Quality of life and efficacy of vinorelbine and fluorouracil versus fluorouracil, adriamycin and cyclophosphamide chemotherapy in advanced breast cancer

ABSTRACT

To assess the effect of vinorelbine and 5-fluorouracil [NF] in comparison to 5-fluorouracil, adriamycin and cyclophosphamide [FAC] chemotherapy regimen on the treatment outcome and their impact on the quality of life in patients with advanced breast cancer [ABC]. The prognostic significance of the quality of life on survival was also studied. It is a phase Ill study that included 104 women with ABC who were randomly assigned to receive either FAC [Group I] or NF regimen [Group II]. Patients were evaluated for response rate [RR], time to tumor progression [TTP], overall survival [OS] and toxicities. The quality of life was assessed using Spitzer's quality of life index [QLI]. Patients who received FAC achieved significantly higher overall RR, compared to those who received NF regimen [69.2% versus 50.0%, p=0.04]. A significantly higher median TTP was achieved in patients who received FAC compared to those received NF [11.4 and 6.1 months] respectively with p=0.03. A higher median OS was observed in group I patients compared to group II 19.0 versus 16.4 months, however, the difference in OS was not statistically significant [p=0.4]. The quality of life index [QLI] was proved to be an independent factor affecting TTP in group I [p=0.001] and in group II as well [p=0.01] As regards OS, QLI has no significant prognostic influence in either groups. Since improvement in TTP is a major goal where treatment is mainly palliative, our impression is that FAC is still one of the standard anthracycline-containing regimens in ABC. Vinorelbine, 5-fluorouracil can be used as second-line or as first-line regimen in cases where anthracyclines are not appropriate. Quality of life can be used as a predictor for progression-free survival