title: A prospective, longitudinal study of the functional status and quality of life of older patients with breast cancer receiving adjuvant chemotherapy.
abstract: OBJECTIVE
  To examine the toxicity experienced by a cohort of older women receiving adjuvant chemotherapy for breast cancer and the longitudinal effect on their functional status and quality of life (QOL).
  
  
  METHODS
  A geriatric assessment measuring functional status, comorbidity, mood, nutritional status, and QOL was performed before chemotherapy, at the end of chemotherapy, and 6 months later.
  
  
  METHODS
  This prospective longitudinal study was conducted at Memorial Sloan-Kettering Cancer Center, New York, New York.
  
  
  METHODS
  Fifty patients aged 65 and older with Stage I to III breast cancer receiving any adjuvant chemotherapy; 49 were evaluable.
  
  
  METHODS
  The chemotherapy regimen and the toxicity to chemotherapy were recorded. A geriatric assessment was performed before the start of chemotherapy, on completion of chemotherapy, and 6 months after completion of chemotherapy. QOL testing was performed at the same times.
  
  
  RESULTS
  Patients (mean age 68, range 65-84) received an anthracycline-based chemotherapy regimen (n=15) or cyclophosphamide 600 mg/m2 intravenously (i.v.), methotrexate 40 mg/m2 i.v., 5-fluorouracil 600 mg/m2 i.v. every 3 weeks for eight cycles (n=34). Grade 3 or 4 toxicity occurred in 53% (n=26), hematological toxicity in 27% (n=13), and nonhematological toxicity in 31% (n=15). Despite toxicity, there was no significant longitudinal change in functional status or QOL.
  
  
  CONCLUSIONS
  Despite toxicity from adjuvant chemotherapy, this cohort of relatively young older patients maintained their functional status and QOL from before chemotherapy to 6 months postchemotherapy. Subtle changes in higher-order functioning would require assessment using different geriatric assessment tools.
authors.affiliation: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. hurriaa@mskcc.org
authors.forename: Arti
authors.initials: A
authors.lastname: Hurria
authors.forename: Anju
authors.initials: A
authors.lastname: Hurria
authors.forename: Enid
authors.initials: E
authors.lastname: Zuckerman
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Panageas
authors.forename: Monica
authors.initials: M
authors.lastname: Fornier
authors.forename: Gabriella
authors.initials: G
authors.lastname: D'Andrea
authors.forename: Chau
authors.initials: C
authors.lastname: Dang
authors.forename: Mark
authors.initials: M
authors.lastname: Moasser
authors.forename: Mark
authors.initials: M
authors.lastname: Robson
authors.forename: Andrew
authors.initials: A
authors.lastname: Seidman
authors.forename: Violante
authors.initials: V
authors.lastname: Currie
authors.forename: Catherine
authors.initials: C
authors.lastname: VanPoznak
authors.forename: Maria
authors.initials: M
authors.lastname: Theodoulou
authors.forename: Mark S
authors.initials: MS
authors.lastname: Lachs
authors.forename: Clifford
authors.initials: C
authors.lastname: Hudis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008408:Mastectomy; D015412:Mastectomy, Segmental; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors