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Dynamics of Long-Term Patient-Reported Quality of Life and Health Behaviors After Adjuvant Breast Cancer Chemotherapy

We aimed to characterize long-term quality of life (QOL) trajectories among patients with breast cancer treated with adjuvant chemotherapy and to identify related patterns of health behaviors. METHODS: Female stage I-III breast cancer patients receiving chemotherapy in CANTO (CANcer TOxicity; Clinic...

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Autores principales: Di Meglio, Antonio, Havas, Julie, Gbenou, Arnauld S., Martin, Elise, El-Mouhebb, Mayssam, Pistilli, Barbara, Menvielle, Gwenn, Dumas, Agnes, Everhard, Sibille, Martin, Anne-Laure, Cottu, Paul H., Lerebours, Florence, Coutant, Charles, Lesur, Anne, Tredan, Olivier, Soulie, Patrick, Vanlemmens, Laurence, Joly, Florence, Delaloge, Suzette, Ganz, Patricia A., André, Fabrice, Partridge, Ann H., Jones, Lee W., Michiels, Stefan, Vaz-Luis, Ines
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509127/
https://www.ncbi.nlm.nih.gov/pubmed/35446677
http://dx.doi.org/10.1200/JCO.21.00277
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author Di Meglio, Antonio
Havas, Julie
Gbenou, Arnauld S.
Martin, Elise
El-Mouhebb, Mayssam
Pistilli, Barbara
Menvielle, Gwenn
Dumas, Agnes
Everhard, Sibille
Martin, Anne-Laure
Cottu, Paul H.
Lerebours, Florence
Coutant, Charles
Lesur, Anne
Tredan, Olivier
Soulie, Patrick
Vanlemmens, Laurence
Joly, Florence
Delaloge, Suzette
Ganz, Patricia A.
André, Fabrice
Partridge, Ann H.
Jones, Lee W.
Michiels, Stefan
Vaz-Luis, Ines
author_facet Di Meglio, Antonio
Havas, Julie
Gbenou, Arnauld S.
Martin, Elise
El-Mouhebb, Mayssam
Pistilli, Barbara
Menvielle, Gwenn
Dumas, Agnes
Everhard, Sibille
Martin, Anne-Laure
Cottu, Paul H.
Lerebours, Florence
Coutant, Charles
Lesur, Anne
Tredan, Olivier
Soulie, Patrick
Vanlemmens, Laurence
Joly, Florence
Delaloge, Suzette
Ganz, Patricia A.
André, Fabrice
Partridge, Ann H.
Jones, Lee W.
Michiels, Stefan
Vaz-Luis, Ines
author_sort Di Meglio, Antonio
collection PubMed
description We aimed to characterize long-term quality of life (QOL) trajectories among patients with breast cancer treated with adjuvant chemotherapy and to identify related patterns of health behaviors. METHODS: Female stage I-III breast cancer patients receiving chemotherapy in CANTO (CANcer TOxicity; ClinicalTrials.gov identifier: NCT01993498) were included. Trajectories of QOL (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–C30 Summary Score) and associations with trajectory group membership were identified by iterative estimations of group-based trajectory models and multivariable multinomial logistic regression, respectively. RESULTS: Four trajectory groups were identified (N = 4,131): excellent (51.7%), very good (31.7%), deteriorating (10.0%), and poor (6.6%) QOL. The deteriorating trajectory group reported fairly good baseline QOL (mean [95% CI], 78.3/100 [76.2 to 80.5]), which significantly worsened at year-1 (58.1/100 [56.4 to 59.9]) and never recovered to pretreatment values through year-4 (61.1/100 [59.0 to 63.3]) postdiagnosis. Healthy behaviors were associated with better performing trajectory groups. Obesity (adjusted odds ratio [aOR] v lean, 1.51 [95% CI, 1.28 to 1.79]; P < .0001) and current smoking (aOR v never, 1.52 [95% CI, 1.27 to 1.82]; P < .0001) at diagnosis were associated with membership to the deteriorating group, which was also characterized by a higher prevalence of patients with excess body weight and insufficient physical activity through year-4 and by frequent exposure to tobacco smoking during chemotherapy. Additional factors associated with membership to the deteriorating group included younger age (aOR, 1-year decrement 1.01 [95% CI, 1.01 to 1.02]; P = .043), comorbidities (aOR v no, 1.22 [95% CI, 1.06 to 1.40]; P = .005), lower income (aOR v wealthier households, 1.21 [95% CI, 1.07 to 1.37]; P = .002), and endocrine therapy (aOR v no, 1.14 [95% CI, 1.01 to 1.30]; P = .047). CONCLUSION: This latent-class analysis identified some patients with upfront poor QOL and a high-risk cluster with severe, persistent postchemotherapy QOL deterioration. Screening relevant patient-level characteristics may inform tailored interventions to mitigate the detrimental impact of chemotherapy and preserve QOL, including early addressal of behavioral concerns and provision of healthy lifestyle support programs.
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spelling pubmed-95091272022-09-26 Dynamics of Long-Term Patient-Reported Quality of Life and Health Behaviors After Adjuvant Breast Cancer Chemotherapy Di Meglio, Antonio Havas, Julie Gbenou, Arnauld S. Martin, Elise El-Mouhebb, Mayssam Pistilli, Barbara Menvielle, Gwenn Dumas, Agnes Everhard, Sibille Martin, Anne-Laure Cottu, Paul H. Lerebours, Florence Coutant, Charles Lesur, Anne Tredan, Olivier Soulie, Patrick Vanlemmens, Laurence Joly, Florence Delaloge, Suzette Ganz, Patricia A. André, Fabrice Partridge, Ann H. Jones, Lee W. Michiels, Stefan Vaz-Luis, Ines J Clin Oncol ORIGINAL REPORTS We aimed to characterize long-term quality of life (QOL) trajectories among patients with breast cancer treated with adjuvant chemotherapy and to identify related patterns of health behaviors. METHODS: Female stage I-III breast cancer patients receiving chemotherapy in CANTO (CANcer TOxicity; ClinicalTrials.gov identifier: NCT01993498) were included. Trajectories of QOL (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–C30 Summary Score) and associations with trajectory group membership were identified by iterative estimations of group-based trajectory models and multivariable multinomial logistic regression, respectively. RESULTS: Four trajectory groups were identified (N = 4,131): excellent (51.7%), very good (31.7%), deteriorating (10.0%), and poor (6.6%) QOL. The deteriorating trajectory group reported fairly good baseline QOL (mean [95% CI], 78.3/100 [76.2 to 80.5]), which significantly worsened at year-1 (58.1/100 [56.4 to 59.9]) and never recovered to pretreatment values through year-4 (61.1/100 [59.0 to 63.3]) postdiagnosis. Healthy behaviors were associated with better performing trajectory groups. Obesity (adjusted odds ratio [aOR] v lean, 1.51 [95% CI, 1.28 to 1.79]; P < .0001) and current smoking (aOR v never, 1.52 [95% CI, 1.27 to 1.82]; P < .0001) at diagnosis were associated with membership to the deteriorating group, which was also characterized by a higher prevalence of patients with excess body weight and insufficient physical activity through year-4 and by frequent exposure to tobacco smoking during chemotherapy. Additional factors associated with membership to the deteriorating group included younger age (aOR, 1-year decrement 1.01 [95% CI, 1.01 to 1.02]; P = .043), comorbidities (aOR v no, 1.22 [95% CI, 1.06 to 1.40]; P = .005), lower income (aOR v wealthier households, 1.21 [95% CI, 1.07 to 1.37]; P = .002), and endocrine therapy (aOR v no, 1.14 [95% CI, 1.01 to 1.30]; P = .047). CONCLUSION: This latent-class analysis identified some patients with upfront poor QOL and a high-risk cluster with severe, persistent postchemotherapy QOL deterioration. Screening relevant patient-level characteristics may inform tailored interventions to mitigate the detrimental impact of chemotherapy and preserve QOL, including early addressal of behavioral concerns and provision of healthy lifestyle support programs. Wolters Kluwer Health 2022-09-20 2022-04-21 /pmc/articles/PMC9509127/ /pubmed/35446677 http://dx.doi.org/10.1200/JCO.21.00277 Text en © 2022 by American Society of Clinical Oncology https://creativecommons.org/licenses/by-nc-nd/4.0/Creative Commons Attribution Non-Commercial No Derivatives 4.0 License: https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle ORIGINAL REPORTS
Di Meglio, Antonio
Havas, Julie
Gbenou, Arnauld S.
Martin, Elise
El-Mouhebb, Mayssam
Pistilli, Barbara
Menvielle, Gwenn
Dumas, Agnes
Everhard, Sibille
Martin, Anne-Laure
Cottu, Paul H.
Lerebours, Florence
Coutant, Charles
Lesur, Anne
Tredan, Olivier
Soulie, Patrick
Vanlemmens, Laurence
Joly, Florence
Delaloge, Suzette
Ganz, Patricia A.
André, Fabrice
Partridge, Ann H.
Jones, Lee W.
Michiels, Stefan
Vaz-Luis, Ines
Dynamics of Long-Term Patient-Reported Quality of Life and Health Behaviors After Adjuvant Breast Cancer Chemotherapy
title Dynamics of Long-Term Patient-Reported Quality of Life and Health Behaviors After Adjuvant Breast Cancer Chemotherapy
title_full Dynamics of Long-Term Patient-Reported Quality of Life and Health Behaviors After Adjuvant Breast Cancer Chemotherapy
title_fullStr Dynamics of Long-Term Patient-Reported Quality of Life and Health Behaviors After Adjuvant Breast Cancer Chemotherapy
title_full_unstemmed Dynamics of Long-Term Patient-Reported Quality of Life and Health Behaviors After Adjuvant Breast Cancer Chemotherapy
title_short Dynamics of Long-Term Patient-Reported Quality of Life and Health Behaviors After Adjuvant Breast Cancer Chemotherapy
title_sort dynamics of long-term patient-reported quality of life and health behaviors after adjuvant breast cancer chemotherapy
topic ORIGINAL REPORTS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509127/
https://www.ncbi.nlm.nih.gov/pubmed/35446677
http://dx.doi.org/10.1200/JCO.21.00277
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