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Supportive Care in Cancer
Erschienen in: Supportive Care in Cancer 11/2015

01.11.2015 | Original Article

Chemotherapy interruptions in relation to symptom severity in advanced breast cancer

verfasst von: Gwen Wyatt, Alla Sikorskii, Irena Tesnjak, David Victorson, Gordan Srkalovic

Erschienen in: Supportive Care in Cancer | Ausgabe 11/2015

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Abstract

Purpose

Interruptions in medical treatment such as dose delays, reductions, or stoppages can lead to suboptimal treatment of cancer. Knowing how and for whom symptom severity and symptom interference with activities of daily living (ADL) are associated with treatment interruptions can guide behavioral interventions for supportive care. The purpose of this analysis is to inform research and clinical practice by bringing attention to specific patient symptoms that may hinder dose completion.

Methods

A secondary analysis of data collected in a randomized clinical trial (RCT) of reflexology for symptom management was performed. The trial enrolled women with advanced breast cancer undergoing treatment (N = 385). Outcome data were collected at baseline, weeks 5 and 11 using valid and reliable measures. Medical records provided data on treatment interruptions and metastasis. The association between alterations in medical treatment during the study period with symptom severity, symptom interference with ADLs, and metastatic status were tested using generalized estimating equation (GEE) models.

Results

The relationship between dose delays and dose reductions and symptom severity was differential according to metastatic status, with the higher strength of association among women with distant metastasis compared to those with loco-regional disease (p = 0.02). The interaction of symptom interference and metastatic status was also significantly related to dose delays and reductions (p = 0.04). Severity of pain was a stronger predictor of dose delays or reductions among patients with distant metastasis compared to those with loco-regional disease (p < 0.01).

Conclusion

The analysis highlights the importance of understanding symptom outcomes that impact research, practice, and treatment decisions.
Literatur
1.
Barbour SY (2008) Caring for the treatment-experienced breast cancer patient: the pharmacist's role. Am J Health Syst Pharm 65(10 Suppl 3):S16–S22CrossRefPubMed
2.
Leonard K (2012) A European survey relating to cancer therapy and neutropenic infections: nurse and patient viewpoints. Eur J Oncol Nurs 16(4):380–386CrossRefPubMed
3.
Chirivella I, Bermejo B, Insa A et al (2009) Optimal delivery of anthracycline-based chemotherapy in the adjuvant setting improves outcome of breast cancer patients. Breast Cancer Res Treat 114(3):479–484CrossRefPubMed
4.
Kubicek GJ, Kimler BF, Wang F, Reddy EK, Girod DA, Williamson SK (2011) Chemotherapy in head and neck cancer: clinical predictors of tolerance and outcomes. Am J Clin Oncol 34(4):380–384CrossRefPubMed
5.
Yood MU, Owusu C, Buist DS et al (2008) Mortality impact of less-than-standard therapy in older breast cancer patients. J Am Coll Surg 206(1):66–75CrossRefPubMed
6.
Kim J, Kim Y, Lee K et al (2014) The early discontinuation of palliative chemotherapy in older patients with cancer. Support Care Cancer 22(3):773–781CrossRefPubMed
7.
Lyman GH (2009) Impact of chemotherapy dose intensity on cancer patient outcomes. J Natl Compr Canc Netw 7(1):99–108PubMed
8.
McLellan B, Kerr H (2011) Cutaneous toxicities of the multikinase inhibitors sorafenib and sunitinib. Dermatol Ther 24(4):396–400CrossRefPubMed
9.
Trotti A, Colevas A, Setser A, Basch E (2007) Patient-reported outcomes and the evolution of adverse event reporting in oncology. J Clin Oncol 25(32):5121–5127CrossRefPubMed
10.
Basch E, Artz D, Dulko D, Scher K, Sabbatini P (2005) Patient online self-reporting of toxicity symptoms during chemotherapy. J Clin Oncol 23(15):3552–3561CrossRefPubMed
11.
Sikorskii A, Wyatt G, Tamkus D, Victorson D, Rahbar M, Ahn S (2012) Concordance between patient reports of cancer-related symptoms and medical records documentation. J Pain Symptom Manage 44(3):362–372PubMedCentralCrossRefPubMed
12.
Stromgren AS, Groenvold M, Pedersen L, Olsen AK, Spile M, Sjogren P (2001) Does the medical record cover the symptoms experienced by cancer patients receiving palliative care? A comparison of the record and patient self-rating. J Pain Symp Manag 21(3):189–196CrossRef
13.
Volgezan NJ, Breitbart W, Cella DF et al (1997) Patient, caregiver, and oncologist perception of cancer-related fatigue: resuslts of a tri-part assessment survey. Semin Hematol 34:4–12
14.
Mazzotti E, Cappellini GCA, Buconovo S et al (2012) Treatment-related side effects and quality of life in cancer patients. Support Care Cancer 20(10):2553–2557CrossRefPubMed
15.
Wyatt G, Sikorskii A, Rahbar M, Victorson D, You M (2012) Health-related quality of life outcomes: a reflexology trial with patients with advanced-stage breast cancer. Oncol Nurs Forum 39(6):568–577PubMedCentralCrossRefPubMed
16.
Margalit DN, Mamon HJ, Ancukiewicz M et al (2011) Tolerability of combined modality therapy for rectal cancer in elderly patients aged 75 years and older. Int J Radiat Oncol Biol Phys 81(5):e735–e741CrossRefPubMed
17.
MA AMT, Barone J, Wallis AE et al (2008) Noncompliance with adjuvant radiation, chemotherapy, or hormonal therapy in breast cancer patients. Am J Surg 196(4):500–504
18.
Salloum RG, Smith TJ, Jensen GA, Lafata JE (2012) Factors associated with adherence to chemotherapy guidelines in patients with non-small cell lung cancer. Lung Cancer 75:255–260PubMedCentralCrossRefPubMed
19.
Gandhi M, Oishi K, Zubal B, Lacouture M (2010) Unanticipated toxicities from anicancer therapies: survivors' perspectives. Support Care Cancer 18(11):1461–1468CrossRefPubMed
20.
Fairclough DL, Fetting JH, Cella D, Wonson W, Moinpour CM (1999) Quality of life and quality adjusted survival for breast cancer patients receiving adjuvant therapy. Qual Life Res 8(8):723–731CrossRefPubMed
21.
Du XL, Osborne C, Goodwin JS (2002) Population-based assessment of hospitalizations for toxicity from chemotherapy in older women with breast cancer. J Clin Oncol 20(24):4636–4642PubMedCentralCrossRefPubMed
22.
Thornton LM, Madlensky L, Flatt SW, Kaplan RM, Pierce JP (2005) The impact of a second breast cancer diagnosis on health related quality of life. Breast Cancer Res Treat 92(1):25–33CrossRefPubMed
23.
Wyatt G, Sikorskii A, Tamkus D, You M (2013) Quality of life among advanced breast cancer patients with and without distant metastasis. Eur J Cancer Care 22:272–280CrossRef
24.
Vilhauer RP (2008) A qualitative study of the experiences of women with metastatic breast cancer. Palliat Supp Care 6:249–258
25.
Given CW, Stommel M, Given B, Osuch J, Kurtz ME, Kurtz JC (1993) The influence of cancer patients' symptoms and functional status on patients' depression and family caregivers' reaction and depression. Health Psychol 12(4):277–285CrossRefPubMed
26.
Given C, Given B, Rahbar M et al (2004) Effect of a cognitive behavioral intervention on reducing symptom severity during chemotherapy. J Clin Oncol 22(3):507–516CrossRefPubMed
27.
Cleeland CS (1990) Assessment of pain in cancer: measurement issues. Advan Pain Res Ther 16:47–55
28.
Mendoza TR, Wang XS, Cleeland CS et al (1999) The rapid assessment of fatigue severity in cancer patients: use of the brief fatigue inventory. Cancer 85(5):1186–1196CrossRefPubMed
29.
Ware JE, Snow KK, Kosinski M, Gandek B (1993) SF-36 health survey: manual and interpretation guide. The Health Institute, New England Medical Center, Boston
30.
Kurtz M, Kurtz J, Stommel M, Given C, Given B (2000) Symptomatology and loss of physical functioning among geriatric patients with lung cancer. J Pain Symptom Manage 19(4):249–256CrossRefPubMed
31.
Van Onselen C, Cooper BA, Lee K et al (2012) Identification of distinct subgroups of breast cancer patients based on self-reported changes in sleep disturbance. Supp Care Canc 20(10):2611–2619CrossRef
32.
Gerber L, Stout N, McGarvey C et al (2011) Factors predicting clinically significant fatigue in women following treatment for primary breast cancer. Support Care Cancer 19(10):1581–1591PubMedCentralCrossRefPubMed
33.
Vavra KL, Saadeh CE, Rosen AL, Uptigrove CE, Srkalovic G (2013) Improving the relative dose intensity of systemic chemotherapy in a community-based outpatient cancer center. J. Oncol Pract 9(5):e203–e211
34.
Bertheussen G, Kaasa S, Hokstad A et al (2012) Deasibility and canges in skymptoms and functioning following inpatient cancer rehabilitation. Acta Oncol 51(8):1070–1080CrossRefPubMed
35.
Sikorskii A, Given C, Given B, Jeon S, McCorkle R (2006) Testing the effects of treatment complications on a cognitive behavioral intervention for reducing symptom severity. J Pain Symptom Manage 32(2):129–139CrossRefPubMed
36.
Given BA, Given CW, Jeon S, Sikorskii A (2005) The effect of neutropenia on the impact of a cognitive-behavioral intervention for symptom management. Cancer 104(3):869–878CrossRefPubMed
Metadaten
Titel
Chemotherapy interruptions in relation to symptom severity in advanced breast cancer
verfasst von
Gwen Wyatt
Alla Sikorskii
Irena Tesnjak
David Victorson
Gordan Srkalovic
Publikationsdatum
01.11.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 11/2015
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2698-5

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