Patient-reported outcomes and symptom clusters pattern of chemotherapy-induced toxicity in patients with early breast cancer

Wiranata, Juan Adrian and Hutajulu, Susanna Hilda and Astari, Yufi Kartika and Leo, Benedreky and Bintoro, Bagas Suryo and Hardianti, Mardiah Suci and Taroeno-Hariadi, Kartika Widayati and Kurnianda, Johan and Purwanto, Ibnu (2024) Patient-reported outcomes and symptom clusters pattern of chemotherapy-induced toxicity in patients with early breast cancer. PLoS ONE, 19 (2 Febr). ISSN 19326203

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Abstract

Objective This study aims to characterize patient-reported chemotherapy-induced toxicity in patients with breast cancer, determine its association with treatment regimens and patient characteristics, identify toxicity symptom clusters within a specific chemotherapy timeframe and analyze the correlation between symptom clusters within and between the timeframe to understand the changes and influences across chemotherapy. Methods Forty-six patient-reported toxicities during neoadjuvant/adjuvant chemotherapy for breast cancer were evaluated using adapted CTCAE version 4.0. Chi-Square/Fisher’s Exact test was performed to analyze the difference in the incidence of toxicity symptoms by chemotherapy regimens. Poisson regression performed to assess factors associated with patient’s total chemotherapy toxicity. Exploratory factor analysis (EFA) conducted to identify symptom clusters at T1 (first half) and T2 (second half of planned cycle). Factor scores were generated and Spearman correlation performed to explore the factor scores correlation between symptom clusters. Results A total of 142 patients with stage I-III breast cancer were included. The incidence of several toxicities differed significantly among three chemotherapy regimens. Subjects age ≥51; years are associated with lower number of reported toxicity (IRR/incidence rate ratio = 0.94, 95 confidence interval/CI 0.88 to 0.99, p = 0.042). Receiving more chemotherapy cycles are associated with higher number of reported toxicity (IRR = 1.06, 95 CI 1.03 to 1.10, p<0.001). Two symptom clusters identified at T1 (psychoneurological-pain/PNP-T1 and gastrointestinal-psychological/GIP-T1 cluster) and three at T2 (psychoneurological-pain/ PNP-T2, epithelial/EPI-T2, and gastrointestinal cluster/GI-T2), with moderate-strong positive correlation between PNP-T1 and GIP-T2 (p<0.001), PNP-T1 and PNP-T2 (p<0.001), and GIP-T1 and PNP-T2 (p<0.001). Conclusions This study investigated 46 patient-reported toxicities prospectively during adjuvant/neoadjuvant chemotherapy for early breast cancer. Anthracycline-taxane combination regimen had higher proportions of toxicity incidence. Subject’s age and number of chemotherapy cycles significantly associated with total number of toxicity symptoms. Two symptom clusters at T1 and three at T2 were identified, with significant correlation between symptom clusters within and between chemotherapy timeframe. © 2024 Wiranata et al. This is an open access article distributed under the terms of the Creative Commons Attribution License,

Item Type: Article
Additional Information: Cited by: 0; All Open Access, Gold Open Access
Uncontrolled Keywords: Antibiotics, Antineoplastic; Breast Neoplasms; Chemotherapy, Adjuvant; Female; Humans; Middle Aged; Pain; Patient Reported Outcome Measures; Syndrome; anthracycline; taxane derivative; antineoplastic antibiotic; abdominal pain; adjuvant chemotherapy; adult; alopecia; anorexia; anxiety disorder; arthralgia; Article; backache; bloating; blurred vision; body mass; body odor; breast cancer; cancer chemotherapy; cancer diagnosis; chemotherapy; clinical article; clinical practice; cognitive defect; Common Terminology Criteria for Adverse Events; comorbidity; constipation; correlation analysis; coughing; depression; diarrhea; dizziness; dry skin; dysgeusia; dyspepsia; dysphagia; dyspnea; ECOG Performance Status; education; epiphora; exploratory factor analysis; fatigue; flatulence; headache; heart palpitation; histopathology; hot flush; human; human tissue; hyperhidrosis; hyperpigmentation; immunohistochemistry; incidence; insomnia; interview; libido disorder; lumpectomy; major clinical study; marriage; mastectomy; medical record; memory disorder; menstrual irregularity; middle aged; multidisciplinary team; myalgia; nail discoloration; nail discoloration; nail ridges; nail ridges; nausea; neoadjuvant chemotherapy; oral mucositis; paresthesia; patient-reported outcome; peripheral neuropathy; pigment disorder; Poisson regression; pruritus; quality of life; questionnaire; sociodemographics; sore throat; symptom; tinnitus; toxicity; underweight; vaginal dryness; vaginal secretion; validity; vomiting; xerostomia; breast tumor; female; pain; patient-reported outcome; syndrome
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Medicine, Public Health and Nursing > Non Surgical Divisions
Depositing User: Yulistiarini Kumaraningrum KUMARANINGRUM
Date Deposited: 05 Nov 2024 03:21
Last Modified: 05 Nov 2024 03:21
URI: https://ir.lib.ugm.ac.id/id/eprint/10706

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