Bleomycin electrochemotherapy in elderly metastatic breast cancer patients: clinical outcome and management considerations

被引:34
作者
Campana, Luca G. [1 ]
Galuppo, Sara [2 ]
Valpione, Sara [3 ]
Brunello, Antonella [4 ]
Ghiotto, Cristina [5 ]
Ongaro, Alessia [6 ]
Rossi, Carlo R. [1 ]
机构
[1] Veneto Inst Oncol IOV IRCCS, Sarcoma & Melanoma Unit, I-35128 Padua, Italy
[2] Veneto Inst Oncol IOV IRCCS, Radiotherapy Unit, I-35128 Padua, Italy
[3] Univ Padua, Med Oncol Sch, Padua, Italy
[4] Veneto Inst Oncol IOV IRCCS, Med Oncol Unit 1, I-35128 Padua, Italy
[5] Veneto Inst Oncol IOV IRCCS, Med Oncol Unit 2, I-35128 Padua, Italy
[6] Univ Ferrara, Dept Morphol Surg & Expt Med, I-44100 Ferrara, Italy
关键词
Breast cancer; Elderly; Electrochemotherapy; Bleomycin; Palliative care; STANDARD OPERATING PROCEDURES; CUTANEOUS METASTASES; CHEST-WALL; SKIN METASTASIS; RECURRENCE; HYPERTHERMIA; MASTECTOMY; EXPERIENCE;
D O I
10.1007/s00432-014-1691-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
To evaluate the efficacy and toxicity of electrochemotherapy (ECT) in elderly metastatic breast cancer (BC) patients. Retrospective analysis of 55 patients with superficial metastases who underwent ECT according to the European Standard Operative Procedures of electrochemotherapy. Treatment schedule consisted of intravenous or intratumoral bleomycin followed by locally delivered electric pulses. Statistical comparisons were performed between two groups: the patients aged < 70 years (n = 27) and those a parts per thousand yen70 years (n = 28). Treatment outcomes were as follows: complete response (CR) rate, local progression-free survival (LPFS), new lesions-free survival (NLFS), toxicity and patient compliance. Patient groups were comparable for clinical-pathological features, except for the number of comorbidities (P < .001). The median follow-up was 32 months (range 6-53). Overall, CR rate was 40 % and was significantly higher in elderly patients (57 vs. 26 %, P = .023) and in patients with better performance status (PS = 0-1, 53 vs. PS = 2, 21 %, P = .048), although local tumor control showed a trend for lower values (2-year LPFS, 67 vs. 93 % among elderly and young patients, respectively; P = .061). Older women seemed less likely to progress outside the ECT field (2-year NLFS, 39 vs. 30 %, P = .075), but discontinued treatment more frequently due to impaired performance status (P = .002). Local pain was graded a parts per thousand yen3, according to a 10-point visual analog scale, by 16/28 (57.1 %) and 8/28 (28.6 %) elderly patients at 4 and 8 weeks, respectively. Wound debridement was required in 5/28 (18 %) older women, due to G3 skin ulceration. Elderly BC patients are highly responsive to ECT and achieve durable local tumor control. Physicians should be aware of possible debilitating side effects, such as pain and skin toxicity. Performance status and frailty screening could be a helpful addition to improve patient selection.
引用
收藏
页码:1557 / 1565
页数:9
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