Quality of life of older patients with early-stage breast cancer receiving adjuvant chemotherapy: A companion study to Cancer and Leukemia Group B 49907 Journal Article


Authors: Kornblith, A. B.; Lan, L.; Archer, L.; Partridge, A.; Kimmick, G.; Hudis, C.; Winer, E.; Casey, R.; Bennett, S.; Cohen, H. J.; Muss, H. B.
Article Title: Quality of life of older patients with early-stage breast cancer receiving adjuvant chemotherapy: A companion study to Cancer and Leukemia Group B 49907
Abstract: Purpose A phase III trial (Cancer and Leukemia Group B CALGB-49907) was conducted to test whether older patients with early-stage breast cancer would have equivalent relapse-free and overall survival with capecitabine compared with standard chemotherapy. The quality of life (QoL) substudy tested whether capecitabine treatment would be associated with a better QoL than standard chemotherapy. Patients and Methods QoL was assessed in 350 patients randomly assigned to either standard chemotherapy (cyclophosphamide, methotrexate, and fluorouracil [CMF] or doxorubicin and cyclophosphamide [AC]; n = 182) or capecitabine (n = 168). Patients were interviewed by telephone before treatment (baseline), midtreatment, within 1 month post-treatment, and at 12, 18, and 24 months postbaseline by using questionnaires from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30), a breast systemic adverse effects scale (EORTC BR23), and the Hospital Anxiety and Depression Scale (HADS). Results Compared with patients who were treated with standard chemotherapy, patients who were treated with capecitabine had significantly better QoL, role function, and social function, fewer systemic adverse effects, less psychological distress, and less fatigue during and at the completion of treatment (P <= .005). Capecitabine treatment was associated with less nausea, vomiting, and constipation and with better appetite than standard treatment (P <= .004), but worse hand-foot syndrome and diarrhea (P < .005). These differences all resolved by 12 months. Conclusion Standard chemotherapy was superior to capecitabine in improving relapse-free and overall survival for older women with early-stage breast cancer. Although capecitabine was associated with better QoL during treatment, QoL was similar for both groups at 1 year. The brief period of poorer QoL with standard treatment is a modest price to pay for a chance at improved survival. J Clin Oncol 29:1022-1028. (c) 2011 by American Society of Clinical Oncology
Keywords: capecitabine; depression; anxiety; phase-ii; disease; european-organization
Journal Title: Journal of Clinical Oncology
Volume: 29
Issue: 8
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2011-03-10
Start Page: 1022
End Page: 1028
Language: English
DOI: 10.1200/jco.2010.29.9859
ACCESSION: WOS:000288161000026
PROVIDER: wos
PMCID: PMC3068052
PUBMED: 21300923
Notes: --- - Article - "Source: Wos"
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  1. Clifford Hudis
    857 Hudis