Quality of life and quality-adjusted survival (Q-TWiST) in patients receiving dose-intensive or standard dose chemotherapy for high-risk primary breast cancer

J. Bernhard, David Zahrieh, J. J. Zhang, G. Martinelli, R. Basser, C. Hürny, J. F. Forbes, S. Aebi, W. Yeo, B. Thürlimann, M. D. Green, M. Colleoni, R. D. Gelber, M. Castiglione-Gertsch, K. N. Price, A. Goldhirsch, A. S. Coates

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Quality of life (QL) is an important consideration when comparing adjuvant therapies for early breast cancer, especially if they differ substantially in toxicity. We evaluated QL and Q-TWiST among patients randomised to adjuvant dose-intensive epirubicin and cyclophosphamide administered with filgrastim and progenitor cell support (DI-EC) or standard-dose anthracycline-based chemotherapy (SD-CT). We estimated the duration of chemotherapy toxicity (TOX), time without disease symptoms and toxicity (TWiST), and time following relapse (REL). Patients scored QL indicators. Mean durations for the three transition times were weighted with patient reported utilities to obtain mean Q-TWiST. Patients receiving DI-EC reported worse QL during TOX, especially treatment burden (month 3: P<0.01), but a faster recovery 3 months following chemotherapy than patients receiving SD-CT, for example, less coping effort (P<0.01). Average Q-TWiST was 1.8 months longer for patients receiving DI-EC (95% CI, -2.5 to 6.1). Q-TWiST favoured DI-EC for most values of utilities attached to TOX and REL. Despite greater initial toxicity, quality-adjusted survival was similar or better with dose-intensive treatment as compared to standard treatment. Thus, QL considerations should not be prohibitive if future intensive therapies show superior efficacy.

Original languageEnglish (US)
Pages (from-to)25-33
Number of pages9
JournalBritish Journal of Cancer
Volume98
Issue number1
DOIs
StatePublished - Jan 15 2008
Externally publishedYes

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Quality of Life
Breast Neoplasms
Drug Therapy
Survival
Anthracyclines
Therapeutics
Recurrence
Epirubicin
Cyclophosphamide
Stem Cells

Keywords

  • Adaptation
  • Adjuvant chemotherapy
  • Breast cancer
  • Quality of life
  • Quality-adjusted survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Quality of life and quality-adjusted survival (Q-TWiST) in patients receiving dose-intensive or standard dose chemotherapy for high-risk primary breast cancer. / Bernhard, J.; Zahrieh, David; Zhang, J. J.; Martinelli, G.; Basser, R.; Hürny, C.; Forbes, J. F.; Aebi, S.; Yeo, W.; Thürlimann, B.; Green, M. D.; Colleoni, M.; Gelber, R. D.; Castiglione-Gertsch, M.; Price, K. N.; Goldhirsch, A.; Coates, A. S.

In: British Journal of Cancer, Vol. 98, No. 1, 15.01.2008, p. 25-33.

Research output: Contribution to journalArticle

Bernhard, J, Zahrieh, D, Zhang, JJ, Martinelli, G, Basser, R, Hürny, C, Forbes, JF, Aebi, S, Yeo, W, Thürlimann, B, Green, MD, Colleoni, M, Gelber, RD, Castiglione-Gertsch, M, Price, KN, Goldhirsch, A & Coates, AS 2008, 'Quality of life and quality-adjusted survival (Q-TWiST) in patients receiving dose-intensive or standard dose chemotherapy for high-risk primary breast cancer', British Journal of Cancer, vol. 98, no. 1, pp. 25-33. https://doi.org/10.1038/sj.bjc.6604092
Bernhard, J. ; Zahrieh, David ; Zhang, J. J. ; Martinelli, G. ; Basser, R. ; Hürny, C. ; Forbes, J. F. ; Aebi, S. ; Yeo, W. ; Thürlimann, B. ; Green, M. D. ; Colleoni, M. ; Gelber, R. D. ; Castiglione-Gertsch, M. ; Price, K. N. ; Goldhirsch, A. ; Coates, A. S. / Quality of life and quality-adjusted survival (Q-TWiST) in patients receiving dose-intensive or standard dose chemotherapy for high-risk primary breast cancer. In: British Journal of Cancer. 2008 ; Vol. 98, No. 1. pp. 25-33.
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