Impact of Granulocyte-Colony Stimulating Factor on Neutropenia and Quality of Life in Breast Cancer Patients Receiving Chemotherapy- An Observational Study

Abstract

Background & objectives: Breast cancer is the most common cancer among females in India. Adjuvant chemotherapy regimen can
cause physical and psychological distress. Chemotherapy drugs have narrow therapeutic index and cause many ADRs like neutropenia
which affects the quality of life. This study assessed the effect of Granulocyte -Colony Stimulating Factors (G-CSFs) on neutropenia
and quality of life in breast cancer patients.
Methods: Pre-menopausal women with confirmed diagnosis of breast cancer, who have received adjuvant TAC chemotherapy regimen
for 6-12 cycles were analyzed. The patients were divided in 2 groups, one group received chemotherapy only and the other received
GCSF with chemotherapy. Quality of life (QOL) and incidence of febrile neutropenia (FN) in patients receiving chemotherapy were
observed in each group. Assessment of QOL was done using QOL instrument of City of Hope National Medical Centre and Beckman
Research Institute which is a questionnaire of 46-item ordinal scale that represents the four domains of quality of life including physical,
psychological, social and spiritual well-being.
Results: 80 patients were evaluated, out of which 40 patients received chemo + GCSF (186 cycles) and 40 patients received only chemo
(172 cycles). Incidence of febrile neutropenia was seen in 4.8% and 14.5% patients receiving chemo + GCSFs and only chemo
respectively. While assessing QOL, the physical domain (specifically fatigue & insomnia) was most commonly affected among other
domains.
Interpretations & conclusions: The use of primary GCSF was associated with reduced incidence of febrile neutropenia, anemia and
other symptoms related to chemotherapy in patients having adjuvant TAC regimen.