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The Impact of AC and AC-T Chemotherapy’s Toxicities on Quality of Life Among Women with Breast Cancer in Ethiopia: A Prospective Patient-Reported Outcomes Study

Authors Gadisa DA, Wang SH, Yimer G

Received 4 November 2020

Accepted for publication 22 January 2021

Published 24 February 2021 Volume 2021:13 Pages 107—132


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Pranela Rameshwar

Diriba Alemayehu Gadisa,1 Shu-Hua Wang,2,3 Getnet Yimer4

1Pharmacy Department, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia; 2Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA; 3Ben Franklin TB Control Program, Columbus, OH, USA; 4Ohio State Global One Health Initiative, Office of International Affairs, The Ohio State University, Addis Ababa, Ethiopia

Correspondence: Diriba Alemayehu Gadisa 19 Tel +251915958190

Purpose: The study aimed to evaluate the quality of life patterns and the effects of AC and AC-T chemotherapy’s toxicities on QoL among Ethiopian women with breast cancer.
Methods: QoL was measured at baseline and at every end of two cycles, for the median of 8 cycles among 146 breast cancer women on AC and AC-T chemotherapy, using EORTC QLQ-C30 and BR23 instruments. The effect of QoL score, socio-demographic, and clinical variables at baseline were adjusted for the effect of chemotherapy’s toxicities on QoL.
Results: Overall QoL, all functional scales (except cognitive functioning, body image, future perspectives, and sexual functioning) and symptom scales (except dyspnea, insomnia, pain score, arm, and breast symptoms) of EORTC QLQ-C30 and BR23 deteriorated significantly both clinically and statistically, in particular, during the first two cycles of chemotherapy. After the end of cycle 2 or 4, except for cognitive, social functioning, and financial difficulties of the patients, almost all other QoL dimensions were improved towards pretreatment score by the end of cycle 8. In addition to age, educational status, and tumor stage, the Global Health Status (− 10.55≤B≤− 7.71, P≤ 0.013), and the functional scales (− 25.320≤B≤− 6.351, P≤ 0.033) of EORTC QLQ-C30 and BR23 were significantly affected at least by one of the AC and AC-T chemotherapy’s toxicity such as grade≥ 2 fatigue, dysgeusia, constipation, dry mouth, vomiting, oral mucositis, skin hyperpigmentation and/or peripheral neuropathy than their lower grade. Grade≥ 2 fatigue, dysgeusia, oral mucositis, constipation, peripheral neuropathy, anemia arthralgia/myalgia, dry mouth, diarrhea, constipation, and/or skin hyperpigmentation were positively predicted for the deterioration of symptoms scale of EORTC QLQ-C30 and BR23 (4.819≤B≤ 26.451, P≤ 0.043).
Conclusion: Quality of life among Ethiopian breast cancer patients on AC and AC-T regimens significantly deteriorated particularly during the first two cycles of chemotherapy. In addition to the age, tumor stage and educational status of the patients, grade≥ 2 fatigue, dysgeusia, constipation, oral mucositis, dry mouth, peripheral neuropathy, and skin hyperpigmentation due to AC and AC-T chemotherapy were frequently associated with deterioration of different scales/items QoL. Hence, devising different strategies to improve the deteriorated QoL due to chemotherapy’s toxicities particularly during the first two cycles has paramount importance.

Keywords: quality of life, deterioration, chemotherapy, toxicity, breast cancer, Ethiopia

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