Safety and Tolerability of Anthracycline-Containing Adjuvant Chemotherapy in Elderly High-Risk Breast Cancer Patients

Autor: Meletios-Athanassios Dimopoulos, George Fountzilas, Christos Christodoulou, Pavlos Papakostas, Nikolaos Pisanidis, Christos Papadimitriou, George Pentheroudakis, George Kouvatseas, Dimitrios Bafaloukos, Epaminontas Samantas, Gerasimos Aravantinos, Paris Kosmidis, Vasilios Karavasilis, Dimitrios Pectasides, Charisios Karanikiotis, Angelos Koutras, Helen Gogas
Rok vydání: 2016
Předmět:
Mucositis
Cancer Research
medicine.medical_specialty
Anthracycline
medicine.medical_treatment
Breast Neoplasms
Risk Assessment
Disease-Free Survival
Drug Administration Schedule
law.invention
03 medical and health sciences
0302 clinical medicine
Breast cancer
Randomized controlled trial
law
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Anthracyclines
030212 general & internal medicine
Chemotherapy-Induced Febrile Neutropenia
Fatigue
Aged
Randomized Controlled Trials as Topic
Chemotherapy
Antibiotics
Antineoplastic
Dose-Response Relationship
Drug
business.industry
Age Factors
Peripheral Nervous System Diseases
Middle Aged
medicine.disease
Surgery
Treatment Outcome
Withholding Treatment
Oncology
Tolerability
Chemotherapy
Adjuvant
Lymphatic Metastasis
030220 oncology & carcinogenesis
Toxicity
Feasibility Studies
Female
Risk assessment
business
Follow-Up Studies
Zdroj: Clinical Breast Cancer. 16:291-298.e3
ISSN: 1526-8209
DOI: 10.1016/j.clbc.2015.12.001
Popis: Intensive chemotherapy confers benefit to patients with high-risk early breast cancer (BC). We characterized the feasibility and toxicity profile of anthracycline-containing adjuvant chemotherapy (ACAC) in older women with early BC.Available data from women who received ACAC for BC in 3 randomized trials were retrieved. We identified women aged65 years and we examined differences in tolerability and delivery of chemotherapy, toxicity, and treatment outcome.From a total of 2640 patients, we identified 453 patients (17%) as being65 years old, 89% of whom had tumors that were node-positive, with 77% who were hormone receptor-positive. At least 90% of the planned doses were delivered in 37% of the elderly, compared with 49% in the younger patients (P .0001). Grade 3 and 4 hematological toxicity was observed in 32% of elderly patients, compared with 21% of the younger (P .0001). Febrile neutropenia occurred in 4.5% of the elderly patients, as opposed to 2.0% in the younger patients (P .002). Elderly patients experienced more frequent Grade 3 and 4 fatigue, mucositis, and sensory neuropathy. Relative dose intensities were significantly lower in elderly patients. Treatment discontinuation was not different in the 2 groups. At a median follow-up of 120 months, competing risks analysis showed a significant benefit in disease-free survival for elderly patients.Elderly BC patients treated with ACAC derive clinical benefit comparable to that in younger patients, mainly at the cost of increased risk of hematological toxicity. This should be taken into account in decision-making and treatment individualization in high-risk BC patients.
Databáze: OpenAIRE
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