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Arraras JI, Illarramendi JJ, Manterola A, de la Cruz S, Zarandona U, Ibañez B, Salgado E, Visus I, Barrado M, Teiejira L, Martinez MI, Martinez E, Vera R. Quality of life in Spanish postmenopausal breast cancer patients with localized disease who finish endocrine treatment: a prospective study. Menopause 2023; 30:613-620. [PMID: 37022296 DOI: 10.1097/gme.0000000000002178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
OBJECTIVE In this article, the quality of life (QOL) of Spanish postmenopausal early-stage breast cancer patients who have finished endocrine therapy (ET), QOL changes after endocrine therapy cessation, and the differences between two endocrine therapy modalities (tamoxifen or aromatase inhibitor [AI]) are studied. More QOL information after endocrine therapy cessation is needed. METHODS A prospective cohort study was performed. Participating in the study were 158 postmenopausal patients who had received tamoxifen or AI for 5 years. In some cases, endocrine therapy may have changed during those 5 years.Patients completed the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BR45 questionnaires at baseline, after 6 months, and after 1 year of follow-up. Patients older than 65 years also completed the QLQ-ELD14. Linear mixed-effect models were used to evaluate longitudinal changes in QOL and differences in QOL between endocrine therapy modalities. RESULTS QOL scores for the whole sample throughout follow-up were high (>80/100 points) in most QOL areas. Moderate limitations (>30 points) occurred in the QLQ-BR45 in sexual functioning and sexual enjoyment, future perspective, and joint symptoms. Moderate limitations also occurred in the QLQ-ELD14 in worries about others, maintaining purpose, joint stiffness, future worries, and family support. In those who had finished endocrine therapy, pain was reduced in all three assessments conducted during the 1-year follow-up period in both groups. Tamoxifen patients showed better QOL in functioning (role functioning, global QOL, financial impact), symptoms (pain), and emotional areas (future perspective and worries about others) than AI patients but worse QOL in skin mucosis symptoms. CONCLUSIONS The results of this study show that postmenopausal early-stage breast cancer patients adapted well to their disease and endocrine therapy treatment. QOL improvements in the 1-year follow-up period appeared in one key area: pain. Differences between endocrine therapy modalities suggested QOL was better in the tamoxifen group than in the AI group.
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Affiliation(s)
| | - Jose Juan Illarramendi
- From the Medical Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Ana Manterola
- Radiotherapeutic Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Susana de la Cruz
- From the Medical Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | | | - Berta Ibañez
- Navarrabiomed, RICAPPS, Unidad de Metodología, Pamplona, Spain
| | - Esteban Salgado
- From the Medical Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Ignacio Visus
- Radiotherapeutic Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Marta Barrado
- Radiotherapeutic Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Lucia Teiejira
- From the Medical Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - María Isabel Martinez
- Radiotherapeutic Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Enrique Martinez
- Radiotherapeutic Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - Ruth Vera
- From the Medical Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
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Arraras JI, Illarramendi JJ, Manterola A, Cruz SDL, Zarandona U, Ibañez B, Salgado E, Visus I, Barrado M, Teijeira L, Martinez E, Vera R. Quality of life of early-stage breast-cancer patients diagnosed with COVID-19 in the first three waves of the epidemic treated in the Spanish region of Navarre. Psychooncology 2023; 32:730-740. [PMID: 36882856 DOI: 10.1002/pon.6118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/01/2023] [Accepted: 02/20/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVES To describe the Quality of Life (QOL) of breast-cancer patients diagnosed with COVID-19 and analyse its evolution, compare the QOL of these patients according to the COVID-19 wave in which they were diagnosed, and examine the clinical and demographic determinants of QOL. METHODS A total of 260 patients with breast cancer (90.8% I-III stages) and COVID-19 (85% light/moderate) were included (February-September 2021) in this study. Most patients were receiving anticancer treatment (mainly hormonotherapy). Patients were grouped according to the date of COVID-19 diagnosis: first wave (March-May 2020, 85 patients), second wave (June-December 2020, 107 patients) and third wave (January-September 2021, 68 patients). Quality of Life was assessed 10 months, 7 months, and 2 weeks after these dates, respectively. Patients completed QLQ-C30, QLQ-BR45, and Oslo COVID-19 QLQ-PW80 twice over four months. Patients ≥65 also completed QLQ-ELD14. The QOL of each group and changes in QOL for the whole sample were compared (non-parametric tests). Multivariate logistic regression identified patient characteristics related to (1) low global QOL and (2) changes in Global QOL between assessments. RESULTS Moderate limitations (>30 points) appeared in the first assessment in Global QOL, sexual scales, three QLQ-ELD14 scales, and 13 symptoms and emotional COVID-19 areas. Differences between the COVID-19 groups appeared in two QLQ-C30 areas and four QLQ-BR45 areas. Quality of Life improvements between assessments appeared in six QLQ-C30, four QLQ-BR45 and 18 COVID-19 questionnaire areas. The best multivariate model to explain global QOL combined emotional functioning, fatigue, endocrine treatment, gastrointestinal symptoms, and targeted therapy (R2 = 0.393). The best model to explain changes in global QOL combined physical and emotional functioning, malaise, and sore eyes (R2 = 0.575). CONCLUSIONS Patients with breast cancer and COVID-19 adapted well to illness. The few differences between wave-based groups (differences in follow-up notwithstanding) may have arisen because the second and third waves saw fewer COVID restrictions, more positive COVID information, and more vaccinated patients.
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Affiliation(s)
| | | | - Ana Manterola
- Radiotherapeutic Oncology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Susana de la Cruz
- Medical Oncology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Uxue Zarandona
- Oncology Departments, Hospital Universitario de Navarra, Pamplona, Spain
| | - Berta Ibañez
- Navarrabiomed, RICAPPS, Unidad de Metodología, Pamplona, Spain
| | - Esteban Salgado
- Medical Oncology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Ignacio Visus
- Radiotherapeutic Oncology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Marta Barrado
- Radiotherapeutic Oncology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Lucia Teijeira
- Medical Oncology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Enrique Martinez
- Radiotherapeutic Oncology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Ruth Vera
- Medical Oncology, Hospital Universitario de Navarra, Pamplona, Spain
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Olivera-Salguero R, Seguí E, Cejalvo JM, Oliveira M, Tolosa P, Vidal M, Malumbres M, Gavilá J, Saura C, Pernas S, López R, Margelí M, Balmaña J, Muñoz M, Blancas I, Boni V, Ciruelos E, Galve E, Perelló A, Sánchez-Bayona R, de la Cruz S, de la Hoya M, Galván P, Sanfeliu E, Gonzalez-Farre B, Sirenko V, Blanch-Torras A, Canes J, Masanas H, Olmos R, Forns M, Prat A, Casas A, Pascual T. HOPE (SOLTI-1903) breast cancer study: real-world, patient-centric, clinical practice study to assess the impact of genomic data on next treatment decision-choice in patients with locally advanced or metastatic breast cancer. Front Oncol 2023; 13:1151496. [PMID: 37188177 PMCID: PMC10175800 DOI: 10.3389/fonc.2023.1151496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023] Open
Abstract
Background Metastatic breast cancer (mBC) causes nearly all BC-related deaths. Next-generation sequencing (NGS) technologies allow for the application of personalized medicine using targeted therapies that could improve patients' outcomes. However, NGS is not routinely used in the clinical practice and its cost induces access-inequity among patients. We hypothesized that promoting active patient participation in the management of their disease offering access to NGS testing and to the subsequent medical interpretation and recommendations provided by a multidisciplinary molecular advisory board (MAB) could contribute to progressively overcome this challenge. We designed HOPE (SOLTI-1903) breast cancer trial, a study where patients voluntarily lead their inclusion through a digital tool (DT). The main objectives of HOPE study are to empower mBC patients, gather real-world data on the use of molecular information in the management of mBC and to generate evidence to assess the clinical utility for healthcare systems. Trial design After self-registration through the DT, the study team validates eligibility criteria and assists patients with mBC in the subsequent steps. Patients get access to the information sheet and sign the informed consent form through an advanced digital signature. Afterwards, they provide the most recent (preferably) metastatic archival tumor sample for DNA-sequencing and a blood sample obtained at the time of disease progression for ctDNA analysis. Paired results are reviewed by the MAB, considering patient's medical history. The MAB provides a further interpretation of molecular results and potential treatment recommendations, including ongoing clinical trials and further (germline) genetic testing. Participants self-document their treatment and disease evolution for the next 2 years. Patients are encouraged to involve their physicians in the study. HOPE also includes a patient empowerment program with educational workshops and videos about mBC and precision medicine in oncology. The primary endpoint of the study was to describe the feasibility of a patient-centric precision oncology program in mBC patients when a comprehensive genomic profile is available to decide on a subsequent line of treatment. Clinical trial registration www.soltihope.com, identifier NCT04497285.
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Affiliation(s)
| | - Elia Seguí
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Juan Miguel Cejalvo
- SOLTI Cancer Research Group, Barcelona, Spain
- Hospital Clínico Universitario de Valencia, INCLIVA (Instituto de Investigación Sanitaria), Universidad Valencia, Valencia, Spain
| | - Mafalda Oliveira
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Breast Cancer Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Pablo Tolosa
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Maria Vidal
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Breast Cancer Unit, Institute of Oncology Barcelona (IOB) – Quirónsalud, Barcelona, Spain
| | - Marcos Malumbres
- Cancer Cell Cycle Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
- Cell Division and Cancer Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Joaquín Gavilá
- SOLTI Cancer Research Group, Barcelona, Spain
- Instituto Valenciano de Oncología (IVO), Valencia, Spain
| | - Cristina Saura
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Sonia Pernas
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Catalan Institute of Oncology (ICO)/Institut d’Investigació Biomédica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Rafael López
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department and Translational Medical Oncology Group, Clinical University Hospital and Health Research Institute of Santiago de Compostela (IDIS)-CIBERONC, Santiago de Compostela, Spain
| | - Mireia Margelí
- SOLTI Cancer Research Group, Barcelona, Spain
- Catalan Institute of Oncology (ICO), Hospital Germans Trias i Pujol/Badalona Applied Research Group in Oncology (B-ARGO Group), Oncology Department, Badalona, Spain
| | - Judith Balmaña
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Montserrat Muñoz
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Isabel Blancas
- SOLTI Cancer Research Group, Barcelona, Spain
- Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada (ibs. Granada) and Medicine Department, Granada University, Granada, Spain
| | - Valentina Boni
- SOLTI Cancer Research Group, Barcelona, Spain
- Next Madrid, Universitary Hospital Quiron Salud Madrid, Madrid, Spain
| | - Eva Ciruelos
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Centro Integral Oncológico Clara Campal HM (CIOCC), Madrid, Spain
| | - Elena Galve
- SOLTI Cancer Research Group, Barcelona, Spain
- Hospital Universitario Basurto (OSI Bilbao-Basurto), Bilbao, Spain
| | - Antonia Perelló
- SOLTI Cancer Research Group, Barcelona, Spain
- Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Rodrigo Sánchez-Bayona
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Susana de la Cruz
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Miguel de la Hoya
- Molecular Oncology Laboratory, CIBERONC, Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| | - Patricia Galván
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Esther Sanfeliu
- SOLTI Cancer Research Group, Barcelona, Spain
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Pathology Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Blanca Gonzalez-Farre
- SOLTI Cancer Research Group, Barcelona, Spain
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Pathology Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Valeria Sirenko
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | | | - Jordi Canes
- SOLTI Cancer Research Group, Barcelona, Spain
| | | | - Rosa Olmos
- Asociación Española de Cáncer de Mama Metastásico, Oviedo, Spain
| | - Margarita Forns
- Asociación Española de Cáncer de Mama Metastásico, Oviedo, Spain
| | - Aleix Prat
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Ana Casas
- SOLTI Cancer Research Group, Barcelona, Spain
- Fundación Actitud Frente al Cáncer, Sevilla, Spain
- *Correspondence: Tomás Pascual, ; Ana Casas,
| | - Tomás Pascual
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain
- *Correspondence: Tomás Pascual, ; Ana Casas,
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Arraras JI, Manterola A, Illarramendi JJ, Asin G, de la Cruz S, Ibañez B, Galbete A, Salgado E, Zarandona U, Vera R, Dominguez MA, Martinez E. Corrigendum to “Quality of life evolution in elderly survivors with localized breast cancer treated with radiotherapy over a three-year follow-up” [Breast 41 (October 2018) 74–81]. Breast 2019; 43:7. [DOI: 10.1016/j.breast.2018.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Arraras JI, Manterola A, Asin G, Illarramendi JJ, Cruz SDL, Ibañez B, Delfrade J, Salgado E, Zarandona U, Cambra K, Vera R, Dominguez MA. Quality of life in elderly patients with localized breast cancer treated with radiotherapy. A prospective study. Breast 2016; 26:46-53. [PMID: 27017241 DOI: 10.1016/j.breast.2015.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 12/12/2015] [Accepted: 12/17/2015] [Indexed: 11/12/2022] Open
Abstract
PURPOSE There is a debate on the role of adjuvant Radiotherapy (RT) in elderly breast cancer patients. The aim is to study Quality of Life (QL) throughout the treatment and follow-up periods in early stages breast cancer patients who have started radiotherapy, and to compare the QL of axillary surgery groups. METHODS 173 patients, ≥65 years completed the EORTC QLQ-C30 and QLQ-BR23, and the Interview for Deterioration in Daily Living Activities in Dementia(IDDD) questionnaires three times throughout treatment and follow-up periods. Linear mixed effect models were used to evaluate longitudinal changes in QL, and whether these changes differed among axillary surgery groups. RESULTS QL scores were high (>70/100 points) in most QL areas, with moderate limitations (>30) in sexual functioning and enjoyment, future perspective and global QL. In six areas there was a decline at the RT sessions end, that after 6 weeks was recovered. For three areas, there was an improvement in the follow-up measurement compared to the previous assessments. Changes in seven areas were <5 points. Axillary node dissection patients had a body image decrease (6 points) in the follow up period. The lymphadenectomy group had more fatigue (10 points, p = 0.078) than the other two axillary surgery groups. CONCLUSIONS Results orientate towards good patients' adaptation to their disease and treatments, and to administering RT in early stages breast cancer patients. QL differences between the axillary surgery groups and in their evolutions were few but have appeared in key QL areas.
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Affiliation(s)
- Juan Ignacio Arraras
- Complejo Hospitalario de Navarra, Radiotherapeutic Oncology Department, Irunlarrea 3, 31008 Pamplona, Spain; Complejo Hospitalario de Navarra, Medical Oncology Department, Irunlarrea 3, 31008 Pamplona, Spain.
| | - Ana Manterola
- Complejo Hospitalario de Navarra, Radiotherapeutic Oncology Department, Irunlarrea 3, 31008 Pamplona, Spain
| | - Gemma Asin
- Complejo Hospitalario de Navarra, Radiotherapeutic Oncology Department, Irunlarrea 3, 31008 Pamplona, Spain
| | - Jose Juan Illarramendi
- Complejo Hospitalario de Navarra, Medical Oncology Department, Irunlarrea 3, 31008 Pamplona, Spain
| | - Susana de la Cruz
- Complejo Hospitalario de Navarra, Medical Oncology Department, Irunlarrea 3, 31008 Pamplona, Spain
| | - Berta Ibañez
- Fundación Miguel Servet-NavarraBiomed, Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Irunlarrea 3, 31008 Pamplona, Spain
| | - Josu Delfrade
- Instituto Salud Pública, CIBER Salud Pública, Leyre 3, 31003 Pamplona, Spain
| | - Esteban Salgado
- Complejo Hospitalario de Navarra, Medical Oncology Department, Irunlarrea 3, 31008 Pamplona, Spain
| | - Uxue Zarandona
- Complejo Hospitalario de Navarra, Radiotherapeutic Oncology Department, Irunlarrea 3, 31008 Pamplona, Spain; Complejo Hospitalario de Navarra, Medical Oncology Department, Irunlarrea 3, 31008 Pamplona, Spain
| | - Koldo Cambra
- Fundación Miguel Servet-NavarraBiomed, Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Irunlarrea 3, 31008 Pamplona, Spain
| | - Ruth Vera
- Complejo Hospitalario de Navarra, Medical Oncology Department, Irunlarrea 3, 31008 Pamplona, Spain
| | - Miguel Angel Dominguez
- Complejo Hospitalario de Navarra, Radiotherapeutic Oncology Department, Irunlarrea 3, 31008 Pamplona, Spain
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Ignacio Arraras J, Juan Illarramendi J, de la Cruz S, Asin G, Manterola A, Ibanez B, Salgado E, Cambra K, Zarandona U, Angel Dominguez M, Vera R. Quality of life in long-term premenopausal early-stage breast cancer survivors from Spain. Effects of surgery and time since surgery. J BUON 2016; 21:1090-1098. [PMID: 27837609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE More research is needed into Quality of Life (QoL) in young early-stage breast cancer patients in the long-term. Knowledge of long-term effects of surgery on QoL in breast cancer patients is limited. The purpose of this study was to assess QoL in premenopausal Spanish early- stage breast cancer patients over a long follow-up period and evaluate differences among surgery-treated groups and the influence of time on patient QoL. METHODS 243 premenopausal stage I-III relapse-free breast cancer patients completed the EORTC QLQ-C30 and QLQ-BR23 questionnaire once during follow-up (5-20 years after surgery). Univariate and multivariate logistic regression analyses were performed to estimate the results. RESULTS QoL mean scores were high in most areas (>80 points in functioning: <20 points in symptoms areas). Limitations were moderate (>30 points) in global QoL, sleep disturbance, future perspective, sexual areas, and hot flashes. Mastectomized patients had a 4-fold greater risk of low scores in body image. Patients with a longer follow-up showed lower systemic side effects, hot flashes and breast symptoms. CONCLUSIONS QoL in Spanish premenopausal early-stage breast cancer patients in a long follow-up after surgery is high. Differences in QoL among surgery-treated groups are limited. Time since surgery influences treatment side effects.
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Affiliation(s)
- Juan Ignacio Arraras
- Complejo Hospitalario de Navarra, Department of Medical Oncology, Pamplona, Spain
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Arraras JI, Illarramendi JJ, Viudez A, Ibáñez B, Lecumberri MJ, de la Cruz S, Hernandez B, Zarandona U, Cambra K, Martinez M, Salgado E, Lainez N, Vera R. Determinants of patient satisfaction with care in a Spanish oncology day hospital and its relationship with quality of life. Psychooncology 2013; 22:2454-61. [PMID: 23733231 DOI: 10.1002/pon.3307] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 04/20/2013] [Accepted: 04/24/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study evaluates satisfaction with care (SC) in cancer patients treated at a Spanish day hospital to identify SC determinants and assess the relationship between SC and quality of life. METHODS One hundred seventy-six patients with different tumour sites and disease stages completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Cancer Outpatient Satisfaction with Care questionnaire for chemotherapy (OUT-PATSAT35 CT), the Oberst patients' perception of care quality and satisfaction scales, and an item on intention to recommend the hospital. Frequencies in the SC instruments, Spearman correlations between each scale of the OUT-PATSAT35 CT and overall satisfaction and between the subscales of OUT-PATSAT35 CT and of QLQ-C30 were calculated, and the determinants of patients' SC were calculated through multivariate regression models. RESULTS Satisfaction with care was high: mean scores were >70 in all OUT-PATSAT35 CT areas except doctor availability and environment. These scores were in line with the other SC instruments. Correlation with overall satisfaction was high and statistically significant (p < 0.01) for all subscales, especially for the nurses domain, which also had higher SC scores. Correlations between the EORTC QLQ-C30 and the OUT-PATSAT35 CT were low (≤ 0.35). Younger patients and those with breast cancer showed significantly lower satisfaction in most subscales. Unmarried patients and patients that had undergone surgery reported lower satisfaction only in specific subscales. CONCLUSIONS Satisfaction with care among cancer patients treated at the day hospital is high. Nurses play a key and successful role. Age and tumour location revealed stronger relationships with SC. Correlations between SC and quality of life indicate that these concepts are complementary.
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Gurpide A, Sadaba B, Martin-Algarra S, Azanza JR, Lopez-Picazo JM, Campanero MA, Cabello JP, Gil-Aldea I, de la Cruz S, Fernandez Gallego V, Reyna C, Olier Garate C, Blanco-Prieto MJ, Ceballos J, Garcia-Foncillas J, Perez-Gracia JL. Randomized crossover pharmacokinetic evaluation of subcutaneous versus intravenous granisetron in cancer patients treated with platinum-based chemotherapy. Oncologist 2007; 12:1151-5. [PMID: 17914085 DOI: 10.1634/theoncologist.12-9-1151] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND 5-HT3-receptor antagonists are one of the mainstays of antiemetic treatment, and they are administered either i.v. or orally. Nevertheless, sometimes neither administration route is feasible, such as in patients unable to admit oral intake managed in an outpatient setting. Our objective was to evaluate the bioavailability of s.c. granisetron. PATIENTS AND METHODS Patients receiving platinum-based chemotherapy were randomized to receive 3 mg of granisetron either s.c. or i.v. in a crossover manner during two cycles. Blood and urine samples were collected after each cycle. Pharmacokinetic parameters observed with each administration route were compared by analysis of variance. RESULTS From May to November 2005, 31 patients were included and 25 were evaluable. Subcutaneous granisetron resulted in a 27% higher area under the concentration-time curve for 0-12 hours (AUC(0-12h)) and higher levels at 12 hours, with similar values for AUC(0-24h). The maximum concentration was lower with the s.c. than with the i.v. route and was observed 30 minutes following s.c. administration. CONCLUSION Granisetron administered s.c. achieves complete bioavailability. This is the first study that shows that s.c. granisetron might be a valid alternative to i.v. delivery. Further trials to confirm clinical equivalence are warranted. This new route of administration might be especially relevant for outpatient management of emesis in cancer patients.
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Affiliation(s)
- Alfonso Gurpide
- Oncology Department, Clínica Universitaria de Navarra, University of Navarra, Navarra, Spain.
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Abstract
We report the case of a 42 year-old woman with myasthenia gravis associated with a malignant thymoma. Despite surgery, chemotherapy and radiotherapy, the thymoma showed soft tissues, pleural and mediastinic progression. Unexpectedly, a complete remission of the thymoma was confirmed by FDG-PET after four cycles of immunoglobulins, administered as treatment for a myasthenic crisis. To our knowledge this is the first case report of complete remission of a malignant thymoma with immunoglobulin therapy.
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