Impact of anthracycline dose on quality of life and rehabilitation in breast cancer treatment.
BACKGROUND
In 2005 the Dutch national guidelines for treatment of breast cancer were updated. From then onwards, patients with operable breast cancer, who formerly received four cycles of adjuvant chemotherapy with doxorubicin/cyclophosphamide (AC), were treated with five cycles of 5-fluorouracil/epirubicin/cyclophosphamide (FEC), based on data suggesting survival benefit.


OBJECTIVE
evaluation of the effect on quality-of-life and trainability after four AC versus five FEC cycles of polychemotherapy.


OBJECTIVE
evaluation of the effectiveness of an 18-week training programme for breast cancer survivors.


METHODS
A prospective cohort study design was used, comparing two chemotherapy regimens historically. The first cohort (group 1) received 4AC (A 60 mg/m2, C 600 mg/m2) (n=25) and the second cohort (group 2) received 5FE C (F 500 mg/m2, E 90 mg/m2, C 500 mg/m2) (n=50) adjuvant polychemotherapy. Both groups completed an 18-week high-intensity strength-training programme. Outcome measures were changes in quality-of-life (EORTC-QLQ-C30, MFI -20), muscular strength (one-repetition maximum; leg press) and cardiopulmonary function (VO2max) between baseline and follow-up.


RESULTS
Between March 2002 and February 2006, 75 female subjects with breast cancer participated in this study. Baseline characteristics were similar in both groups. After completing the training programme, both groups showed a significant improvement in all outcome measures. No significant differences in changes of the EORTC-QLQ-C30 and MFI-20, one repetition maximum of the leg press and the VO2max between the two groups were demonstrated.


CONCLUSIONS
After adaptation of the Dutch national breast cancer treatment guidelines, patients received prolonged and increased doses of anthracyclines. This, however, did not result in a difference in the baseline situation before rehabilitation and in training response, nor in quality of life between the two groups.
Hokken
J W E
JW
Department of Medical Oncology, Erasmus University Medical Centre Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands. j.hokken@erasmusmc.nl
van der Cruijsen-Raaijmakers
M
M
Schep
G
G
Vreugdenhil
G
G
D000704:Analysis of Variance; D018943:Anthracyclines / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000534:rehabilitation; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006305:Health Status Indicators; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D010101:Oxygen Consumption; D015397:Program Evaluation; D011446:Prospective Studies; D011788:Quality of Life
D018943:Anthracyclines; D015251:Epirubicin; D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil