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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ICR Authors
Authors
Hall, E
Cameron, D
Waters, R
Barrett-Lee, P
Ellis, P
Russell, S
Bliss, JM
Hopwood, P
TACT Trial Investigators,
Cameron, D
Waters, R
Barrett-Lee, P
Ellis, P
Russell, S
Bliss, JM
Hopwood, P
TACT Trial Investigators,
Document Type
Journal Article
Date
2014-09-01
Date Accepted
2014-06-08
Abstract
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.
Citation
European journal of cancer (Oxford, England : 1990), 2014, 50 (14), pp. 2375 - 2389
Source Title
Publisher
ELSEVIER SCI LTD
ISSN
0959-8049
eISSN
1879-0852
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Research Team
Clinical Trials & Statistics Unit
ICR-CTSU Urology and Head and Neck Trials Team
ICR-CTSU Urology and Head and Neck Trials Team