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Keywords {🔍}

patients, cancer, breast, chemotherapy, adjuvant, older, toxicity, treatment, elderly, article, clinical, google, scholar, cmf, radiotherapy, age, group, trials, study, pubmed, compliance, younger, data, cycles, risk, trial, received, concomitant, table, cas, oncol, early, years, clin, cyclophosphamide, neutropenia, women, planned, survival, march, severe, aged, frequent, weeks, gcsf, tamoxifen, national, authors, fluorouracil, results,

Topics {✒️}

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Questions {❓}

• Adjuvant chemotherapy in elderly patients with primary breast cancer: are women ≥65 undertreated?
• Evidence of Possible Age Bias?
• Extermann M, Albrand G, Chen H, Zanetta S, Schonwetter R, Zulian GB, Cantor A, Droz JP: Are Older French Patients As Willing As Older American Patients to Undertake Chemotherapy?
• Extermann M, Balducci L, Lyman GH: What Threshold for Adjuvant Therapy in Older Breast Cancer Patients?
• Is adjuvant chemotherapy necessary in older patients with breast cancer?
• Simes RJ, Coates AS: Patient Preferences for Adjuvant Chemotherapy of Early Breast Cancer: How Much Benefit Is Needed?

Schema {🗺️}

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         headline:Compliance and toxicity of adjuvant CMF in elderly breast cancer patients: a single-center experience
         description:Few data are available on compliance and safety of adjuvant chemotherapy when indicated in elderly breast cancer patients; CMF (cyclophosphamide, methotrexate, fluorouracil) can be reasonably considered the most widely accepted standard of treatment. We retrospectively reviewed compliance and safety of adjuvant CMF in patients older than 60. The treatment was indicated if patients had no severe comorbidity, a high-risk of recurrence, and were younger than 75. Toxicity was coded by NCI-CTC. Toxicity and compliance were compared between two age subgroups (<65, ≥ 65) by Fisher exact test and exact Wilcoxon rank-sum test. From March 1991 to March 2002, 180 patients were identified, 100 older than 60 and younger than 65, and 80 aged 65 or older. Febrile neutropenia was more frequent among older patients (p = 0.05). Leukopenia, neutropenia, nausea, cardiac toxicity and thrombophlebitis tended to be more frequent or severe among elderlies, while mucositis tended to be more evident among younger patients, all not significantly. Almost one half (47%) of the older patients receiving concomitant radiotherapy experienced grade 3–4 haematological toxicity. Compliance was similar in the two groups, with 6 cycles administered in 86% and 79%, day-8 chemotherapy omitted at least once in 36% and 39%, dose reduction in 27% and 38%, prolonged treatment duration (≥ 29 weeks) in 10% and 11% and need of G-CSF in 9% and 18%, among younger and older patients, respectively. Our data show that, in a highly selected population of patients 65 or more years old, CMF is as feasible as in patients older than 60 and younger than 65, but with a relevant burden of toxicity. We suggest that prospective trials in elderly patients testing less toxic treatment schemes are mandatory before indicating adjuvant chemotherapy to all elderly patients with significant risk of breast cancer recurrence.
         datePublished:2005-03-24T00:00:00Z
         dateModified:2005-03-24T00:00:00Z
         pageStart:1
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            Breast Cancer
            Tamoxifen
            Adjuvant Chemotherapy
            Febrile Neutropenia
            Early Breast Cancer Patient
            Cancer Research
            Oncology
            Surgical Oncology
            Health Promotion and Disease Prevention
            Biomedicine
            general
            Medicine/Public Health
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      headline:Compliance and toxicity of adjuvant CMF in elderly breast cancer patients: a single-center experience
      description:Few data are available on compliance and safety of adjuvant chemotherapy when indicated in elderly breast cancer patients; CMF (cyclophosphamide, methotrexate, fluorouracil) can be reasonably considered the most widely accepted standard of treatment. We retrospectively reviewed compliance and safety of adjuvant CMF in patients older than 60. The treatment was indicated if patients had no severe comorbidity, a high-risk of recurrence, and were younger than 75. Toxicity was coded by NCI-CTC. Toxicity and compliance were compared between two age subgroups (<65, ≥ 65) by Fisher exact test and exact Wilcoxon rank-sum test. From March 1991 to March 2002, 180 patients were identified, 100 older than 60 and younger than 65, and 80 aged 65 or older. Febrile neutropenia was more frequent among older patients (p = 0.05). Leukopenia, neutropenia, nausea, cardiac toxicity and thrombophlebitis tended to be more frequent or severe among elderlies, while mucositis tended to be more evident among younger patients, all not significantly. Almost one half (47%) of the older patients receiving concomitant radiotherapy experienced grade 3–4 haematological toxicity. Compliance was similar in the two groups, with 6 cycles administered in 86% and 79%, day-8 chemotherapy omitted at least once in 36% and 39%, dose reduction in 27% and 38%, prolonged treatment duration (≥ 29 weeks) in 10% and 11% and need of G-CSF in 9% and 18%, among younger and older patients, respectively. Our data show that, in a highly selected population of patients 65 or more years old, CMF is as feasible as in patients older than 60 and younger than 65, but with a relevant burden of toxicity. We suggest that prospective trials in elderly patients testing less toxic treatment schemes are mandatory before indicating adjuvant chemotherapy to all elderly patients with significant risk of breast cancer recurrence.
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      dateModified:2005-03-24T00:00:00Z
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         Breast Cancer
         Tamoxifen
         Adjuvant Chemotherapy
         Febrile Neutropenia
         Early Breast Cancer Patient
         Cancer Research
         Oncology
         Surgical Oncology
         Health Promotion and Disease Prevention
         Biomedicine
         general
         Medicine/Public Health
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      name:Clinical Trials Unit, National Cancer Institute, Naples, Italy
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