A longitudinal prospective study of health-related quality of life in breast cancer patients following high-dose chemotherapy with autologous blood stem cell transplantation

Bl, Conner-Spady; Cumming, Ceinwen E.; Jm, Nabholtz; Jacobs, Philip; Stewart, Douglas A.

doi:10.1038/sj.bmt.1705032

Cited by 59 publications

(75 citation statements)

References 37 publications

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“…An improvement across time was recorded to the reported health states both at the completion of chemotherapy and at the 6-month follow-up time point. This is consistent with findings from other prospective studies [25,26], where even though deterioration in quality of life following administration of chemotherapy was reported, a quick rebounding effect was observed. The improvement of reported health states observed in our study was not different between treatment arms.…”

Section: Discussionsupporting

confidence: 92%

A randomized phase III study comparing three anthracycline-free taxane-based regimens, as first line chemotherapy, in metastatic breast cancer

Fountzilas

Dafni

Dimopoulos

et al. 2008

Breast Cancer Res Treat

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Section: Discussionsupporting

confidence: 92%

A randomized phase III study comparing three anthracycline-free taxane-based regimens, as first line chemotherapy, in metastatic breast cancer

Fountzilas

Dafni

Dimopoulos

et al. 2008

Breast Cancer Res Treat

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“…The studies were transparent with regard to the information provided for the methodologies applied. One study did not include patients aged < 65 years, 128 another excluded those aged > 65 years 130 and three studies did not state clearly if any individuals relevant to this review were excluded. 129,131,134 One study 131 did not describe participant characteristics.…”

Section: Critical Appraisal Of the Included Studiesmentioning

confidence: 99%

“…The designs of the included studies varied: three were RCTs, 126,128,133 two were single-cohort studies, 127,129 one was a longitudinal study, 130 one was a retrospective descriptive study 131 and two were cross-sectional studies. 132,134 All nine included studies defined the study question and explained the treatment strategies.…”

Section: Critical Appraisal Of the Included Studiesmentioning

confidence: 99%

“…Full data extraction of all the included studies is shown in Appendix 8. The nine studies provided data for five out of the seven health states potentially relevant for the independent model: disease free after WLE (one study), 126 WLE + WB-EBRT (three studies), [127][128][129] disease free after local recurrence (one study), 132 mastectomy and reconstruction (two studies), 130,131 and distant recurrence/ metastatic breast cancer (three studies). 132,133,134 No EQ-5D data were identified for the health states WLE + INTRABEAM or WLE + INTRABEAM + WB-EBRT.…”

mentioning

confidence: 99%

“…132,133,134 No EQ-5D data were identified for the health states WLE + INTRABEAM or WLE + INTRABEAM + WB-EBRT. Out of the nine studies, two studies each were based in the UK, 126,128 the USA, 127,129 and Sweden, 131,132 one study each was based in Canada 130 and Germany, 134 and the remaining study was based on a RCT conducted across the UK and USA. EQ-5D…”

mentioning

confidence: 99%

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The INTRABEAM® Photon Radiotherapy System for the adjuvant treatment of early breast cancer: a systematic review and economic evaluation

Picot

Copley

Colquitt

et al. 2015

Health Technol Assess

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BackgroundInitial treatment for early breast cancer is usually either breast-conserving surgery (BCS) or mastectomy. After BCS, whole-breast external beam radiotherapy (WB-EBRT) is the standard of care. A potential alternative to post-operative WB-EBRT is intraoperative radiation therapy delivered by the INTRABEAM®Photon Radiotherapy System (Carl Zeiss, Oberkochen, Germany) to the tissue adjacent to the resection cavity at the time of surgery.ObjectiveTo assess the clinical effectiveness and cost-effectiveness of INTRABEAM for the adjuvant treatment of early breast cancer during surgical removal of the tumour.Data sourcesElectronic bibliographic databases, including MEDLINE, EMBASE and The Cochrane Library, were searched from inception to March 2014 for English-language articles. Bibliographies of articles, systematic reviews, clinical guidelines and the manufacturer’s submission were also searched. The advisory group was contacted to identify additional evidence.MethodsSystematic reviews of clinical effectiveness, health-related quality of life and cost-effectiveness were conducted. Two reviewers independently screened titles and abstracts for eligibility. Inclusion criteria were applied to full texts of retrieved papers by one reviewer and checked by a second reviewer. Data extraction and quality assessment were undertaken by one reviewer and checked by a second reviewer, and differences in opinion were resolved through discussion at each stage. Clinical effectiveness studies were included if they were carried out in patients with early operable breast cancer. The intervention was the INTRABEAM system, which was compared with WB-EBRT, and study designs were randomised controlled trials (RCTs). Controlled clinical trials could be considered if data from available RCTs were incomplete (e.g. absence of data on outcomes of interest). A cost–utility decision-analytic model was developed to estimate the costs, benefits and cost-effectiveness of INTRABEAM compared with WB-EBRT for early operable breast cancer.ResultsOne non-inferiority RCT, TARGeted Intraoperative radioTherapy Alone (TARGIT-A), met the inclusion criteria for the review. The review found that local recurrence was slightly higher following INTRABEAM than WB-EBRT, but the difference did not exceed the 2.5% non-inferiority margin providing INTRABEAM was given at the same time as BCS. Overall survival was similar with both treatments. Statistically significant differences in complications were found for the occurrence of wound seroma requiring more than three aspirations (more frequent in the INTRABEAM group) and for a Radiation Therapy Oncology Group toxicity score of grade 3 or 4 (less frequent in the INTRABEAM group). Cost-effectiveness base-case analysis indicates that INTRABEAM is less expensive but also less effective than WB-EBRT because it is associated with lower total costs but fewer total quality-adjusted life-years gained. However, sensitivity analyses identified four model parameters that can cause a switch in the treatment option that is considered cost-effective.LimitationsThe base-case result from the model is subject to uncertainty because the disease progression parameters are largely drawn from the single available RCT. The RCT median follow-up of 2 years 5 months may be inadequate, particularly as the number of participants with local recurrence is low. The model is particularly sensitive to this parameter.Conclusions and implicationsA significant investment in INTRABEAM equipment and staff training (clinical and non-clinical) would be required to make this technology available across the NHS. Longer-term follow-up data from the TARGIT-A trial and analysis of registry data are required as results are currently based on a small number of events and economic modelling results are uncertain.Study registrationThis study is registered as PROSPERO CRD42013006720.FundingThe National Institute for Health Research Health Technology Assessment programme. Note that the economic model associated with this document is protected by intellectual property rights, which are owned by the University of Southampton. Anyone wishing to modify, adapt, translate, reverse engineer, decompile, dismantle or create derivative work based on the economic model must first seek the agreement of the property owners.

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Overexpression of toll‐like receptors 3 and 4 in synovial tissue from patients with early rheumatoid arthritis: Toll‐like receptor expression in early and longstanding arthritis

Ospelt

Brentano

Rengel

et al. 2008

Arthritis & Rheumatism

298

244

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Objective. To analyze the expression, regulation, and biologic relevance of Toll-like receptors (TLRs) 1-10 in synovial and skin fibroblasts and to determine the expression levels of TLRs 2, 3, and 4 in synovial tissues from patients with early rheumatoid arthritis (RA), longstanding RA, and osteoarthritis (OA).Methods. Expression of TLRs 1-10 in RA synovial fibroblasts (RASFs), OASFs, and skin fibroblasts was analyzed by real-time polymerase chain reaction (PCR).

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A longitudinal prospective study of health-related quality of life in breast cancer patients following high-dose chemotherapy with autologous blood stem cell transplantation

Cited by 59 publications

References 37 publications

A randomized phase III study comparing three anthracycline-free taxane-based regimens, as first line chemotherapy, in metastatic breast cancer

A randomized phase III study comparing three anthracycline-free taxane-based regimens, as first line chemotherapy, in metastatic breast cancer

The INTRABEAM® Photon Radiotherapy System for the adjuvant treatment of early breast cancer: a systematic review and economic evaluation

Overexpression of toll‐like receptors 3 and 4 in synovial tissue from patients with early rheumatoid arthritis: Toll‐like receptor expression in early and longstanding arthritis

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