Breast Cancer Research and Treatment

, Volume 139, Issue 2, pp 607–616

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
  • for the Alliance for Clinical Trials in Oncology
Brief Report

DOI: 10.1007/s10549-013-2562-6

Cite this article as:
Freedman, R.A., Pitcher, B., Keating, N.L. et al. Breast Cancer Res Treat (2013) 139: 607. doi:10.1007/s10549-013-2562-6

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.

Keywords

Cognitive function  Older women  Breast cancer  Age 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Rachel A. Freedman
    • 1
  • Brandelyn Pitcher
    • 2
  • Nancy L. Keating
    • 3
    • 4
  • Karla V. Ballman
    • 5
  • Jeanne Mandelblatt
    • 6
  • Alice B. Kornblith
    • 1
  • Gretchen G. Kimmick
    • 7
  • Arti Hurria
    • 8
    • 12
  • Eric P. Winer
    • 1
  • Clifford A. Hudis
    • 9
  • Harvey Jay Cohen
    • 10
  • Hyman B. Muss
    • 11
  • for the Alliance for Clinical Trials in Oncology
  1. 1.Department of Medical OncologyDana-Farber Cancer InstituteBostonUSA
  2. 2.Alliance Statistics and Data CenterDuke UniversityDurhamUSA
  3. 3.Department of Health Care PolicyHarvard Medical SchoolBostonUSA
  4. 4.Division of General Internal MedicineBrigham and Women’s HospitalBostonUSA
  5. 5.Alliance Statistics and Data CenterMayo ClinicRochesterUSA
  6. 6.Department of Oncology, Lombardi Comprehensive Cancer CenterGeorgetown UniversityWashingtonUSA
  7. 7.Duke Medical OncologyDurhamUSA
  8. 8.Department of Medical Oncology & Therapeutics ResearchCity of HopeDuarteUSA
  9. 9.Department of Medical OncologyMemorial Sloan KetteringNew YorkUSA
  10. 10.Center for the Study of AgingDuke Medical OncologyDurhamUSA
  11. 11.Department of Medicine and Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillUSA
  12. 12.Department of Population SciencesCity of HopeDuarteUSA