Quality of life in patients undergoing systemic therapy for advanced breast cancer

Quality of life in patients undergoing systemic therapy for advanced breast cancer Authors’ objectives The authors appear to have studied the effects of systemic therapy on health -related quality of life (HRQOL).Specific interventions included in the review The inclusion or exclusion criteria for the intervention were not stated. Twelve of the included trials involved chemotherapy: CNF (cyclophosphamide, mitoxantrone, fluorouracil) or CDF (cyclophosphamide, doxorubicin, fluorouracil) (1 trial);  vinorelbine versus alkeran (1 trial); CEF (cyclophosphamide, epirubicin, fluorouracil) plus mitomycin c versus epirubicin plus mitomycin c (1 trial); paclitaxel versus CMF  (cyclophosphamide, methotrexate, fluorouracil) plus prednisone (1 trial); CMF versus methotrexate plus mitoxantrone (1 trial); doxorubicin versus docetaxel (1 trial); docetaxel versus mitomycin c (1 trial); doxetaxel versus methotrexate plus fluorouracil (1 trial); paclitaxel versus doxorubicin (1 trial);  CEF versus CEF with double-dose epirubicin (1 trial); doxorubicin versus doxorubicin plus vinorelbine (1 trial); doxorubicin plus paclitaxel versus CDF (1 trial). Six included trials involved hormonal therapy: anastrozole, formestane , vorozore, exemestane and letrozole versus megestrol acetate; and chemotherapy plus medroxyprogesterone acetate or chemotherapy alone. One included trial involved biological therapy (trastuzumab) plus chemotherapy versus trastuzmab alone. Authors’ conclusions The HRQOL data provided some invaluable insights into the treatment and care of patients, but future studies should address several common problems with the methods. CRD commentary The authors clearly specified inclusion criteria for the participants, outcome and study design. However, the clarity of the review question would have been improved had inclusion criteria for the intervention been specified. The literature search was reasonable, although it could have been improved with a more extensive range of databases and by checking the reference lists of relevant papers. The limitation to papers published in English after 1995 may have led to relevant studies being missed. Two reviewers  independently reviewed all of the articles; information on the data extraction  was limited. Although study heterogeneity was not investigated, it was appropriate that the studies were not pooled. The authors reported the findings of the  individual studies in the context of study quality. The synthesis was more concerned with examining general issues, such as the measurement of QOL, rather than exploring the effects of specific treatments on QOL. No treatment-specific conclusions were drawn. What are the implications of the review? Practice: The authors did not state any implications for practice. Research: The authors stated that prior to the commencement of a trial, a clear hypothesis should be stated with the main outcomes specified and with a clear distinction made between the primary and secondary outcomes. They also stated that any generic HRQOL measures should be supplemented with a specific breast cancer measure (which should have undergone psychometric evaluation), in order to provide a detailed assessment that is sensitive to disease- or treatment-related influences.

Source

DARE

Ref.

2002

Resource Links

Abstract Link

Format

Web page [.htm, .html, .asp]

OSRS Sections

D – Disease focused reviews

Categories

BNF Category > 8: Malignant disease and immunosuppression > 8.1 Cytotoxic drugsMedical Specialty > Oncology > Cancer: breast