Cognitive function in older women with breast cancer treated with standard chemotherapy and capecitabine on Cancer and Leukemia Group B 49907

Rachel A. Freedman, Brandelyn Pitcher, Nancy L. Keating, Karla V. Ballman, Jeanne Mandelblatt, Alice B. Kornblith, Gretchen G. Kimmick, Arti Hurria, Eric P. Winer, Clifford A. Hudis, Harvey Jay Cohen, Hyman B. Muss

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Cognitive changes in older women receiving chemotherapy are poorly understood. We examined self-reported cognitive function for older women who received adjuvant chemotherapy on Cancer and Leukemia Group B (CALGB) 49907. CALGB 49907 randomized 633 women aged ≥65 with stage I-III breast cancer to standard adjuvant chemotherapy (cyclophosphamide-methotrexate-5-fluorouracil or doxorubicin-cyclophosphamide) versus capecitabine. We examined self-reported cognitive function in 297 women (CALGB 361002) who enrolled on the quality of life substudy and had no gross impairment on cognitive screening. Women were evaluated using an 18-item instrument at six time points (baseline through 24 months). At each time point for each patient, we calculated a cognitive function score (CFS) defined as the mean response of items 1-18 and defined impairment as a score >1.5 standard deviations above the overall average baseline score. Differences in scores by patient characteristics were evaluated using a Kruskal-Wallis test. A linear mixed-effects model was used to assess CFSs by treatment over time. Among 297 women, the median age was 71.5 (range 65-85) and 73 % had performance status of 0. Baseline depression and fatigue were reported in 6 and 14 % of patients, respectively. The average CFS at baseline was 2.08 (corresponding to "normal ability"), and baseline cognitive function did not differ by treatment regimen (p = 0.350). Over 24 months, women reported minimal changes at each time point and insignificant differences by treatment arm were observed. In a healthy group of older women, chemotherapy was not associated with longitudinal changes in self-reported cognitive function.

Original languageEnglish (US)
Pages (from-to)607-616
Number of pages10
JournalBreast Cancer Research and Treatment
Volume139
Issue number2
DOIs
StatePublished - Jun 2013

Keywords

  • Age
  • Breast cancer
  • Cognitive function
  • Older women

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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