Table 2

QOL of patients with BC

Subjects	Themes	Study (n)	Author	Outcomes
Physical symptoms	Body image	1	Basen-Engquist et al.28	The difference in body image was not significant between IG and CG.
	Nausea/vomit	2	Lee et al.21	48.5% of patients undergoing NAC experienced CINV.
	Nausea/vomit	2	Souza et al.27	Nutritional interventions during NAC positively affected the occurrence of nausea/vomiting and loss of appetite.
	Fatigue	2	Ding et al.20	Patients experienced increased fatigue after NAC.
	Fatigue	2	Rezapour et al.24	The PG group had increased fatigue than the AC group.
	Cognitive function	2	Hermelink et al.23	During NAC, cognitive function remained stable in most patients, but cognitive decline predominated in 27% of patients.
	Cognitive function	2	Rezapour et al.24	The PG group had impaired cognitive function than the AC group.
	Dyspnoea	3	Ding et al.20	Patients experienced increased dyspnoea after NAC.
			Coelho et al.25	Patients who received NAC had increased dyspnoea compared with adjuvant chemotherapy.
			Rezapour et al.24	The AC group had increased dyspnoea than the PG group.
	Pain	3	Takada et al.29	Before NAC, the low QOL group had significantly lower scores on the subscale of Physical symptoms and pain than the high QOL groups(p<0.001). However, there was no significant difference between the two groups after NAC.
			Souza et al.27	Nutritional interventions reduced the frequency of abdominal pain during NAC.
			Walker et al.26	The pain was significantly greater in the 3-weekly group compared with the weekly group(p=0.034).
	Other symptoms	5	Chellappan et al.22	There was no difference in physical problems between the weekly regimen of paclitaxel and the 3-weekly regimen of paclitaxel.
			Takada et al.29	Before NAC, the low QOL group had significantly lower scores on the subscale of Dress, sexual aspect, other categories than the high QOL groups(p<0.001). However, there was no significant difference between the two groups after NAC.
			Rezapour et al.24	The AC group had a significantly better situation in constipation compared with the PG group. Insomnia and diarrhoea were better in the PG group.
			Coelho et al.25	The physical function had a greater impact in the neoadjuvant group compared with the adjuvant group.
			Souza et al.27	Nutritional interventions improved patients’ grip strength, positively affected the loss of appetite and reduced the frequency of leucopenia during NAC.
Psychological effects	Role function	2	Rezapour et al.24	The AC group had a better role function compared with the PG group.
	Role function	2	Souza et al.27	Nutritional interventions were able to improve the role function.
	Anxiety/depression	3	Lee S et al.31	The depression in BC patients was most severe during NAC compared with before and after NAC. Anxiety was most severe before NAC but gradually improved throughout the treatment session.
			Lee KM et al.21	40 patients were anxious and 49 were depressed. In the univariate analyses, overall CINV was significantly associated with anxiety (p=0.036).
			Walker et al.26	Anxiety and depression were not statistically significant between the weekly group and the 3-weekly group.
	Emotional function	4	Chellappan et al.22	Three weekly patients had more problems regarding emotional well-being than weekly patients. But the observed difference in scores of depression among the two groups was not statistically significant.
			Rezapour et al.24	The PG group had better emotional functioning compared with the AC group.
			Coelho et al.25	The emotional function was significantly affected in adjuvant chemotherapy and NAC, but there was no difference in the effects of the two treatments.
			Basen-Engquist et al.28	Differences in role emotional were not significant between IG and CG.
Support	Family support	1	Aprilianto et al.30	36 respondents (64.3%) were in a good category of family social support. The self-esteem of almost half of the BC patients (27 respondents or 48.2%) was in a moderate level category.
	Social function	4	Chellappan et al.22	Weekly group had a high level of social well-being than 3-weekly group.
			Walker et al.26	There was no significant difference in the social dimension between weekly group and 3-weekly group.
			Basen-Engquist et al.28	Differences in social function of IG and CG groups were not significant.
			Rezapour et al.24	The AC group had better social function compared with the PG group.

AC, doxorubicin and cyclophosphamide; BC, breast cancer; CG, control group; CINV, chemotherapy-induced nausea and vomiting; IG, intervention group; NAC, neoadjuvant chemotherapy; PG, paclitaxel and gemcitabine; QOL, quality of life.