Taxanes are a standard part of adjuvant breast chemotherapy[i]. Concern has been emerging about increased rates of permanent alopecia with docetaxel therapy[ii],[iii]. We aimed to compare self-reported hair regrowth satisfaction with a cross-sectional survey.
We screened 142 patients who received adjuvant chemotherapy for early breast cancer between 2010-2013 at the Royal Prince Alfred Hospital of whom 85 (59.8%) received docetaxel and 56 (38.4%) received paclitaxel. We performed a mail-out including a questionnaire measuring satisfaction with hair regrowth with the Dermatology Quality of Life (DLQI)[i] score, visual analogue scale (VAS) and EORTC quality of life. Simple descriptive statistics were used to analyse the alopecia scores in patients who received docetaxel compared with those who received paclitaxel regimens. Patients who received both treatments were excluded.
At time of writing 32 patients responded (11 paclitaxel and 21 docetaxel). Using the Wilcoxon signed rank test the mean DLQI score was 11.50 for the paclitaxel group compared with 18.48 for the docetaxel group (p = 0.04) with a mean VAS rank of 13.36 in the paclitaxel group vs a mean VAS rank of 17.45 in the docetaxel group (p = 0.244) with higher scores reflecting distress and dissatisfaction with hair regrowth in both groups. These findings show a statistically significant difference with patients receiving adjuvant docetaxel reporting worse outcomes.
Adjuvant fluorouracil, epirubicin and cyclophosphamide followed by docetaxel is equivalent in efficacy to doxorubicin, cyclophosphamide and paclitaxel. This cross-sectional study supports previous concern about increased rates of long-term dissatisfaction with hair regrowth among those who received docetaxel compared to paclitaxel. This is an important consideration with curative chemotherapy. Further data including quality of life and additional toxicity (such as neuropathy) should also be compared.