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

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.

Q & A

Question and answer session with presenters Roger Burt, Peter V. Krats, Paul Lubotina.

Q & A

Question and answer session with presenters John Beck, Thomas Mackaman, and Erik Nordberg.

Q & A

Question and answer session with presenters Sarah Fayen Scarlett and Peter V. Krats.

Q & A

Question and answer session with presenters Daniel Schneider, Gary Kaunonen, and Jari Nikkola.

Q & A

Question and answer session with presenters Pauli Heikkilä, Oren Tikkanen, and Lynn Laitala.

Q & A

Question and answer session with presenters Tanja Aho, A. Brooke Boulton, and Saku Pinta.

Q & A

Question and answer session with presenters Auvo Kostiainen, William Pratt, and Richard Hudelson.

Q & A

Question and answer session with presenters Hilary Virtanen and Teuvo Peltoniemi.

Q & A

Question and answer session with presenters Patrick Allan Pospisek, Alice Margerum, and Shannon Rebecca Kirkwood.

Q & A

Question and answer session with presenters Daniel Schneider, Ryan Tate, and Brendan Pelto.

Panelist Presentations & Q&A

Immediately following lunch, our women panelists will speak about the mathematics courses they took and the role mathematics plays in their chosen career, followed by questions from the audience.