האם תופעות לוואי בעקבות כימותרפיה לנשים עם סרטן שד יכולות להוות סימן להישרדות? [מאמר מחקר]

Background: Over the years, changes have been made to the treatment protocol for early breast cancer, which include chemotherapy as a complementary treatment and the use of Anthracyclines and Taxanes. These changes significantly improved survival rates. However, these chemical treatments in many cases cause multiple and sometime seven serious adverse events (AEs). Evidence has shown high inter-individual variability in the occurrence and severity of AEs, despite the fact that they administrated identical treatment protocol.Aims: To examine the occurrence and severity of chemotherapy-induced AEs for women with early breast cancer, who survived ten years later and women whose disease returned during this period.Methods: This cohort study is based on data collected in 2010 from 110 women with breast cancer (baseline study). At the time of their recruitment to the study, women were undergoing chemotherapy, after receiving several cycles of treatment, with at least two of them with Taxol (Paclitaxel). At the time, all women filled out a questionnaire to estimate 32 AEs that may be caused, for example, by the treatments - Memorial Symptom Assessment Scale, MSAS. In the current study, survival data of women was added, using the medical records. No additional meeting was held with women who were located, and they were not asked to fill out questionnaires. Women who were located were included in the ״survivor״ group or in the group in which disease recurrence was observed (״recurrent disease״ group).Results: Out of 110 patients who filled the questionnaire 10 years ago, survival data was identified for 79. Disease recurrence was observed in 17 women (20%) (״recurrent disease״ group) and 62 survived (״survivors״ group). A higher occurrence of multiple AEs was found in the recurrent disease group with statistically significant difference than survivor group in numbness/tingling in hands/feet, swelling of arms or legs and vomiting. The severity of AEs was significantly higher in the recurrent disease group in numbness/tingling in hands/feet and vomiting (p<0.05).Conclusions: It appears that, in general, patients with recurrent disease experience more AEs during chemotherapy, both in terms of occurrence and severity, than patients who survived. It can be concluded that albeit identical diagnosis and treatment protocol,differences in AEs experience are exist, some of which may be related to treatment success and survival. This should be considered in treatment management of the healthcare providers by adjusting personal treatment in early detection of AEs.