Longitudinal effects of high-dose chemotherapy and autologous stem cell transplantation on quality of life in the treatment of metastatic breast cancer

This study determined the effects of high-dose chemotherapy (HDCT) with aut ologous blood stem cell transplantation (ASCT) on quality of life (QL) in w omen with metastatic breast cancer prior to, and during treatment, and up t o 1-year post-ASCT, Thirty-three women diagnosed with metastatic breast can cer participated in a phase 1 clinical trial of a new combination of cyclop hosphamide (CTX) and mitoxantrone (MXT), with dose escalation of paclitaxel , Longitudinal QL data were collected using the functional living index-can cer (FLIC) and symptom scales at seven time periods: pre-induction chemothe rapy (CT), post-induction CT, post-high dose CT (HDCT), and at 3, 6, 9 and 12 months post-ASCT, FLIC scores indicated that the worst problems for pati ents were feelings of hardship on themselves and their families, followed b y psychological functioning and physical functioning problems. The time aro und diagnosis of the metastatic disease and following HDCT were the worst t imes for all levels of quality of life, but anxiety and depression symptoms continued to increase in severity across the entire follow-up period. The symptoms that were most problematic were worry about the future, loss of se xual interest, anxiety about the treatment, general worrying, and joint pai n. These data highlight the problems that women with metastatic breast canc er encounter at different stages of the disease and treatment process, and can be used to tailor psychosocial interventions appropriate for treating t he relevant issues at different points in time.