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Is chemotherapy dose intensity adequate in breast cancer management in the A ustralian healthcare setting: A retrospective analysis
Author(s) -
Bae Susie,
Yeung Yvonne,
Ng Say,
Craike Melinda,
Livingston Patricia M,
Chirgwin Jacquie
Publication year - 2014
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/j.1743-7563.2012.01591.x
Subject(s) - medicine , breast cancer , regimen , oncology , chemotherapy , neutropenia , febrile neutropenia , retrospective cohort study , cancer , population , adjuvant , surgery , environmental health
Aim To determine the adequacy of chemotherapy received dose intensity ( RDI ) in breast cancer treatment in a general population and to identify factors that influence RDI . Methods A retrospective analysis of breast cancer patients who commenced a course of i.v. chemotherapy in 2008 was undertaken. Data were collected on patient and tumor characteristics, chemotherapy regimen, dose (including delays, reductions and the reasons for these), granulocyte colony‐stimulating factor ( G ‐ CSF) use and febrile neutropenia incidence. RDI was calculated using the planned and actual dose received and time taken. A level of ≥85% RDI was considered acceptable for treatment given with curative intent. Results In all, 131 patients (aged 28 to 77 years) received chemotherapy in adjuvant ( n = 76, 58%), neoadjuvant ( n = 11, 8%) and metastatic settings ( n = 44, 34%). RDI did not reach 85% for 12% adjuvant, 36% neoadjuvant and 34% metastatic cases (χ 2 = 10.55, P = 0.005). Overall, 43% of patients received G ‐ CSF . Conclusion Acceptable chemotherapy RDI was delivered for most patients in the adjuvant setting but not in the neoadjuvant setting. G ‐ CSF treatment contributed to the optimization of dose intensity in the adjuvant setting only. Dose intensity in the metastatic setting was considered satisfactory where quality of life is the primary focus. Other factors can be modified to improve RDI .