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Health-related quality of life as prognostic factor for response, progression-free survival, and survival in women with metastatic breast cancer

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Abstract

The purpose of this study was to, on an exploratory basis, investigate the role of health-related quality of life (HRQoL) at randomization as an independent prognostic factor for response to treatment, progression-free survival (PFS), and survival. In the TEX trial, 287 patients with locally advanced or distant metastatic breast cancer were randomized to either epirubicin and paclitaxel (ET) or epirubicin, paclitaxel, and capecitabine (TEX). Treatment was repeated every 3 weeks. The EORTC QLQ-C30 questionnaire was used to assess HRQoL before randomization. A total of 252 (88%) patients completed EORTC QLQ-C30 before randomization. Clinical conditions included in the multivariate model were age, number of metastases, ECOG performance status, time between diagnosis and randomization, and treatment arm. Univariate analysis revealed an association between prolonged survival and the HRQoL variables global health, physical functioning, role functioning, fatigue, and pain (P < 0.01). After controlling for clinical conditions, only fatigue remained statistically significant. No statistically significant relationships were found between HRQoL and PFS. In the analysis of the association between HRQoL and response to treatment, role functioning, social functioning, fatigue, nausea/vomiting, and appetite loss remained statistically significant. HRQoL variables could act as important predictors of response to treatment, progression-free survival, and overall survival in women with metastatic breast cancer.

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Acknowledgments

This research was funded by the King Gustav V Jubilee Clinic Cancer Research Foundation, the Swedish Cancer Society, and the Swedish Breast Cancer Association (BRO).

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Authors and Affiliations

  1. Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University, 413 45, Gothenburg, Sweden

    Helene Svensson

  2. Department of Oncology, Division of Selected Clinical Specialities, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden

    Helene Svensson & Zakaria Einbeigi

  3. Department of Oncology-Pathology, Karolinska University Hospital, 171 76, Stockholm, Sweden

    Thomas Hatschek & Hemming Johansson

  4. Department of Oncology–Pathology, Karolinska Institute, 171 76, Stockholm, Sweden

    Yvonne Brandberg

Authors
  1. Helene Svensson
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  2. Thomas Hatschek
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  3. Hemming Johansson
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  4. Zakaria Einbeigi
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  5. Yvonne Brandberg
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Corresponding author

Correspondence to Helene Svensson.

Members of the TEX study group

Members of the TEX study group

Thomas Hatschek (Coordinating Investigator), Yvonne Brandberg (QoL), John Carstensen (Statistics), Mårten Fernö (Translational research), Marianne Frostvik Stolt (Laboratory), Mats Hellström (CTO), Maarit Maliniemi (CTO), Helene Svensson (CTO), Gunnar Åström (Radiology), Jonas Bergh, Judith Bjöhle, Elisabet Lidbrink, Sam Rotstein, Birgitta Wallberg (Karolinska University Hospital, Stockholm), Zakaria Einbeigi (Sahlgrenska University Hospital, Gothenburg), Thomas Walz (Linköping University Hospital), Martin Söderberg (Malmö University Hospital), Niklas Loman, Per Malmström (Lund University Hospital), Martin Malmberg (Helsingborg General Hospital), Lena Carlsson (Sundsvall General Hospital), Birgitta Lindh (Umeå University Hospital), Marie Sundqvist (Kalmar General Hospital), Lena Malmberg (Karlstad General Hospital).

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Svensson, H., Hatschek, T., Johansson, H. et al. Health-related quality of life as prognostic factor for response, progression-free survival, and survival in women with metastatic breast cancer. Med Oncol 29, 432–438 (2012). https://doi.org/10.1007/s12032-011-9844-9

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  • DOI: https://doi.org/10.1007/s12032-011-9844-9

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