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