title: Tailored chemotherapy doses based on toxicity in breast cancer result in similar quality of life values, irrespective of given dose levels.
abstract: BACKGROUND
  From March 1994 to March 1998, breast cancer patients (an estimated relapse risk with 70% or more within five years with standard therapy) were randomised to treatment with tailored fluorouracil, epirubicin, and cyclophosphamide (FEC) therapy or FEC followed by marrow-supported high dose therapy in the Scandinavian Breast Group 9401 study. The aim of the present paper was to investigate differences in toxicity and eight health-related quality of life (HRQoL) variables (physical functioning, role functioning, emotional functioning, social functioning, cognitive functioning, fatigue, nausea-vomiting, and global quality of life) between women in the six dose steps used in the tailored and granulocyte colony stimulating factor supported FEC-arm at the assessment point 16 weeks after random assignment to treatment.
  
  
  METHODS
  The European Organization and Treatment of Cancer Quality of Life Questionnaire EORTC QLQ-C30 were mailed to the patients.
  
  
  RESULTS
  A total of 157 (87%) in the tailored FEC-group responded to the questionnaire within the time frame 16 weeks after inclusion in the study. Overall, toxicity was low, reaching grade 1-2 also in the higher dose steps. There were no overall differences between the dose steps on any of the tested HRQoL variables. Patients at dose step 4 scored statistically significantly higher on physical functioning than patients at dose step 1 (p = 0.022) and compared to those at dose step 2 (p = 0.014). Patients at dose steps -2 and -1 (combined to one group) reported statistically significantly higher mean scores on cognitive functioning than patients at dose step 1 (p = 0.022).
  
  
  CONCLUSIONS
  Patients who received higher doses, based on the tailored dosing strategy, did not seem to have worse HRQoL than those who had lower doses.
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mariann
authors.initials: M
authors.lastname: Iiristo
authors.forename: Tom
authors.initials: T
authors.lastname: Wiklund
authors.forename: Nils
authors.initials: N
authors.lastname: Wilking
authors.forename: Jonas
authors.initials: J
authors.lastname: Bergh
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Brandberg
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D002277:Carcinoma / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007206:Individuality; D008875:Middle Aged; D057285:Precision Medicine / Q000379:methods; D011788:Quality of Life; D012016:Reference Values; D012107:Research Design / Q000592:standards; D011795:Surveys and Questionnaires / Q000592:standards
chemical_list: D015251:Epirubicin; D003520:Cyclophosphamide; D005472:Fluorouracil