Annals of Oncology Advance Access published online on August 26, 2005
Annals of Oncology, doi:10.1093/annonc/mdi370
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1 NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
* To whom correspondence should be addressed. 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.
Received May 8, 2005
Revised July 7, 2005
Accepted July 12, 2005
Original article
Patients' preferences for adjuvant chemotherapy in early breast cancer: what makes AC and CMF worthwhile now?
2 NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia; Sydney Cancer Centre, Sydney, Australia
3 Mater Hospital, Sydney, Australia
4 Sydney Cancer Centre, Sydney, Australia
5 Nepean Hospital, Sydney, Australia
6 The Cancer Council Australia, Sydney, Australia; School of Public Health, University of Sydney, Sydney, Australia
M. R. Stockler, E-mail: stockler{at}med.usyd.edu.au
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