Table 8

A list of studies on systemic therapies and quality of life in breast cancer patients (1974–2007)

Author(s) [Ref.]




Moore et al. [36]


Adrenalectomy + chemotherapy in advanced breast cancer

In most patients the subjective palliation involved a return to normal living.

Priestman and Baum [37]


Chemotherapy in advanced breast cancer

Toxicity is not related to the patients' age and diminished with successive courses of drugs.

Palmer et al. [114]


A single agent vs. five drug combination in node positive primary breast cancer

Better QOL in single agent group.

Coates et al. [115]


Intermittent vs. continuous chemotherapy in metastatic breast cancer

Continuous chemotherapy was better; changes in the QOL were independent prognostic factor of survival.

Kiebert et al. [116]


Peri-operative chemotherapy vs. no chemotherapy in early stage breast cancer

No differences 1 year after; patients considered chemotherapy most burdensome aspect of treatment.

Gelber et al. [117]


Single cycle of combination chemotherapy vs. longer duration chemotherapy for pre-menopausal or chemo-endocrine therapy for postmenopausal women

Better QOL in longer duration chemotherapy or chemo-endocrine therapy.

Berglund et al. [118]


Late effects of adjuvant chemotherapy vs. postoperative radiotherapy in pre- and post-menopausal breast cancer

Chemotherapy patients had higher overall QOL.

Richards et al. [119]


A (weekly for 12 courses vs. every three weeks for 4 courses) in advanced breast cancer

Similar survival but higher psychological distress in the three weeks group.

Hurny et al. [120]


CMF (6 cycles vs. 3 cycles) in operable breast cancer

QOL improved with increasing time from the study entry.

Campora et al. [121]


Adjuvant chemotherapy vs. palliative chemotherapy in metastatic breast cancer

No significant difference between groups.

Fraser et al. [122]


CMF vs. E in advanced breast cancer

Similar survival and no significant difference in overall global QOL.

Twelves et al. [123]


Iododoxorubicin in advanced breast cancer

Little evidence of benefit in terms of physical symptom relief, level of activity, psychological symptoms or global QOL.

Bertsch and Donaldson. [124]


Vinorelbine vs. melphalan

Vinorelbine was better in some aspects of QOL.

Swain et al. [125]


AC + G-CSF in node positive breast cancer

Tolerable physical symptoms and emotional distress.

McQuellon et al. [126]


High-dose chemotherapy + ABMT

No significant difference between pre- and post-treatment QOL.

Larsen et al. [127]


High-dose chemotherapy + ASCT

Resulting in poor physical and emotional health.

Hurny et al. [128]


6 cycles of CMF vs. 3 cycles CMF in node-positive operable breast cancer

Worse QOL during treatment but not after treatment completion.

Griffiths and Beaver [129]


High-dose chemotherapy in advanced breast cancer

No significant deterioration in QOL.

Lindley et al. [130]


Systemic adjuvant therapy

2–5 years after treatment good QOL. Small to modest gain was acceptable to women.

Ganz et al. [131]


TAM or chemotherapy alone or chemotherapy + TAM, or no adjuvant therapy

No significant differences in global QOL among treatment groups; those who received chemotherapy had more sexual problems and those who received TAM had more vasomotor symptoms.

Bernhard et al. [132]


Formestane vs. megestrol acetate in postmenopausal advanced breast cancer while on TAM

No significant difference in QOL; baseline QOL was strong predictive for QOL under treatment but not for time to treatment failure.

Fairclough et al. [133]


CAF vs. dose intensive a 16-week multi-drug regimen

Negative impact of the dose intensive 16-week regimen was observed, although Q-TwiST analysis showed a small gain for this regimen.

Osoba and Burchmore [134]


Trastuzumab (Hercptin) in metastatic breast cancer who may or may not have had prior chemotherapy

Trastuzumab was associated with an amelioration of the deleterious effects of chemotherapy alone; the drug was not associated with worsening of QOL.

McLachlan et al. [135]


Chemotherapy in metastatic breast cancer

QOL maintained or improved; patients did not want to trade quantity for QOL.

Macquart-Moulin et al. [136]


High-dose chemotherapy + G-CSF + ASCT in inflammatory breast cancer

QOL deterioration disappeared after treatment and returned to baseline after one year.

Riccardi et al. [137]


Doubling E within FEC vs. FEC in metastatic breast cancer

No significant difference in response or improvement of baseline QOL.

Kramer et al. [138,139]


Paclitaxel vs. A in advanced breast cancer

QOL appeared to be prognostic for survival and response to treatment.

Joly et al. [140]


CMF + irradiation vs. irradiation in pre-menopausal breast cancer

Similar QOL was observed.

Hakamies-Blomqvist et al. [141]


T vs. sequential MF in metastatic breast cancer

Difference in QOL was minor favoring MF.

Broeckel et al. [142]


Adjuvant chemotherapy treated breast cancer (after 3 to 36 months)

Younger age, unmarried status, time since diagnosis and chemotherapy completion related to greeter depressive symptoms.

Carlson et al. [143]


High-dose chemotherapy + ASCT in metastatic breast cancer

Anxiety and depression continued to increase, loss of sexual interest, worrying and joint pain were reported.

Osoba et al. [144]


Chemotherapy + Trastuzumab (Hercptin) vs. Chemotherapy alone in metastatic breast cancer

More improved global QOL with chemotherapy + Herceptin.

Modi et al. [145]


Paclitaxel in metastatic breast cancer

QOL benefit in tumor response patients.

Heidemann et al [146].


Mitoxantrone vs. FEC in metastatic breast cancer

No significant difference in survival or response but a QOL scores favored mitoxantrone.

Genre et al. [147]


High-dose-intensity AC (21 vs. 14 days)

Shortening cycles had a high negative impact on QOL.

de Haes et al. [148]


Goserelin vs. CMF in peri-and pre-menopausal node-positive early breast cancer

Better QOL in favor of goserelin.

Brandberg et al. [149]


Tailored FEC vs. induction FEC followed with high-dose CTCb + peripheral SCT

No significant overall differences were found between groups.

Land et al. [150]


CMF vs. AC in axillary node negative and estrogen receptor negative breast cancer

Overall QOL was equivalent between two groups.

Fallowfield et al. [151]


ANA vs. TAM alone or in combination in postmenopausal early breast cancer

Similar overall QOL impact but some small differences in side effects profiles.

Bottomely et al. [152]


AT vs. AC in metastatic breast cancer

No significant differences in QOL between two groups.

Bernhard et al. [153]


TAM for 5 years or three prior cycles of CMF followed by 57 months TAM in estrogen receptor-negative and estrogen receptor-positive breast cancer

At completion there were no differences by treatment groups.

Tong et al. [154]


Capecitabine, idarubicin and cyclophosphamide (all-oral regimen, XIC) in metastatic breast cancer

No significant decease in global QOL scores.

Galalae et al. [155]


Radiotherapy and adjuvant chemotherapy vs. radiotherapy and hormonal therapy vs. radiotherapy alone after conserving surgery

Adjuvant chemotherapy lowered QOL vs. hormones or radiotherapy alone.

Elkin et al. [156]


Ovarian suppression vs. chemotherapy in pre-menopausal hormone-responsive breast cancer

Assuming equal efficacy ovarian suppression was superior. Efficacy would have impact on treatment choice.

Conner-Spady et al. [157]


High-dose chemotherapy + ABST in breast cancer with poor prognosis

Impaired QOL in short term but improved after 2 years.

Bottomley et al. [158]


Dose-intensives chemotherapy (CE + filgrastim) vs. CEF in locally advanced breast cancer

Groups did not differ in progression free survival; lower QOL in intensified group at short term but no difference at long term.

Ahles et al. [159]


Standard-dose systemic chemotherapy vs. local therapy only in long-term breast cancer survivors

Lower overall QOL in chemotherapy group.

Peppercorn et al. [160]


High-dose chemotherapy + ABMT vs. intermediate-dose chemotherapy in patients with stage II and III breast cancer

Patients who received more intensive therapy experienced transient declines in QOL; by 12 months after, QOL was comparable between the 2 arms, regardless of therapy intensity, and many QOL areas were improved from baseline.

Semiglazov et al. [161]


CMF + mistletoe lectin (PS76A2) vs. CMF + placebo

PS76A2 improved QOL during and after chemotherapy.

Martin et al. [162]


FAC vs. TAC or TAC + G-CSF in node negative breast cancer

Lower QOL in patients treated with TAC. Addition of G-CSF improves QOL.

Hurria et al. [163]


Anthracyclin-based chemotherapy or CMF in older women with breast cancer

QOL maintained in both group.

Fallowfield et al. [164]


EXE vs. TAM after 2–3 years of TAM in postmenopausal primary breast cancer

Temporary decrease in overall QOL for EXE but no other differences.

Groenvold et al. [165]


CMF vs. ovarian ablation

CMF had more negative impact on QOL.

Cella et al. [166]


ANA vs. TAM alone or in combination in postmenopausal breast cancer

ANA and TAM had similar impact on QOL.

Liu et al. [167]


DPPE + A vs. A in patients with advanced or metastatic breast cancer

Patients on A alone had fewer disease and treatment adverse events and better QOL.

Karamouzis et al. [168]


Chemotherapy vs. supportive care in metastatic patients

QOL was better in patients receiving chemotherapy than those under supportive care.

Hopwood et al. [169]


Adjuvant radiotherapy

QOL and mental health were favorable for most patients about to start radiotherapy but younger age and receiving chemotherapy were significant risk factors for poorer QOL.


C: Cyclophosphamide, M: Methotrexate, F: 5-fluorouracil, A: Doxorubcin, E: Epirubcin, T: Docetaxel, TAM: Tamoxifen, ANA: Anastrozole, EXE: Exemestane, QOL: Quality of life, DPPE: Tesmilifene, Granulocyte colony stimulating factor: G-CSF, CTCb: Cyclophosphamide, thiotepa, and carboplatin

Montazeri Journal of Experimental & Clinical Cancer Research 2008 27:32   doi:10.1186/1756-9966-27-32

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