Long-term behavioral symptom clusters among survivors of early-stage breast cancer: Development and validation of a predictive model - Archive ouverte HAL
Article Dans Une Revue JNCI: Journal of the National Cancer Institute Année : 2024

Long-term behavioral symptom clusters among survivors of early-stage breast cancer: Development and validation of a predictive model

Martina Pagliuca
Julie Havas
Davide Soldato
  • Fonction : Auteur
Maria Alice Franzoi
  • Fonction : Auteur
Joana Ribeiro
Camila Chiodi
  • Fonction : Auteur
Emma Gillanders
  • Fonction : Auteur
Barbara Pistilli
Gwenn Menvielle
  • Fonction : Auteur
Florence Joly
  • Fonction : Auteur
Florence Lerebours
  • Fonction : Auteur
Olivier Rigal
Thierry Petit
Sylvie Giacchetti
  • Fonction : Auteur
Florence Dalenc
  • Fonction : Auteur
Johanna Wassermann
  • Fonction : Auteur
Olivier Arsene
  • Fonction : Auteur
Anne Laure Martin
  • Fonction : Auteur
Sibille Everhard
  • Fonction : Auteur
Sandrine Boyault
  • Fonction : Auteur
Michelino de Laurentiis
Jean Francois Deleuze
  • Fonction : Auteur
Aurelie Bertaut
  • Fonction : Auteur
Fabrice André
  • Fonction : Auteur
Ines Vaz-Luis
  • Fonction : Auteur
Antonio Di Meglio

Résumé

Abstract Background Fatigue, cognitive impairment, anxiety, depression, and sleep disturbance are cancer-related behavioral symptoms that may persist years after early-stage breast cancer, affecting quality of life. We aimed to generate a predictive model of long-term cancer-related behavioral symptoms clusters among breast cancer survivors 4 years after diagnosis. Methods Patients with early-stage breast cancer were included from the CANcer TOxicity trial (ClinicalTrials.gov identifier NCT01993498). Our outcome was the proportion of patients reporting cancer-related behavioral symptoms clusters 4 years after diagnosis (≥3 severe symptoms). Predictors, including clinical, behavioral, and treatment-related characteristics; Behavioral Symptoms Score (BSS; 1 point per severe cancer-related behavioral symptom at diagnosis); and a proinflammatory cytokine (interleukin 1b; interleukin 6; tumor necrosis factor α) genetic risk score were tested using multivariable logistic regression, implementing bootstrapped augmented backwards elimination. A 2-sided P less than .05 defined statistical significance. Results In the development cohort (n = 3555), 642 patients (19.1%) reported a cluster of cancer-related behavioral symptoms at diagnosis, and 755 (21.2%) did so 4 years after diagnosis. Younger age (adjusted odds ratio for 1-year decrement = 1.012, 95% confidence interval [CI] = 1.003 to 1.020), previous psychiatric disorders (adjusted odds ratio vs no = 1.27, 95% CI = 1.01 to 1.60), and BSS (adjusted odds ratio ranged from 2.17 [95% CI = 1.66 to 2.85] for BSS = 1 vs 0 to 12.3 [95% CI = 7.33 to 20.87] for BSS = 5 vs 0) were predictors of reporting a cluster of cancer-related behavioral symptoms (area under the curve = 0.73, 95% CI = 0.71 to 0.75). Genetic risk score was not predictive of these symptoms. Results were confirmed in the validation cohort (n = 1533). Conclusion Younger patients with previous psychiatric disorders and higher baseline symptom burden have greater risk of long-term clusters of cancer-related behavioral symptoms. Our model might be implemented in clinical pathways to improve management and test the effectiveness of risk-mitigation interventions among breast cancer survivors.

Domaines

Cancer
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Dates et versions

hal-04765650 , version 1 (04-11-2024)

Identifiants

Citer

Martina Pagliuca, Julie Havas, Emilie Thomas, Youenn Drouet, Davide Soldato, et al.. Long-term behavioral symptom clusters among survivors of early-stage breast cancer: Development and validation of a predictive model. JNCI: Journal of the National Cancer Institute, 2024, ⟨10.1093/jnci/djae222⟩. ⟨hal-04765650⟩
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