期刊
PSYCHO-ONCOLOGY
卷 26, 期 11, 页码 1914-1921出版社
WILEY
DOI: 10.1002/pon.4404
关键词
cancer; long-term quality-of-life trajectories; older breast cancer survivors; oncology; personality; social support
资金
- National Cancer Institute (NCI) at the National Institutes of Health (NIH) [UG1CA189823, U10CA084131, R01CA127617]
- Biostatistics and Bioinformatics Shared Resources at Georgetown-Lombardi Comprehensive Cancer Center [P30CA051008]
- NCI at the NIH legacy [U10CA031946, U10CA033601]
BackgroundTo determine long-term quality-of-life (QOL) trajectories among breast cancer survivors aged 65+ (older) evaluating the effects of personality and social support. MethodsOlder women (N=1280) newly examined with invasive, nonmetastatic breast cancer completed baseline assessments. Follow-up data were collected 6 and 12months later and then annually for up to 7years (median 4.5years). Quality of life was assessed using EORTC-QLQ-C30 emotional, physical, and cognitive scales. Optimism (Life Orientation Test), Coping (Brief COPE), and social support (Medical Outcomes Study) were assessed at baseline. Group-based trajectory modeling identified QOL trajectories; multinomial regression evaluated effects of predictors on trajectory groups. Age, education, systemic therapy, comorbidity, and reported precancer function (SF-12) were considered as controlling variables. ResultsThree trajectories were identified for each QOL domain: maintained high, phase shift (lower but parallel scores to maintained high group), and accelerated decline (lowest baseline scores and steepest decline). Accelerated decline in emotional, physical, and cognitive function was seen in 6.9%, 31.8%, and 7.6% of older survivors, respectively. Maladaptive coping and lower social support increased adjusted odds of being in the accelerated decline group for all QOL domains; lower optimism was only related to decline in emotional function. Chemotherapy was related to physical and cognitive but not emotional function trajectories. ConclusionsPersonality and social resources affect the course of long-term emotional well-being of older breast cancer survivors; treatment is more important for physical and cognitive than emotional function. Early identification of those vulnerable to deterioration could facilitate clinical and psychological support.
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