TO ASSESS THE QUALITY OF LIFE OF PACLITAXEL BASED DOSE DENSE AND CONVENTIONAL NEOADJUVANT CHEMOTHERAPY IN LOCALLY ADVANCED FEMALE BREAST CANCER PATIENTS

Abstract

BACKGROUND Breast cancer has become one of the most common cancers in women all over the world. It is a heterogeneous disease. Locally advanced breast cancer most commonly is diagnosed after a palpable mass is detected within the breast. The aim of this study is to assess the quality of life of paclitaxel-based dose dense and conventional neoadjuvant chemotherapy in locally advanced female breast cancer patients. MATERIALS AND METHODS This observational study design was done between January 2011 and November 2012. A total of hundred locally advanced female breast cancer patients randomly selected from Department of Oncology, Government Medical College, Thiruvananthapuram. Fifty patients received paclitaxel 200 mg/m(2) and doxorubicin 50 mg/m(2) (4 course) every three weeks and other fifty patients received paclitaxel 80 mg/m(2) weekly (10 course) along with doxorubicin 50 mg/m(2) (4 course) every three weeks. Chemotherapy-induced toxicities and the quality of life of patients evaluated weekly (Total 10 weeks) by using Karnofsky Performance Status, Hamilton Depression scale, FACT-B (Functional Assessment of Cancer Therapy of Breast) and FACT-Taxane. Patients underwent modified radical mastectomy after the 4th week of chemotherapy and received adjuvant chemotherapy (Fluorouracil 500 mg/m(2), doxorubicin 50 mg/m(2), cyclophosphamide 500 mg/m(2) four course), external beam radiotherapy (dose of 50 Gy in 25 fractions using co-radioactive isotope) and hormone therapy for those who have receptor status positive. RESULTS Weekly patients had more problems regarding physical and social well-being, significantly less functional and emotional wellbeing, significantly more additional chemotherapy related problems and Taxane toxicity than three weekly patients. Based on Karnofsky Performance Status, three weekly patients had better performance status. Hamilton Depression Scale shows more depression in weekly patients. CONCLUSION This study shows that the quality of life during neoadjuvant chemotherapy in locally advanced female breast cancer patients was better in three weekly arm. Patients in three weekly arm have significantly more functional and emotional well-being. Patients in weekly arm had more depression which may be due to the physical problem, poor performance status, frequent hospital visits and change in life pattern.