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Metastatik Meme Kanserinde Parenteral ve Oral Tedavilerin Psikolojik ve Yaşam Kalitesi Üzerindeki Etkileri: Karşılaştırmalı Analiz

Year 2025, Volume: 10 Issue: 3, 73 - 78, 31.12.2025
https://doi.org/10.55694/jamer.1815786

Abstract

Amaç: Bu çalışmada metastatik meme kanseri tanılı hastalarda uygulanan parenteral ve oral tedavi yöntemlerinin depresyon,anksiyete, uyku kalitesi ve bu etkenlerin kişinin hayat kalitesi üzerindeki etkilerinin karşılaştırılması amaçlanmıştır.

Gereç ve Yöntemler: Çalışmaya metastatik meme kanseri tanısı almış toplam 106 hasta dahil edilmiştir. Hastalar tedavi şekline göre parenteral tedavi (M grubu) ve oral CDK4/6 inhibitörü tedavisi (CDK grubu) alanlar olarak iki gruba ayrılmıştır. Anksiyete ve depresyon düzeyleri Hospital Anxiety and Depression Scale (HADS) ile , uyku kalitesi Pittsburgh Sleep Quality Index (PSQI) kullanılarak, menapoz semptomu şiddeti için Menopause Rating Scale (MRS) ve yaşam kalitesi ise Nottingham Health Profile (NHP) ölçekleriyle değerlendirilmiştir.

Bulgular: Çalışma grubunun ortalama yaşı 55,8±10,7 yıl olarak bulunmuştur. Hastaların %42,5’inde anksiyete, %39,6’sında depresyon, %46,2’sinde uyku bozukluğu ve %31,8 hastada MRS skoruna göre şiddetli menopoz semptomları saptanmıştır. Gruplar arasında yaş, HADS-A, HADS-D, PSQI, MRS ve NHP skorları açısından anlamlı fark saptanmamıştır (p>0,05). Anksiyete ve uyku bozukluğu olan hastalarda NHP skorları daha yüksek olup, yaşam kalitesiyle ters yönde ilişki göstermiştir.

Sonuç: Metastatik meme kanserinde uygulanan parenteral ve oral tedavi yöntemleri arasında a depresyon, anksiyete,uyku kalitesi ve bu etkenlerin kişi üzerindeki hayat kalitesi açısından anlamlı fark saptanmamıştır. Her iki tedavi yaklaşımı da benzer düzeyde psikolojik tolere edilebilirliğe sahiptir. Tedavi seçimi yapılırken psikososyal faktörlerin dikkate alınması, hasta merkezli yaklaşımlar açısından önem taşımaktadır.

Ethical Statement

Çalışma için 23.11.22 tarih ve 2022-16/10 sayılı Bursa Şehir Hastanesi Etik Kurulu onayı alınmıştır.

Supporting Institution

herhangi bir kurumdan finansal bir desteğimiz yoktur.

Thanks

teşekkür edilecek kişi ve kuruluş yoktur.

References

  • 1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):7–35.
  • 2. Cardoso F, Paluch-Shimon S, Senkus E, Curigliano G, Aapro MS, André F, et al. 5th ESO–ESMO international consensus guidelines for advanced breast cancer (ABC 5). Ann Oncol. 2020;31(12):1623– 1649.
  • 3. Gradishar WJ, Moran MS, Abraham J, Abramson V, Aft R, Agnese D, et al. NCCN clinical practice guidelines in oncology: Breast cancer, version 4.2025. J Natl Compr Canc Netw. 2025;23(1):1–107.
  • 4. Johnston SRD, Harbeck N, Hegg R, Toi M, Martin M, Shao ZM, et al. Abemaciclib combined with endocrine therapy for HR- positive, HER2-negative advanced breast cancer. N Engl J Med. 2020;382(6):514 –524.
  • 5. Slamon DJ, Neven P, Chia S, Fasching PA, De Laurentiis M, Im SA, et al. Overall survival with ribociclib plus endocrine therapy in breast cancer. N Engl J Med. 2020;382(6):514–524.
  • 6. Verma S, Bartlett CH, Schnell P, et al. Patient-reported outcomes in metastatic breast cancer treated with palbociclib plus endocrine therapy. Cancer Med. 2021;10(3):923–934.
  • 7. Mitchell AJ, Ferguson DW, Gill J, Paul J, Symonds P. Depression and anxiety in long-term cancer survivors: prevalence and risk factors. J Affect Disord. 2022;307:123–133.
  • 8. Bower JE. Cancer-related fatigue—mechanisms, risk factors, and treatments. Nat Rev Clin Oncol. 2023;20(1):25–38.
  • 9. Wang Y, Wang F, et al. Psychological distress and adherence in breast cancer patients during targeted oral therapy. Support Care Cancer. 2024;32(4):1813–1824.
  • 10. Savard J, Ivers H, Villa J, Caplette-Gingras A, Morin CM. Natural course of insomnia comorbid with cancer: an 18-month longitudinal study. J Clin Oncol. 2021;39(12):1356–1366.
  • 11. Howell D, Oliver TK, Keller-Olaman S, Davidson JR, Garland S, Samuels C, et al. Sleep disturbance in cancer patients: prevalence, impact, and management. J Natl Cancer Inst. 2020;112(2):131–142.
  • 12. Hunt SM, McEwen J, McKenna SP. Measuring health status: a new tool for clinicians and epidemiologists. J R Coll Gen Pract. 1985;35(273):185–188.
  • 13. Ponde NF, Zardavas D, Piccart M. Progress in adjuvant systemic therapy for breast cancer. Nat Rev Clin Oncol. 2020;17(1):27–44.
  • 14. Du Y, Zhang X, Wang H, et al. Anxiety, depression and quality of life in breast cancer patients receiving chemotherapy: a cross- sectional study. Support Care Cancer. 2023;31(5):2457–2468.
  • 15. Chen Y, Sun Y, et al. Impact of CDK4/6 inhibitors on fatigue, sleep, and mental health in metastatic breast cancer patients: a prospective observational study. Breast Cancer Res Treat. 2024;203(2):355–367.
  • 16. Hortobagyi GN, Stemmer SM, Burris HA, Yap YS, Sonke GS, Paluch-Shimon S, et al. Ribociclib as first-line therapy for HR- positive, advanced breast cancer. Lancet Oncol. 2022;23(7):907–921.

Psychological and Quality-of-Life Outcomes of Parenteral versus Oral Treatments in Metastatic Breast Cancer: A Comparative Analysis

Year 2025, Volume: 10 Issue: 3, 73 - 78, 31.12.2025
https://doi.org/10.55694/jamer.1815786

Abstract

Aim: This study aimed to compare the effects of parenteral and oral treatment modalities on depression,anxiety, sleep quality, and this factors related to quality of life in patients with metastatic breast cancer.

Materials and Methods: A total of 106 patients diagnosed with metastatic breast cancer were included in the study. Patients were divided into two groups according to their treatment method: those receiving parenteral treatment (M group) and those receiving oral CDK4/6 inhibitor treatment (CDK group). Anxiety and depression levels were assessed using the Hospital Anxiety and Depression Scale (HADS), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), menopausal symptom severity using the Menopause Rating Scale (MRS), and quality of life using the Nottingham Health Profile (NHP)

Results: The mean age of the study group was found to be 55.8 ± 10.7 years. Anxiety was detected in 42.5% of patients, depression in 39.6%, sleep disturbances in 46.2%, and severe menopausal symptoms according to the MRS score in 31.8% of patients. No significant differences were found between the groups in terms of age, HADS-A, HADS-D, PSQI, MRS, and NHP scores (p>0.05). Patients with anxiety and sleep disturbances had higher NHP scores, which showed an inverse relationship with quality of life.

Conclusion: There were no significant differences in depression,anxiety, sleep quality, or quality of life between patients receiving parenteral and oral treatments. Both approaches showed similar psychological tolerability. Considering psychosocial factors in treatment selection may enhance patient-centered care.

Ethical Statement

Bursa City Hospital ethics committee application numbered 23/11/22 and 2022-16/10

Supporting Institution

We do not have any financial support from any institution.

Thanks

There is no person or organization to thank.

References

  • 1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):7–35.
  • 2. Cardoso F, Paluch-Shimon S, Senkus E, Curigliano G, Aapro MS, André F, et al. 5th ESO–ESMO international consensus guidelines for advanced breast cancer (ABC 5). Ann Oncol. 2020;31(12):1623– 1649.
  • 3. Gradishar WJ, Moran MS, Abraham J, Abramson V, Aft R, Agnese D, et al. NCCN clinical practice guidelines in oncology: Breast cancer, version 4.2025. J Natl Compr Canc Netw. 2025;23(1):1–107.
  • 4. Johnston SRD, Harbeck N, Hegg R, Toi M, Martin M, Shao ZM, et al. Abemaciclib combined with endocrine therapy for HR- positive, HER2-negative advanced breast cancer. N Engl J Med. 2020;382(6):514 –524.
  • 5. Slamon DJ, Neven P, Chia S, Fasching PA, De Laurentiis M, Im SA, et al. Overall survival with ribociclib plus endocrine therapy in breast cancer. N Engl J Med. 2020;382(6):514–524.
  • 6. Verma S, Bartlett CH, Schnell P, et al. Patient-reported outcomes in metastatic breast cancer treated with palbociclib plus endocrine therapy. Cancer Med. 2021;10(3):923–934.
  • 7. Mitchell AJ, Ferguson DW, Gill J, Paul J, Symonds P. Depression and anxiety in long-term cancer survivors: prevalence and risk factors. J Affect Disord. 2022;307:123–133.
  • 8. Bower JE. Cancer-related fatigue—mechanisms, risk factors, and treatments. Nat Rev Clin Oncol. 2023;20(1):25–38.
  • 9. Wang Y, Wang F, et al. Psychological distress and adherence in breast cancer patients during targeted oral therapy. Support Care Cancer. 2024;32(4):1813–1824.
  • 10. Savard J, Ivers H, Villa J, Caplette-Gingras A, Morin CM. Natural course of insomnia comorbid with cancer: an 18-month longitudinal study. J Clin Oncol. 2021;39(12):1356–1366.
  • 11. Howell D, Oliver TK, Keller-Olaman S, Davidson JR, Garland S, Samuels C, et al. Sleep disturbance in cancer patients: prevalence, impact, and management. J Natl Cancer Inst. 2020;112(2):131–142.
  • 12. Hunt SM, McEwen J, McKenna SP. Measuring health status: a new tool for clinicians and epidemiologists. J R Coll Gen Pract. 1985;35(273):185–188.
  • 13. Ponde NF, Zardavas D, Piccart M. Progress in adjuvant systemic therapy for breast cancer. Nat Rev Clin Oncol. 2020;17(1):27–44.
  • 14. Du Y, Zhang X, Wang H, et al. Anxiety, depression and quality of life in breast cancer patients receiving chemotherapy: a cross- sectional study. Support Care Cancer. 2023;31(5):2457–2468.
  • 15. Chen Y, Sun Y, et al. Impact of CDK4/6 inhibitors on fatigue, sleep, and mental health in metastatic breast cancer patients: a prospective observational study. Breast Cancer Res Treat. 2024;203(2):355–367.
  • 16. Hortobagyi GN, Stemmer SM, Burris HA, Yap YS, Sonke GS, Paluch-Shimon S, et al. Ribociclib as first-line therapy for HR- positive, advanced breast cancer. Lancet Oncol. 2022;23(7):907–921.
There are 16 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases, Clinical Oncology
Journal Section Research Article
Authors

Hülya Ertaş 0000-0002-5872-8825

Burcu Caner 0000-0003-1591-3323

Sibel Oyucu Orhan 0000-0001-8217-3471

Arife Ulaş 0000-0003-2918-2592

Submission Date November 3, 2025
Acceptance Date December 27, 2025
Publication Date December 31, 2025
Published in Issue Year 2025 Volume: 10 Issue: 3

Cite

Vancouver Ertaş H, Caner B, Oyucu Orhan S, Ulaş A. Metastatik Meme Kanserinde Parenteral ve Oral Tedavilerin Psikolojik ve Yaşam Kalitesi Üzerindeki Etkileri: Karşılaştırmalı Analiz. JAMER. 2025;10(3):73-8.