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Mar Fan, H. G., Clemons, M., Xu, W., Chemerynsky, I., Breunis, H., Braganza, S., & Tannock, I. F. (2008). A randomised, placebo-controlled, double-blind trial of the effects of d-methylphenidate on fatigue and cognitive dysfunction in women undergoing adjuvant chemotherapy for breast cancer. Supportive Care in Cancer, 16, 577–583.
To investigate the effects of d-methylphenidate (d-MPH) on fatigue and cognitive function in women undergoing adjuvant chemotherapy for early breast cancer.
Intervention Characteristics/Basic Study Process
Patients were given 5 mg of placebo for the first chemotherapy cycle to assess for compliance and were then randomized to either d-MPH 5 mg twice daily (BID) or matched placebo. The dosage increased to 10 mg BID after one week and was taken in the morning and at noon.
Sample Characteristics
The sample was comprised of 57 women with breast cancer.
Median age was 50 years.
Of the patients, 29 received d-MPH and 28 received placebo.
Patients were eligible for the study if they were receiving four cycles of standard adjuvant chemotherapy.
Setting
Multisite
Three hospital outpatient clinics in Toronto, Canada
Study Design
The study was a randomized, controlled trial with a placebo arm.
Measurement Instruments/Methods
High Sensitivity Cognitive Screen (HSCS)
Hopkins Learning Test–Revised (HLT-R)
Functional Assessment of Cancer Therapy–General (FACT-G)
FACT–Fatigue (FACT-F)
Mini-Mental State Examination (MMSE)
All were measured at baseline, end of chemotherapy, and at six-month follow-up.
Results
The difference between groups was not significant in cognitive function or fatigue.
Conclusions
The findings do not support the effectiveness of d-MPH at the doses given here in reducing fatigue during active treatment for breast cancer.
Limitations
The study had a small sample size, with less than 100 patients.
The study was underpowered; no trends suggest that d-MPH taken concurrently with adjuvant chemotherapy improves quality of life or fatigue.
Nursing Implications
D-MPH cannot be suggested as an intervention to relieve cancer-related fatigue or cognitive functioning.