Chemotherapy versus ovarian ablation as adjuvant therapy for breast cancer

impact on health-related quality of life in a randomised trial

M. Groenvold, Peter Fayers, M. A. A. Peterson, H. T. Mouridsen

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background. Ovarian ablation is an effective adjuvant therapy for primary breast cancer but little is known about its quality of life impact relative to the more widely used adjuvant chemotherapy. This randomized study compared quality of life outcomes of adjuvant ovarian ablation versus cyclophosphamide, methotrexate, fluoracil (CMF) chemotherapy.

Methods. The Danish Breast Cancer Cooperative Group (DBCG) trial 89-b randomized premenopausal patients with receptor-positive, primary breast cancer between nine cycles of CMF chemotherapy given every 3 weeks and ovarian ablation by oophorectomy. In total, 317 randomized patients were invited to take part in a longitudinal quality of life study with assessments at 1, 3, 5, 9, 15, and 24 months after randomization. The questionnaire included the EORTC QLQ-C30, the Hospital Anxiety and Depression Scale, and additional items assessing potential symptoms not included in the standard instruments.

Results. After 2 years, 260 women were alive and recurrence-free, and 196 of these (75%) had completed all six questionnaires. Overall, patients in the chemotherapy group had more symptomatology at the first three assessments (i.e., during the 6 months treatment period), except for hot flushes/sweats. There were few differences between groups at later assessments. In chemotherapy patients, the likelihood of preserving ovarian function decreased steeply with increasing age. CMF chemotherapy and ovarian ablation have similar impact on recurrence and survival.

Conclusion. Chemotherapy had more negative impact on health-related quality of life but preserved ovarian function in some younger patients.

Original languageEnglish
Pages (from-to)275-284
Number of pages10
JournalBreast Cancer Research and Treatment
Volume98
Issue number3
Early online date16 Mar 2006
DOIs
Publication statusPublished - Aug 2006

Keywords

  • breast neoplasms
  • chemotherapy
  • outcomes
  • ovarian ablation
  • quality of life
  • randomized trial
  • PREMENOPAUSAL WOMEN
  • CLINICAL-TRIALS
  • EUROPEAN-ORGANIZATION
  • RESEARCH-ASSOCIATION
  • GOSERELIN
  • CYCLOPHOSPHAMIDE
  • FLUOROURACIL
  • METHOTREXATE
  • QUESTIONNAIRE
  • VALIDATION

Cite this

Chemotherapy versus ovarian ablation as adjuvant therapy for breast cancer : impact on health-related quality of life in a randomised trial. / Groenvold, M.; Fayers, Peter; Peterson, M. A. A.; Mouridsen, H. T.

In: Breast Cancer Research and Treatment, Vol. 98, No. 3, 08.2006, p. 275-284.

Research output: Contribution to journalArticle

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title = "Chemotherapy versus ovarian ablation as adjuvant therapy for breast cancer: impact on health-related quality of life in a randomised trial",
abstract = "Background. Ovarian ablation is an effective adjuvant therapy for primary breast cancer but little is known about its quality of life impact relative to the more widely used adjuvant chemotherapy. This randomized study compared quality of life outcomes of adjuvant ovarian ablation versus cyclophosphamide, methotrexate, fluoracil (CMF) chemotherapy.Methods. The Danish Breast Cancer Cooperative Group (DBCG) trial 89-b randomized premenopausal patients with receptor-positive, primary breast cancer between nine cycles of CMF chemotherapy given every 3 weeks and ovarian ablation by oophorectomy. In total, 317 randomized patients were invited to take part in a longitudinal quality of life study with assessments at 1, 3, 5, 9, 15, and 24 months after randomization. The questionnaire included the EORTC QLQ-C30, the Hospital Anxiety and Depression Scale, and additional items assessing potential symptoms not included in the standard instruments.Results. After 2 years, 260 women were alive and recurrence-free, and 196 of these (75{\%}) had completed all six questionnaires. Overall, patients in the chemotherapy group had more symptomatology at the first three assessments (i.e., during the 6 months treatment period), except for hot flushes/sweats. There were few differences between groups at later assessments. In chemotherapy patients, the likelihood of preserving ovarian function decreased steeply with increasing age. CMF chemotherapy and ovarian ablation have similar impact on recurrence and survival.Conclusion. Chemotherapy had more negative impact on health-related quality of life but preserved ovarian function in some younger patients.",
keywords = "breast neoplasms, chemotherapy, outcomes, ovarian ablation, quality of life, randomized trial, PREMENOPAUSAL WOMEN, CLINICAL-TRIALS, EUROPEAN-ORGANIZATION, RESEARCH-ASSOCIATION, GOSERELIN, CYCLOPHOSPHAMIDE, FLUOROURACIL, METHOTREXATE, QUESTIONNAIRE, VALIDATION",
author = "M. Groenvold and Peter Fayers and Peterson, {M. A. A.} and Mouridsen, {H. T.}",
note = "Acknowledgement Supported by the Danish Cancer Society (Grants 91-505 and 94 150 01).",
year = "2006",
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TY - JOUR

T1 - Chemotherapy versus ovarian ablation as adjuvant therapy for breast cancer

T2 - impact on health-related quality of life in a randomised trial

AU - Groenvold, M.

AU - Fayers, Peter

AU - Peterson, M. A. A.

AU - Mouridsen, H. T.

N1 - Acknowledgement Supported by the Danish Cancer Society (Grants 91-505 and 94 150 01).

PY - 2006/8

Y1 - 2006/8

N2 - Background. Ovarian ablation is an effective adjuvant therapy for primary breast cancer but little is known about its quality of life impact relative to the more widely used adjuvant chemotherapy. This randomized study compared quality of life outcomes of adjuvant ovarian ablation versus cyclophosphamide, methotrexate, fluoracil (CMF) chemotherapy.Methods. The Danish Breast Cancer Cooperative Group (DBCG) trial 89-b randomized premenopausal patients with receptor-positive, primary breast cancer between nine cycles of CMF chemotherapy given every 3 weeks and ovarian ablation by oophorectomy. In total, 317 randomized patients were invited to take part in a longitudinal quality of life study with assessments at 1, 3, 5, 9, 15, and 24 months after randomization. The questionnaire included the EORTC QLQ-C30, the Hospital Anxiety and Depression Scale, and additional items assessing potential symptoms not included in the standard instruments.Results. After 2 years, 260 women were alive and recurrence-free, and 196 of these (75%) had completed all six questionnaires. Overall, patients in the chemotherapy group had more symptomatology at the first three assessments (i.e., during the 6 months treatment period), except for hot flushes/sweats. There were few differences between groups at later assessments. In chemotherapy patients, the likelihood of preserving ovarian function decreased steeply with increasing age. CMF chemotherapy and ovarian ablation have similar impact on recurrence and survival.Conclusion. Chemotherapy had more negative impact on health-related quality of life but preserved ovarian function in some younger patients.

AB - Background. Ovarian ablation is an effective adjuvant therapy for primary breast cancer but little is known about its quality of life impact relative to the more widely used adjuvant chemotherapy. This randomized study compared quality of life outcomes of adjuvant ovarian ablation versus cyclophosphamide, methotrexate, fluoracil (CMF) chemotherapy.Methods. The Danish Breast Cancer Cooperative Group (DBCG) trial 89-b randomized premenopausal patients with receptor-positive, primary breast cancer between nine cycles of CMF chemotherapy given every 3 weeks and ovarian ablation by oophorectomy. In total, 317 randomized patients were invited to take part in a longitudinal quality of life study with assessments at 1, 3, 5, 9, 15, and 24 months after randomization. The questionnaire included the EORTC QLQ-C30, the Hospital Anxiety and Depression Scale, and additional items assessing potential symptoms not included in the standard instruments.Results. After 2 years, 260 women were alive and recurrence-free, and 196 of these (75%) had completed all six questionnaires. Overall, patients in the chemotherapy group had more symptomatology at the first three assessments (i.e., during the 6 months treatment period), except for hot flushes/sweats. There were few differences between groups at later assessments. In chemotherapy patients, the likelihood of preserving ovarian function decreased steeply with increasing age. CMF chemotherapy and ovarian ablation have similar impact on recurrence and survival.Conclusion. Chemotherapy had more negative impact on health-related quality of life but preserved ovarian function in some younger patients.

KW - breast neoplasms

KW - chemotherapy

KW - outcomes

KW - ovarian ablation

KW - quality of life

KW - randomized trial

KW - PREMENOPAUSAL WOMEN

KW - CLINICAL-TRIALS

KW - EUROPEAN-ORGANIZATION

KW - RESEARCH-ASSOCIATION

KW - GOSERELIN

KW - CYCLOPHOSPHAMIDE

KW - FLUOROURACIL

KW - METHOTREXATE

KW - QUESTIONNAIRE

KW - VALIDATION

U2 - 10.1007/s10549-006-9160-9

DO - 10.1007/s10549-006-9160-9

M3 - Article

VL - 98

SP - 275

EP - 284

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 3

ER -