Quantitative analysis of the effect of docetaxel-induced edema on quality of life in patients with breast cancer and related factors: a prospective cohort study

• Published in: BMC women's health Vol. 24; no. 1; pp. 165 - 13
• Main Authors: Izawa, Tomoko, Kobayashi, Ami, Kawashima, Masahiro, Kawaguchi-Sakita, Nobuko, Nakakura, Akiyoshi, Kataoka, Yuki, Shide, Kenichiro, Mori, Yukiko, Yamazaki, Kazuhiro, Toi, Masakazu, Arao, Harue
• Format: Journal Article
• Language: English
• Published: London BioMed Central 07.03.2024; BioMed Central Ltd; BMC
• Subjects: Bioimpedance analysis; Body composition; Body fat; Body mass index; Breast cancer; Breast Neoplasms - chemically induced; Breast Neoplasms - drug therapy; Causes of; Chemotherapy; Cohort analysis; Complications and side effects; Diagnosis; Diet; Docetaxel; Docetaxel - adverse effects; Dosage and administration; Dropsy; Drug therapy; Edema; Edema - chemically induced; Evaluation; Female; Gynecology; Health aspects; Humans; Hypotheses; Maternal and Child Health; Medicine; Medicine & Public Health; Nutrition research; Patient outcomes; Patients; Prospective Studies; Quality of Life; Quantitative analysis; Questionnaires; Regression analysis; Reproductive Medicine; Risk factors; Systemic edema; Taxoids - adverse effects; Terminology; Water content; Womens health; Japan; Breast cancer; Bioimpedance analysis; Systemic edema; Docetaxel; Quality of life
• ISSN: 1472-6874; 1472-6874
• DOI: 10.1186/s12905-024-03003-4

Background Systemic edema is an adverse effect of docetaxel chemotherapy and causes distress to patients, including those receiving this agent for breast cancer. However, its characteristics and factors related to its effect on quality of life (QoL) have not been adequately investigated. In this study, we assessed systemic edema quantitatively, explored related factors, and evaluated QoL in patients receiving docetaxel for breast cancer. Methods The study had a prospective cohort design and included 37 patients with no known history of swelling who were treated with docetaxel between September 2019 and April 2022. Patients were examined at the start, middle, and end of their course of treatment and 1 and 2 months later. Body water content, body mass, fat mass, and muscle mass were quantified using bioelectrical impedance analysis. Systemic edema was evaluated with reference to the Common Terminology Criteria for Adverse Events. The timing of development of systemic edema at any anatomical site that was grade 2 or worse was recorded. QoL was assessed using the Quality of Life-Anti Cancer Drug scale. Nutrition was evaluated using the Brief-type self-administered diet history questionnaire. Multivariable logistic regression analysis was performed to identify related factors. QoL was also compared between patients with edema and those without edema. Results Systemic edema developed in 67% of the study participants and was most prevalent at the end of treatment. Body fat mass (adjusted odds ratio [aOR] 0.802, 95% confidence interval [CI] 0.651–0.988, p  = 0.038), disease stage (aOR 3.279, 95% CI 0.493–21.793, p  = 0.219), and history of alcohol consumption (aOR 0.141, 95% CI 0.013–1.521, p  = 0.106) were identified as risk factors for docetaxel-induced edema. Participants who developed systemic edema experienced more physical, vital, and emotional distress 1 month after treatment than those who did not. There was no association between systemic edema and nutrition. Conclusions Systemic edema may develop after treatment with docetaxel and increase distress in patients with a high body fat mass. Patients at risk of systemic edema should be informed in advance about the potential frequency, location, and timing of its onset and encouraged to self-manage this condition.