PMID- 15986124
OWN - NLM
STAT- MEDLINE
DCOM- 20051025
LR  - 20131121
IS  - 0167-6806 (Print)
IS  - 0167-6806 (Linking)
VI  - 92
IP  - 2
DP  - 2005 Jul
TI  - Patterns of toxicity in older patients with breast cancer receiving adjuvant 
      chemotherapy.
PG  - 151-6
AB  - OBJECTIVE: To retrospectively determine the relationship of age to toxicity from 
      adjuvant chemotherapy for breast cancer. DESIGN AND METHODS: We identified 1,405 
      consecutive patients age 65 or older with primary invasive breast cancer who were 
      seen at Memorial Sloan-Kettering Cancer Center from January 1998 to December 
      2000. Patients selected from this cohort for analysis were aged 65 or older at 
      diagnosis; received their follow-up care at Memorial Sloan-Kettering Cancer 
      Center; had stage I, II, or III breast cancer; and received adjuvant chemotherapy 
      consisting of CMF (cyclophosphamide, methotrexate, and 5-fluorouracil), an 
      anthracycline-based regimen (AC [doxorubicin and cyclophosphamide], or AC-T [AC 
      and paclitaxel or docetaxel]). Exclusion criteria included prior chemotherapy or 
      previous breast cancer. RESULTS: One hundred thirty-two patients were included in 
      this study, with a mean age of 70 (range 65--79). Comorbidity measured by the 
      Charlson comorbidity index was low: score 0 (83%), 1 (12%), 2 (5%); with stages: 
      I(18%), IIA (41%), IIB (27%), IIIA (8%), IIIB (6%), T1Nx (1%). Patients receiving 
      an anthracycline-based regimen were more likely to experience grade 3 or 4 
      toxicity (p=0. 01), require hospitalization (p<0.001), and/or develop febrile 
      neutropenia (p<0.001). Treatment delays due to myelosuppression occurred more 
      frequently in patients receiving CMF (p<0.001). The type of chemotherapy regimen 
      (anthracycline compared to CMF) was a better predictor for toxicity than 
      increased age or comorbidity score. CONCLUSIONS: In this cohort of older patients 
      with breast cancer, the risk for toxicity from adjuvant chemotherapy depended 
      more on the type of regimen (anthracycline vs. CMF) than the patient's 
      chronological age.
FAU - Hurria, Arti
AU  - Hurria A
AD  - Memorial Sloan-Kettering Cancer Center, NY 10021, New York, USA. 
      hurriaa@mskcc.org
FAU - Brogan, Kelly
AU  - Brogan K
FAU - Panageas, Katherine S
AU  - Panageas KS
FAU - Pearce, Carol
AU  - Pearce C
FAU - Norton, Larry
AU  - Norton L
FAU - Jakubowski, Ann
AU  - Jakubowski A
FAU - Zauderer, Marjorie
AU  - Zauderer M
FAU - Howard, Jane
AU  - Howard J
FAU - Hudis, Clifford
AU  - Hudis C
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Netherlands
TA  - Breast Cancer Res Treat
JT  - Breast cancer research and treatment
JID - 8111104
RN  - 0 (Anthracyclines)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - U3P01618RT (Fluorouracil)
RN  - YL5FZ2Y5U1 (Methotrexate)
RN  - CMF regimen
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Anthracyclines/adverse effects
MH  - Antineoplastic Combined Chemotherapy Protocols/*adverse effects
MH  - Breast Neoplasms/*drug therapy/epidemiology/pathology
MH  - Chemotherapy, Adjuvant
MH  - Comorbidity
MH  - Cyclophosphamide/adverse effects
MH  - Female
MH  - Fluorouracil/adverse effects
MH  - Humans
MH  - Methotrexate/adverse effects
MH  - Multivariate Analysis
MH  - Retrospective Studies
MH  - Risk
MH  - United States/epidemiology
EDAT- 2005/06/30 09:00
MHDA- 2005/10/26 09:00
CRDT- 2005/06/30 09:00
PHST- 2005/06/30 09:00 [pubmed]
PHST- 2005/10/26 09:00 [medline]
PHST- 2005/06/30 09:00 [entrez]
AID - 10.1007/s10549-005-1410-8 [doi]
PST - ppublish
SO  - Breast Cancer Res Treat. 2005 Jul;92(2):151-6. doi: 10.1007/s10549-005-1410-8.