Arnold Library

Chemotherapeutic impact on pain and global health-related quality of life in hormone-refractory prostate cancer: Dynamically Modified Outcomes (DYNAMO) analysis of a randomized controlled trial.

Moinpour, Carol M and Donaldson, Gary W and Nakamura, Yoshio (2009) Chemotherapeutic impact on pain and global health-related quality of life in hormone-refractory prostate cancer: Dynamically Modified Outcomes (DYNAMO) analysis of a randomized controlled trial. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 18 (2). pp. 147-155. ISSN 0962-9343

[img]
Preview
Text (Complete manuscript)
MoinpourCQualLifeRes03011_revised030910.pdf
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (712Kb) | Preview
Article URL: http://www.springerlink.com/content/g65m78l3kv6078...

Abstract

PURPOSE: This paper applies the Dynamically Modified Outcomes (DYNAMO) model to a clinical trial of two chemotherapeutic regimens on global health-related quality of life (GHRQL) in hormone-refractory prostate cancer. METHODS: DYNAMO identifies the causal influences operating in a clinical trial and their mediation, moderation, and modulation by uncontrolled variables. The Southwest Oncology Group trial S9916 randomized assignment to mitoxantrone plus prednisone (M + P) versus docetaxel plus estramustine (D + E) treatments. In this application, we examine baseline-adjusted impacts of worst pain (McGill Pain Questionnaire) on GHRQL (EORTC Quality of Life Questionnaire-C30) at 10 weeks. RESULTS: The average treatment levels of pain did not differ, hence, the average mediated effect of treatment on GHRQL was zero. Nonetheless, M + P reduced the impact (the relational outcome) of pain on GHRQL by 54% relative to D + E. Individual variation in the relational outcome (modulation) was of the same magnitude as the average difference between the groups. Performance status moderated the direct effects of treatment, with D + E being more effective in good, but not poor, performance strata. CONCLUSIONS: The DYNAMO approach comprehensively accounted for treatment effects. Rather than a single average effect, there were three distinct treatment effects: one direct effect for each performance status level and a direct effect on the relationship between pain and GHRQL.

Item Type: Article
Additional Information: The final publication is available at www.springerlink.com
DOI: 10.1007/s11136-008-9433-3
PubMed ID: 19130298
NIHMSID: NIHMS190803
PMCID: PMC2859212
Keywords or MeSH Headings: Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Estramustine/administration & dosage; Humans; Male; Mitoxantrone/administration & dosage; Models, Statistical; Neoplasms, Hormone-Dependent/drug therapy; Pain/drug therapy/etiology; Pain Measurement; Prednisone/administration & dosage; Prostatic Neoplasms/complications/drug therapy; Quality of Life; Randomized Controlled Trials as Topic/methods; Taxoids/administration & dosage; Treatment Outcome;
Subjects: Research Methodologies > Clinical Trials
Psychology > Pain
Psychology > Quality of Life
Diseases > Solid tumors > Prostate cancer
Therapeutics > Drug Therapy
Depositing User: Library Staff
Date Deposited: 25 Mar 2010 15:49
Last Modified: 14 Feb 2012 14:43
URI: http://authors.fhcrc.org/id/eprint/414

Repository Administrators Only

View Item View Item
Fred Hutchinson Cancer Research Center
1100 Fairview Ave. N. PO Box 19024
Seattle, WA 98109

a 501(c)(3) nonprofit organization.

© Terms of Use & Privacy Policy