Febrile Neutropaenia and Chemotherapy Discontinuation in Women Aged 70 Years or Older Receiving Adjuvant Chemotherapy for Early Breast Cancer

被引:12
作者
Adjogatse, D. [1 ]
Thanopoulou, E. [2 ,3 ]
Okines, A. [4 ]
Thillai, K. [5 ]
Tasker, F. [1 ]
Johnston, S. R. D. [2 ,3 ]
Harper-Wynne, C. [4 ]
Torrisi, E. [2 ,3 ]
Ring, A. [1 ,2 ,3 ]
机构
[1] Brighton & Sussex Univ Hosp NHS Trust, Sussex Canc Ctr, Brighton, E Sussex, England
[2] Royal Marsden NHS Fdn Trust, London, England
[3] Royal Marsden NHS Fdn Trust, Sutton, Surrey, England
[4] Maidstone & Tunbridge Wells NHS Trust, Maidstone, Kent, England
[5] Guys & St Thomas NHS Fdn Trust, London, England
关键词
Adjuvant; breast cancer; neutropaenia; toxicity; ELDERLY-WOMEN; CYCLOPHOSPHAMIDE; DOXORUBICIN; TOXICITY;
D O I
10.1016/j.clon.2014.05.002
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Aims: Low rates of adjuvant chemotherapy use are frequently reported in older women with early breast cancer. One of the reasons for this may be the risk of febrile neutropaenia or the perception that older patients will probably not complete the chemotherapy course prescribed. There are no data regarding these adverse outcomes in routine clinical practice. Patients and methods: We identified 128 patients aged 70 years or over who received neoadjuvant or adjuvant chemotherapy for early breast cancer in seven UK cancer centres between 2006 and 2012. Data were collected regarding standard clinical and pathological variables and treatment toxicity and outcomes. Results: Twenty-four patients (19%) had an episode of febrile neutropaenia. Overall, 27 patients (21%) did not complete their planned therapy. Chemotherapy discontinuation was more common in those patients with an episode of febrile neutropaenia (46% versus 16%, P = 0.004). Thirty patients (23%) were admitted with chemotherapy-related complications. There were no treatment-related deaths. Conclusions: The rates of febrile neutropaenia and treatment discontinuation are high in women aged 70 years or over receiving adjuvant chemotherapy for breast cancer. Close attention should be paid to the choice or regimen and the use of supportive therapies in this patient population. (C) 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:692 / 696
页数:5
相关论文
共 17 条
[1]   2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumours [J].
Aapro, M. S. ;
Bohlius, J. ;
Cameron, D. A. ;
Dal Lago, Lissandra ;
Donnelly, J. Peter ;
Kearney, N. ;
Lyman, G. H. ;
Pettengell, R. ;
Tjan-Heijnen, V. C. ;
Walewski, J. ;
Weber, Damien C. ;
Zielinski, C. .
EUROPEAN JOURNAL OF CANCER, 2011, 47 (01) :8-32
[2]   Management of elderly patients with breast cancer: updated recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA) [J].
Biganzoli, Laura ;
Wildiers, Hans ;
Oakman, Catherine ;
Marotti, Lorenza ;
Loibl, Sibylle ;
Kunkler, Ian ;
Reed, Malcolm ;
Ciatto, Stefano ;
Voogd, Adri C. ;
Brain, Etienne ;
Cutuli, Bruno ;
Terret, Catherine ;
Gosney, Margot ;
Aapro, Matti ;
Audisio, Riccardo .
LANCET ONCOLOGY, 2012, 13 (04) :E148-E160
[3]   Older female cancer patients: Importance, causes, and consequences of undertreatment [J].
Bouchardy, Christine ;
Rapiti, Elisabetta ;
Blagojevic, Stina ;
Vlastos, Anne-Therese ;
Vlastos, Georges .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (14) :1858-1869
[4]  
Carlson Robert W, 2008, J Natl Compr Canc Netw, V6 Suppl 4, pS1
[5]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[6]   Tumor characteristics and clinical outcome of elderly women with breast cancer [J].
Diab, SG ;
Elledge, RM ;
Clark, GM .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2000, 92 (07) :550-556
[7]   Breast cancer treatment of older women in integrated health care settings [J].
Enger, Shelley M. ;
Thwin, Soe Soe ;
Buist, Diana S. M. ;
Field, Terry ;
Frost, Floyd ;
Geiger, Ann M. ;
Lash, Timothy L. ;
Prout, Marianne ;
Yood, Marianne Ulcickas ;
Wei, Feifei ;
Silliman, Rebecca A. .
JOURNAL OF CLINICAL ONCOLOGY, 2006, 24 (27) :4377-4383
[8]   2 MONTHS OF DOXORUBICIN-CYCLOPHOSPHAMIDE WITH AND WITHOUT INTERVAL REINDUCTION THERAPY COMPARED WITH 6 MONTHS OF CYCLOPHOSPHAMIDE, METHOTREXATE, AND FLUOROURACIL IN POSITIVE-NODE BREAST-CANCER PATIENTS WITH TAMOXIFEN-NONRESPONSIVE TUMORS - RESULTS FROM THE NATIONAL SURGICAL ADJUVANT BREAST AND BOWEL PROJECT B-15 [J].
FISHER, B ;
BROWN, AM ;
DIMITROV, NV ;
POISSON, R ;
REDMOND, C ;
MARGOLESE, RG ;
BOWMAN, D ;
WOLMARK, N ;
WICKERHAM, DL ;
KARDINAL, CG ;
SHIBATA, H ;
PATERSON, AHG ;
SUTHERLAND, CM ;
ROBERT, NJ ;
AGER, PJ ;
LEVY, L ;
WOLTER, J ;
WOZNIAK, T ;
FISHER, ER ;
DEUTSCH, M .
JOURNAL OF CLINICAL ONCOLOGY, 1990, 8 (09) :1483-1496
[9]   Predicting Chemotherapy Toxicity in Older Adults With Cancer: A Prospective Multicenter Study [J].
Hurria, Arti ;
Togawa, Kayo ;
Mohile, Supriya G. ;
Owusu, Cynthia ;
Klepin, Heidi D. ;
Gross, Cary P. ;
Lichtman, Stuart M. ;
Gajra, Ajeet ;
Bhatia, Smita ;
Katheria, Vani ;
Klapper, Shira ;
Hansen, Kurt ;
Ramani, Rupal ;
Lachs, Mark ;
Wong, F. Lennie ;
Tew, William P. .
JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (25) :3457-3465
[10]   Docetaxel With Cyclophosphamide Is Associated With an Overall Survival Benefit Compared With Doxorubicin and Cyclophosphamide: 7-Year Follow-Up of US Oncology Research Trial 9735 [J].
Jones, Stephen ;
Holmes, Frankie Ann ;
O'Shaughnessy, Joyce ;
Blum, Joanne L. ;
Vukelja, Svetislava J. ;
McIntyre, Kristi J. ;
Pippen, John E. ;
Bordelon, James H. ;
Kirby, Robert L. ;
Sandbach, John ;
Hyman, William J. ;
Richards, Donald A. ;
Mennel, Robert G. ;
Boehm, Kristi A. ;
Meyer, Wally G. ;
Asmar, Lina ;
Mackey, Daniel ;
Riedel, Stefan ;
Muss, Hyman ;
Savin, Michael A. .
JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (08) :1177-1183