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Quality of Life of Long-Term Survivors of Breast Cancer and Lymphoma Treated With Standard-Dose Chemotherapy or Local Therapy

From the Department of Psychiatry and Center for Psycho-Oncology Research, and Department of Psychiatry (Neuropsychology Program), Community and Family Medicine and the Norris Cotton Cancer Center; Dartmouth-Hitchcock Medical Center; Lebanon; and New Hampshire Hospital, Concord, NH

Address reprint requests to Tim A. Ahles, PhD, Department of Psychiatry, Dartmouth-Hitchcock Medical Center, One Medical Center Dr, Lebanon, NH 03756; e-mail: Tim.A.Ahles{at}Dartmouth.edu

PURPOSE: This study compared the quality of life (QOL) of long-term survivors of breast cancer and lymphoma who had been treated with standard-dose systemic chemotherapy or local therapy only.

PATIENTS AND METHODS: Long-term survivors (mean, 10.0 ± 5.3 years after treatment) of breast cancer or lymphoma who had been treated with systemic chemotherapy (breast, n = 141, age = 57.0 ± 10.1 years; lymphoma, n = 66, age = 55.8 ± 13.5 years) or local therapy only (breast, n = 294, age = 65.8 ± 9.1 years; lymphoma, n = 37, age = 50.4 ± 12.8 years) were interviewed by phone using the Quality of Life–Cancer Survivors Tool.

RESULTS: Multivariate analysis of covariance, controlling for sex, age, education, stage of disease, and time since last treatment, revealed that survivors who had been treated with systemic chemotherapy scored significantly lower on overall QOL compared with survivors treated with local therapy only (P = .04). Analysis of covariance on the subscale scores revealed that, compared with survivors who received local therapy, survivors treated with chemotherapy scored significantly lower on the Social subscale (P < .0001), but no differences emerged on the Psychological or Spiritual subscales. There was a statistically significant interaction between treatment and diagnosis (P = .01), as measured by the Physical subscale, indicating that lymphoma survivors treated with chemotherapy scored worse than all other groups.

CONCLUSION: Important QOL differences emerged between the chemotherapy and local therapy groups, suggesting that long-term QOL may vary depending on the type of treatment and diagnosis.

Supported by a supplement to the Norris Cotton Cancer Center Core grant No. P30CA23108 and by grant No. RO1 CA87845 from the Office of Cancer Survivorship, National Cancer Institute, Bethesda, MD.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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