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Background: Despite the significant impact of chemotherapy-induced peripheral neuropathy on the quality of life for breast cancer survivors, there is a notable lack of comprehensive research. Therefore, a crucial need exists for further systematic investigation and inquiry into this matter., Aims: This study examined predictors of quality of life in breast cancer survivors with chemotherapy-induced peripheral neuropathy., Design: A cross-sectional, correlational design., Settings: This study was conducted at a medical center in northern Taiwan and a teaching hospital in northeastern Taiwan., Participants/subjects: One hundred and thirty adult women with breast cancer, who have undergone chemotherapy and obtained a Total Neuropathy Scale-Clinical Version score>0, were enrolled., Methods: Neuropathic pain, sleep disturbances, depression, and quality of life were evaluated using multiple regression analysis to identify quality of life predictors. Clinical importance was established using the minimally important difference of Functional Assessment of Cancer Therapy-Breast., Results: The study indicated that improving depression (B = -10.87, p < .001) and neuropathic pain (B = -8.33, p = .004) may enhance the quality of life of breast cancer survivors with chemotherapy-induced peripheral neuropathy. Moreover, the individual's marital status and family history of breast cancer were identified as predictive factors., Conclusions: This study illuminates quality of life determinants for breast cancer survivors with chemotherapy-induced peripheral neuropathy, advocating comprehensive care and addressing depression and neuropathic pain for better outcomes., Competing Interests: Declaration of competing interest All authors declare no conflicts of interest., (Copyright © 2024 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)

Introduction: This multicenter, phase II randomized, non-inferiority study reports from the first prospective two-armed randomized control trial that compared the efficacy, safety, and quality of life (QoL) of pegylated liposomal doxorubicin (PLD)-based and epirubicin-based as adjuvant chemotherapy for stage I-II human epidermal growth factor receptor 2 (HER2)-negative breast cancer., Methods: Patients with stage I/II HER2-negative breast cancer received PLD (37.5 mg/m2, Q3W, 5 cycles, LC arm) plus cyclophosphamide (600 mg/m2) or epirubicin (90 mg/m2, Q3W, 4 cycles, EC arm) plus cyclophosphamide (600 mg/m2). Randomization was stratified by lymph node and ER and PR status. The primary endpoint was disease-free survival (DFS), and secondary endpoints were overall survival (OS), safety profiles, and QoL. QoL was assessed using the EORTC-QLQ-C30 and QLQ-BR23 questionnaires., Results: A total of 256 patients were assigned to LC (n = 148) and EC (n = 108). There was no difference in 5-year DFS and OS rate between the two groups. LC-based adjuvant regimens had significantly less alopecia and low-grade 3-4 hematologic adverse events (AEs). Significantly improved QoL was observed in the LC arm during and after treatment for symptoms including fatigue, nausea and vomiting, and systemic therapy side effects., Conclusion: Comparable efficacy and safety between adjuvant PLD and epirubicin for stage I-II HER2-negative breast cancer was observed. There was no difference in the 5-year DFS and OS rates between the two treatment arms. However, low-grade 3-4 AEs and a trend of favorable QoL symptom scales were observed in the LC arm, suggesting that PLD-containing regimen could become a new standard treatment for early-stage HER2-negative breast cancer patients., (© 2024 S. Karger AG, Basel.)

Background: The important role of self-efficacy in facilitating health behavior and, in turn, promoting health outcomes has been widely presumed in the theoretical literature. However, little research has focused on the mechanism by which self-care mediates the relationship between symptom-management self-efficacy and quality of life (QOL) in breast cancer patients., Objective: The purpose of this study was to examine the relationship between symptom-management self-efficacy and quality of life in Taiwanese oncology outpatients with breast cancer and then proposes self-care as a mediator between these two factors., Methods: This cross-sectional study enrolled 201 oncology outpatients at one teaching hospital in metropolitan Taipei City, Taiwan. The research instruments included the Symptom-Management Self-Efficacy Scale-Cancer (SMSES-Breast Ca.), the Self-Care Scale, and the European Organization for Research & Treatment of Cancer Quality of Life Group Questionnaire (EORTC-QLQ-C30)., Results: Symptom-management self-efficacy (SMSE) was directly associated with the QOL of the participants (β = 5.94, p < .001). Moreover, SMSE was indirectly associated with QOL through self-care. Self-care was found to mediate the relationship between symptom-management self-efficacy and global QOL (indirect effect = 0.54, 95% CI 0.12 to 1.18). The level of 95% CI was significant., Conclusions: The present study supports that self-efficacy beliefs and self-care both significantly and positively influence the quality of life of patients., Competing Interests: The authors have declared that no competing interests exist.

Purpose: To explore the effects of non-sporting qigong (NSQG) and sporting qigong (SQG) on frailty and quality of life (QOL) of breast cancer patients during chemotherapy., Methods: A time series (three-group, pre-test-post-test) quasi-experimental design was applied in the study. Ninety-five participants were assigned to three groups: controls (n = 31), NSQG (n = 33), or SQG (n = 31). All patients performed the qigong interventions three times per week for at least 30 min per session. Data were collected in face-to-face interviews before chemotherapy and at 1 and 3 months after chemotherapy. Frailty was assessed using the Edmonton Frail Scale. The Medical Outcomes Survey Short-Form 36-Taiwanese version was used to evaluate the physical and mental component scores of QOL., Results: In the 1st and 3rd months after practicing qigong, patients in the SQG group had lower frailty scores than those in the control group. In the 3rd month after the intervention, patients in the NSQG group also had lower frailty scores and higher mental component scores for QOL than those in the control group. Patients with higher frailty scores had worse physical and mental component scores for QOL than those with lower frailty scores. The Sobel test showed that the frailty score mediated SQG and physical component scores for QOL., Conclusions: SQG and NSQG appeared to be beneficial for improving frailty and QOL among the breast cancer patients receiving chemotherapy in the study. The results are preliminary and larger, well-constructed clinical studies are needed to verify the findings., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

This study explored the relationship between participants' pain experience and quality of life (QOL). One hundred nine patients aged 18 years and older who had taken prescribed opioid analgesics for cancer-related pain at a teaching hospital in Taipei, Taiwan, completed the Brief Pain Inventory and European Organization for Research and Treatment of Cancer Quality of Life Group Questionnaire. The results indicated that participants in this study had experienced a mean functional QOL of 55.47 (SD 21.48), a mean symptom QOL of 41.97 (SD 16.89), and a mean global QOL of 42.13 (SD 20.69). Participants reported that in the previous 7 days, they had experienced a mean least pain of 1.75 (SD 0.18) and a mean worst pain of 6.81 (SD 0.24). The mean score for average pain intensity was 4.14 (SD 0.21), whereas the mean for current pain level was 2.53 (SD 0.21). The mean pain interference in the patients' daily activities was 3.50 (SD 0.22) on a scale ranging from 0 to 10. Furthermore, a significant correlation existed between global (r = -0.375, p < .01), functional (r = -0.300, p < .01), and symptom (r = 0.405, p < .01) QOL and worst pain. Moreover, the results indicated a significant correlation between global (r = -0.461, p < .01), functional (r = -0.430, p < .01), and symptom (r = 0.505, p < .01) QOL and pain interference. The current results support the observation that cancer pain substantially affects a patient's quality of life. The findings provide empirical support for the need for better programmatic efforts to improve pain management in Taiwanese oncology outpatients., (Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)

Background: We assessed the effect of zoledronic acid on quality of life (QOL) and pain outcome in breast cancer patients with bone metastases using the European Organization for Research and Treatment of Cancer bone metastases module (EORTC QLQ-BM22)., Patients and Methods: Three hundred sixty-six breast cancer patients receiving zoledronic acid for bone metastases from 13 Centers were prospectively enrolled. QOL was evaluated using the EORTC QLQ-BM22 and pain outcome were measured monthly with a Visual Analog Scale (VAS) score for 24 months., Results: No significant change of functional scale (functional interference and psychosocial aspects) of the EORTC QLQ-BM22 was reported. Significant reduction of the symptom scale was noted after treatment compared with the baseline. The painful site subscale was significantly reduced during the first 12 months, with the exception the 6-month follow-up of point. Pain characteristics subscale was also significantly lower from the 2-month time point onwards. VAS scores indicated a significant reduction in pain over the course of the study to the 22-month time point follow-up compared to the baseline., Conclusion: Zoledronic acid treatment improved QOL of breast cancer patients with bone metastases by relieving bone pain., (Copyright © 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)

Objective: To identify which domains/symptoms from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were predictive of overall quality of life (QoL) in advanced cancer patients., Methods: Four hundred and forty seven patients with brain metastases or bone metastases from seven countries were enrolled with regression analysis to determine the predictive value of the QLQ-C30 functional/symptom scores for patient reported overall QoL (question 30), overall health (question 29) and the global health status domain (questions 29 and 30)., Results: Worse role functioning, social functioning, fatigue and financial problems were the most significant predictive factors for worse QoL. In the bone metastases subgroup (n = 400), role functioning, fatigue and financial problems were the most significant predictors. In patients with brain metastases (n = 47), none of the EORTC domains significantly predicted worse QOL., Conclusion: Deterioration of certain QLQ-C30 functional/symptom scores significantly contributes to worse QoL, overall health and global health status.

Background: The current study aimed to examine the impact of zoledronic acid therapy on health-related quality of life (HRQoL) in Taiwanese patients with bone metastases from breast cancer., Patients and Methods: Patients with bone metastases from breast cancer who received zoledronic acid according to the standards of care were enrolled in this observational phase IV study. HRQoL was measured monthly using the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (QLQ-C30) and the breast cancer-specific module (BR-23) for 24 months., Results: A total of 366 patients from 13 centers were enrolled. QLQ C-30 demonstrated that zoledronic acid improved the HRQoL in different aspects. In particular, a significant reduction of pain in the first 14 months and the 22-month follow-up was reported by patients. QLQ-BR23 indicated improved future perspective and breast symptom scores over the course of the study., Conclusion: These data confirm the HRQoL benefits and safety of zoledronic acid in Taiwanese patients with bone metastases from breast cancer.

Purpose: Assessment of health-related quality of life (HRQOL) is critical to effective delivery of palliative care in patients with advanced cancer. The current study analyzes relationships between baseline social determinants of health and medical factors, and self-reported HRQOL in patients with bone metastases receiving palliative radiotherapy., Methods and Materials: Advanced cancer patients referred for radiotherapy treatment of bone metastases completed the EORTC QLQ-C30 questionnaire in multiple outpatient clinics internationally. Demographics and social determinants were collected as baseline information. Univariate and Bonferroni-adjusted multivariate linear regression analyses were used to detect significant correlations between baseline determinants and different HRQOL domains., Results: Karnofsky Performance Status (KPS) was correlated with better physical (p = 0.0002), role (p < 0.0001), emotional (p < 0.0001), and social (p < 0.0001) functioning, and global health scores (p = 0.0015) and predicted lower symptom scores for fatigue (p < 0.0001), pain (p < 0.0001), appetite loss (p < 0.0001), and constipation (p < 0.0001). Increased age was predictive of better social functioning (p < 0.0001) and less insomnia (p = 0.0036), higher education correlated with better global health status (p = 0.0043), and patients who were employed or retired had improved physical functioning (p = 0.0004 and p = 0.0030, respectively) and less financial challenges compared to patients who were unemployed (p = 0.0005)., Conclusions: Baseline KPS had the greatest influence on EORTC QLQ-C30 domain scores. Age, education level, and employment status had significant impacts, although on fewer domains. Further studies that investigate baseline determinants are worthwhile to clarify relationships in order to care for patients more effectively at the end of life.

Objective: Health related quality of life (HRQOL) is a multidimensional concept that is especially important for cancer patients with bone metastases, as maintaining and improving HRQOL is often the main focus of treatment. This study aims to determine factors that may influence HRQOL, which may in turn influence treatment and care of patients., Methods: Patients (n=396) completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) Bone Metastases module (BM22) at baseline. The EORTC QLQ-BM22 consists of four scales: painful site (PS), pain characteristics (PC), functional interference (FI), and psychosocial aspect (PA) scales. EORTC QLQ-BM22 data, together with sociodemographic and medical factors were analyzed by univariate analysis of variance (ANOVA). Items of significance were determined through backward selection, which were then put through multivariate analysis to determine further significance., Results: Through ANOVA analysis, KPS>80 and breast primary histology were predictive of better HRQOL in the PS scale, while KPS>80, female gender, and breast primary histology were predictive of better HRQOL in the PC and FI scales. KPS>80 and prostate primary histology were predictive of better HRQOL in the PA scale. KPS>80 and primary cancer site were confirmed as significant predictive factors in multivariate analysis., Recommendations: This study identified baseline factors of gender, performance status, and primary histology as determinants of HRQOL in patients with bone metastases. Further study focusing on current treatment (chemotherapy, bisphosphonates, and radiotherapy) and spiritual well-being may identify additional factors affecting HRQOL. Understanding the influence of these factors will allow health care professionals to provide more effective palliative care.

Background: Studies have rarely compared health outcomes for patients with breast cancer at different treatment stages., Objective: The purpose of the study was to compare symptoms and quality of life among patients with breast carcinoma receiving target, chemotherapy, or combined therapy., Methods: A longitudinal study was carried out with 57 patients receiving chemotherapy, 30 receiving target therapy, and 34 receiving combined therapy. Data were collected before the start of treatment, at 4 weeks, and at 12 weeks following the start of treatment. Symptom severity and interference were assessed by the M. D. Anderson Symptom Inventory. The physical and mental components of quality of life (physical component score [PCS] and mental component score [MCS]) were assessed using SF-36., Results: There were no significant differences in symptom severity and interference for patients in the 3 therapy groups. The PCSs did not differ significantly according to the therapy group but did decrease significantly after each treatment. Patients receiving target therapy had significantly higher MCSs than did patients receiving chemotherapy, but the MCSs did not differ significantly before and after the treatment. Patients with higher symptom severity and interference had worse PCS and MCS., Conclusions: Patients at all treatment groups had worse physical components quality of life after treatment as compared with before treatment. Patients receiving target therapy had better mental components of quality of life. The mental components of quality of life remained stable during treatment., Implications for Practice: Nurses should assess the patients' symptoms during treatment and provide timely intervention to optimize their quality of life.

Objective: The European Organization of Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 15 Palliative (EORTC QLQ-C15-PAL) was developed to assess quality of life (QOL) for the palliative cancer population to decrease patient burden. The purpose of this study was to compare predictive factors for well-being in the QLQ-C15-PAL extracted from the EORTC Quality of Life Questionnaire - Core 30 (QLQ-C30) with the QLQ-C30 itself., Methods and Materials: Patients with advanced cancer referred for treatment of bone metastases completed the QLQ-C30. Fifteen items from the QLQ-C15-PAL were extracted from the QLQ-C30. Univariate and multivariate analyses were used to determine predictive factors of the global QOL/health score in both tools. In the multivariate analyses, a p value of <0.003 indicated statistical significance., Results: Overall, predictive factors were similar when analyzing data from both tools. Predictive factors for the QLQ-C30 were role functioning (p<0.0001), fatigue (p<0.0001), nausea/vomiting (p<0.0001), and financial problems (p<0.0001) and factors for the extracted QLQ-C15-PAL were physical functioning (p<0.0001) and fatigue (p<0.0001)., Conclusions: Extraction of the QLQ-C15-PAL items from the QLQ-C30 resulted in similar predictive QOL domains for all patient subgroups analyzed individually. The QLQ-C15-PAL is reflective of the QLQ-C30 domains and is recommended for future studies involving patients in a palliative setting, as this shorter questionnaire reduces patient burden and may increase accrual and compliance, while maintaining a similar breadth of coverage and achieving the same predictive ability.

Purpose: Quality of life (QOL) is frequently an endpoint in clinical trials involving patients with advanced cancer. Statistical significance of minimal differences can be achieved with sufficient sample size, yet the actual clinical relevance is unknown. The purpose of this study was to establish the minimal clinically important difference (MCID) for the European Organisation for Research and Treatment of Cancer (EORTC) bone metastases module (EORTC QLQ-BM22)., Methods: Patients with bone metastases across seven countries were prospectively enrolled in a trial validating the EORTC QLQ-BM22 and completed the QLQ-BM22 and core measure (QLQ-C30) at baseline and 1-month follow-up. MCIDs were calculated for each QOL scale for both improvement and deterioration using both an anchor- (performance status) and distribution-based approach., Results: A total of 93 patients completed both baseline and follow-up QOL and had recorded performance status at both intervals. Statistically significant meaningful differences were seen in seven scales. There were improvements of 30.5 (95 % confidence interval, 9.0 to 52.0), 20.1 (7.1 to 33.2), 30.5 (13.8 to 47.3) and 19.6 (5.0 to 34.3) in the pain, painful site, painful characteristic and functional interference scales, respectively, demonstrated clinical relevance. Decreases of 12.4 (0.3 to 24.6), 22.4 (11.8 to 32.9) and 13.5 (1.9 to 25.1) were required to represent clinically relevant deterioration in emotional functioning, global health status and financial issues, respectively. Minimal differences for improvement were closest to 0.5 standard deviations (SD) while for deterioration, closer to 0.3 SD on the QLQ-BM22., Conclusion: Identification of requirements for clinical significance can assist in determining the relevance of QOL changes after treatment and in sample size determination in future trials. Our study is limited by the small sample size. Future studies should continue to determine MCID and confirm our findings using a variety of appropriate anchors and in a larger sample.

Purpose: Radiation therapy (RT) is an effective method of palliating painful bone metastases and can improve function and reduce analgesic requirements. In advanced cancer patients, quality of life (QOL) is the primary outcome of interest over traditional endpoints such as survival. The purpose of our study was to compare bone metastasis-specific QOL scores among patients who responded differently to palliative RT., Methods and Materials: Patients receiving RT for bone metastases across 6 countries were prospectively enrolled from March 2010-January 2011 in a trial validating the QLQ-BM22 and completed the QLQ-BM22 and the core measure (QLQ-C30) at baseline and after 1 month. Pain scores and analgesic intake were recorded, and response to RT was determined according to the latest published guidelines. The Kruskal-Wallis nonparametric and Wilcoxon rank sum tests compared changes in QOL among response groups. A Bonferroni-adjusted P<.003 indicated statistical significance., Results: Of 79 patients who received palliative RT, 59 were assessable. Partial response, pain progression, and indeterminate response were observed in 22, 8, and 29 patients, respectively; there were no patients with a complete response. Patients across all groups had similar baseline QOL scores apart from physical functioning (patients who progressed had better initial functioning). One month after RT, patients who responded had significant improvements in 3 of 4 QLQ-BM22 domains (painful site, P<.0001; painful characteristic, P<.0001; and functional interference, P<.0001) and 3 QLQ-C30 domains (physical functioning, P=.0006; role functioning, P=.0026; and pain, P<.0001). Patients with progression in pain had significantly worse functional interference (P=.0007) and pain (P=.0019)., Conclusions: Patients who report pain relief after palliative RT also have better QOL with respect to bone metastasis-specific issues. The QLQ-BM22 and QLQ-C30 are able to discriminate among patients with varying responses and are recommended for use in future bone metastasis clinical trials., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Background: The objective of this international field study was to test the reliability, validity, and responsiveness of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-BM22 module to assess health-related quality of life (HRQOL) in patients with bone metastases., Methods: Patients undergoing a variety of bone metastases-specific treatments were accrued. The QLQ-BM22 was administered with the QLQ-C30 at baseline and at 1 follow-up time point internationally. A debriefing questionnaire was administered to determine patient acceptability and understanding., Results: Large-scale field testing of the QLQ-BM22 in addition to the QLQ-C30 took place in 7 countries: Brazil, Canada, Cyprus, Egypt, France, India, and Taiwan. A total of 400 patients participated. Multitrait scaling analyses confirmed 4 scales in the 22-item module. The scales were able to discriminate between clinically distinct patient groups, such as between those with a poor and those with a better performance status. The QLQ-BM22 was well received in all 7 countries, and the majority of patients did not recommend any significant changes from the module in its current form., Conclusions: The final QLQ-BM22 module contains 22 items and 4 scales assessing Painful Sites, Painful Characteristics, Functional Interference, and Psychosocial Aspects. Results confirmed the validity, reliability, cross-cultural applicability, and sensitivity of the 22-item EORTC QLQ-BM22. It is therefore recommended that the QLQ-BM22 be used in addition to the QLQ-C30 in clinical trials to assess HRQOL in patients with bone metastases., (Copyright © 2011 American Cancer Society.)