Role of supportive care in improving the quality of life and reducing unscheduled hospital care in patients with metasta
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ORIGINAL ARTICLE
Role of supportive care in improving the quality of life and reducing unscheduled hospital care in patients with metastatic breast cancer Antoine Arnaud 1 & Julien Grenier 1 & Rania Boustany 1 & Sylvie Kirscher 1 & Alice Mege 1 & Gaëtan de Rauglaudre 1 & Léa Vazquez 1 & Philippe Debourdeau 1 Received: 24 January 2020 / Accepted: 5 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Metastatic breast cancer (MBC) patients experience long survival and report poorer quality of life than localized breast cancer patients. Comprehensive supportive care (CSC) has been shown to improve the quality of life (QoL) of MBC. The respective part of each support care has not been fully examined, and little is known about whether meeting patients’ needs is accompanied by decreased unscheduled hospital care (UHC). Methods This prospective monocentric study included women who started a new treatment line for MBC between January 2018 and December 2018. The endpoints were factors associated with UHC and QoL (SF36) at month 12. Results 100 patients were offered CSC, 78 were included (21 refusals, 1 no MBC). CSC was provided to 60 patients: pain (43%), psychological (37%), kinesitherapy (30%), social assistance (22%), esthetic (18%), nutrition (18%), massage (13%), and none (10%). CSC rate was not statistically different among patients with (58%) and without UHD (49%). Factors associated with a decrease of UHC were age > 65 years (p = 0.01), no previous treatment for MBC (p = 0.0001) with a trend for the lack of CSC (p = 0.054). Among the 8 domains of the SF36 scale, only health change perception was improved (p = 0.01) and its predictive factors were treatment carried out as planned (p = 0.0004), pain care (p = 0.003), and lack of MBC progression (p = 0.0035). Conclusion CSC can improve QoL in MBC. Painful patients might benefit more from CSC. UHC did not decrease for patients receiving CSC as expected possibly because of their important needs for clinical care. Keywords Supportive care . Quality of life . Unscheduled hospital care . Metastatic breast cancer
Introduction Among women, the most common incident site of cancer remains the breast and metastatic breast cancer (MBC) is the leading cause of death from cancer (respectively 24.2% of 8 622 539 cases and 15% of 4 169 387 deaths worldwide in 2018) [1]. In recent years, new targeted biologic agents active against MBC, such as HER2 and CDK 4/6 inhibitors, antiangiogenic agents, have demonstrated meaningful survival improvement [2]. Therefore, the MBC population is growing, with 15,4794 women estimated to be living in the USA in 2017 with MBC [3]. Metastatic breast cancer remains
* Léa Vazquez [email protected] 1
Institut Sainte Catherine, 250 chemin de baigne-pieds, 84918 Avignon, France
essentially incurable, and goals of therapy include palliation of symptoms, delay of disease progression, and prolongation of overall survival time without negatively impacting the quality of life (QoL). MBC patients report poor QoL,
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