to pay for a chance at improved survival.
机译:目的:进行了一项III期试验(癌症和白血病B组CALGB-49907),以测试与标准化疗相比,卡培他滨对老年早期乳腺癌患者是否具有相同的无复发和总体生存率。生活质量(QoL)子研究测试了卡培他滨治疗是否比标准化疗具有更好的QoL。患者和方法:对350名随机分配至标准化疗方案(环磷酰胺,甲氨蝶呤和氟尿嘧啶[CMF]或阿霉素和环磷酰胺[AC]; n = 182)或卡培他滨(n = 168)的患者进行了QoL评估。治疗前(基线),中期,治疗后1个月内以及基线后12、18和24个月,通过电话访问患者,方法是使用欧洲研究和治疗癌症生活质量调查问卷组织(C30)的问卷QLQ-C30),乳房全身不良反应量表(EORTC BR23)和医院焦虑和抑郁量表(HADS)。结果:与接受标准化疗的患者相比,接受卡培他滨治疗的患者的QoL,角色功能和社交功能明显更好,全身不良反应更少,心理困扰更少,并且在治疗过程中和治疗完成时疲劳更少( P≤.005)。卡培他滨治疗与标准治疗相比,具有较少的恶心,呕吐和便秘,且食欲更好(P≤.004),但手足综合症和腹泻更严重(P <.005)。这些差异在12个月内全部解决。结论:标准化疗优于卡培他滨在改善早期乳腺癌的老年妇女的无复发和总体生存方面。尽管卡培他滨与治疗期间的QoL相关,但两组的QoL在1年时相似。短期接受标准治疗后,生活质量较差,这是为提高生存率付出的适度代价。

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