Annals of Oncology Advance Access originally published online on August 26, 2005
Annals of Oncology 2005 16(11):1786-1794; doi:10.1093/annonc/mdi370
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2005 European Society for Medical Oncology
Patients' preferences for adjuvant chemotherapy in early breast cancer: what makes AC and CMF worthwhile now?
1 NHMRC Clinical Trials Centre, University of Sydney; 2 Sydney Cancer Centre; 3 Mater Hospital; 4 Nepean Hospital; 5 The Cancer Council Australia; 6 School of Public Health, University of Sydney, Sydney, Australia
* Correspondence to: Dr M. R. Stockler, NHMRC Clinical Trials Centre, University of Sydney, Locked Bag 77, Camperdown, NSW 2050, Australia. Tel: +61-02-9562-5000; Fax: +61-02-9565-1863; E-mail: stockler{at}med.usyd.edu.au
Background: Studies of women who had adjuvant chemotherapy for early breast cancer 10–20 years ago showed that many judged small benefits sufficient to make it worthwhile. Indications, regimens and supportive care have changed. We sought the preferences of contemporary women who received similar chemotherapy.
Patients and methods: Ninety-seven consecutive consenting women who completed adjuvant chemotherapy for early breast cancer 3–34 months previously were interviewed. Preferences were elicited with a structured, scripted interview using the trade-off method. Women were presented with four hypothetical scenarios based on known life expectancies (5 and 15 years) and survival rates (65% and 85% at 5 years) without adjuvant chemotherapy.
Results: Improvements of an additional year in life expectancy or 3% in survival rates were judged sufficient to make adjuvant chemotherapy worthwhile by 68–84% of women. Half the women judged 1 day or 0.1% sufficient to make adjuvant chemotherapy worthwhile. Recollections of better well-being during adjuvant chemotherapy, having dependants and having a friend or relative who died from cancer were independently associated with judging smaller benefits sufficient to make adjuvant chemotherapy worthwhile (all P < 0.05).
Conclusions: Preferences were highly variable, but the benefits judged sufficient to make adjuvant chemotherapy worthwhile were even smaller than those found in previous studies. Preferences were influenced by factors other than direct benefits and harms of chemotherapy.
Key words: adjuvant chemotherapy, early breast cancer, patient preferences
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T. Watanabe, M. Sano, S. Takashima, T. Kitaya, Y. Tokuda, M. Yoshimoto, N. Kohno, K. Nakagami, H. Iwata, K. Shimozuma, et al. Oral Uracil and Tegafur Compared With Classic Cyclophosphamide, Methotrexate, Fluorouracil As Postoperative Chemotherapy in Patients With Node-Negative, High-Risk Breast Cancer: National Surgical Adjuvant Study for Breast Cancer 01 Trial J. Clin. Oncol., March 20, 2009; 27(9): 1368 - 1374. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. R. Bossema, C. A. M. Marijnen, M. C. M. Baas-Thijssen, C. J. H. van de Velde, and A. M. Stiggelbout Evaluation of the Treatment Tradeoff Method in Rectal Cancer Patients: Is Surgery Preference Related to Outcome Utilities? Med Decis Making, November 1, 2008; 28(6): 888 - 898. [Abstract] [PDF]
|
|
|
|
|
|
S. C. O'Neill, N. T. Brewer, S. E. Lillie, E. F. Morrill, E. C. Dees, L. A. Carey, and B. K. Rimer Women's Interest in Gene Expression Analysis for Breast Cancer Recurrence Risk J. Clin. Oncol., October 10, 2007; 25(29): 4628 - 4634. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. S. Punglia, M. Morrow, E. P. Winer, and J. R. Harris Local Therapy and Survival in Breast Cancer N. Engl. J. Med., June 7, 2007; 356(23): 2399 - 2405. [Full Text] [PDF]
|
|