Comparison of patient reported quality of life and impact of treatment side effects experienced with a taxane-containing regimen and standard anthracycline based chemotherapy for early breast cancer: 6 year results from the UK TACT trial (CRUK/01/001).
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Date
2014-09-01Author
Hall, E
Cameron, D
Waters, R
Barrett-Lee, P
Ellis, P
Russell, S
Bliss, JM
Hopwood, P
TACT Trial Investigators,
Type
Journal Article
Metadata
Show full item recordAbstract
BACKGROUND: The TACT trial (CRUK/01/001) compared adjuvant sequential FEC-docetaxel (FEC-D) chemotherapy with standard anthracycline-based chemotherapy of similar duration in women with early breast cancer. Results at a median of 5 years suggested no improvement in disease-free survival with FEC-D. Given differing toxicity profiles of the regimens, the impact on quality of life (QL) was explored. METHODS: Patients from 44 centres completed standardised QL questionnaires before chemotherapy, after cycles 4 and 8, at 9, 12, 18 and 24 months and at 6 years follow-up. Patient diaries assessed frequency, associated distress and impact on daily activity of 15 treatment related side effects. FINDINGS: 830 patients (415 FEC-D; 415 controls) contributed assessments during 0-24 months; 362 of whom participated again at 6 years. During chemotherapy, FEC-D impaired global health/QL and depression rates and significantly more QL domains than standard regimens. Novel diary card ratings highlighted significantly more distress and interference with daily activities due to FEC-D side effects compared with standard treatment. In both groups, most QL parameters returned to baseline levels by 2 years and were unchanged at 6 years. INTERPRETATION: Within expected negative effects of chemotherapy on wide ranging QL domains FEC-D patients reported greater toxicity, disruption and distress during treatment with no improvement in disease outcome at 5 years than patients receiving standard anthracycline-based chemotherapy. Findings should inform future patients of relative costs and benefits of adjuvant chemotherapy.
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Subject
TACT Trial Investigators
Humans
Breast Neoplasms
Taxoids
Tamoxifen
Cyclophosphamide
Fluorouracil
Methotrexate
Anthracyclines
Epirubicin
Antineoplastic Combined Chemotherapy Protocols
Therapeutics
Chemotherapy, Adjuvant
Quality of Life
Adult
Middle Aged
Female
Surveys and Questionnaires
United Kingdom
Bridged-Ring Compounds
Research team
Clinical Trials & Statistics Unit
ICR-CTSU Urology and Head and Neck Trials Team
Language
eng
Date accepted
2014-06-08
License start date
2014-09
Citation
European journal of cancer (Oxford, England : 1990), 2014, 50 (14), pp. 2375 - 2389
Publisher
ELSEVIER SCI LTD