Adjogatse D, Thanopoulou E, Okines A, Thillai K, Tasker F, Johnston S R D, Harper-Wynne C, Torrisi E, Ring A
Sussex Cancer Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Royal Marsden NHS Foundation Trust, London and Sutton, UK.
Clin Oncol (R Coll Radiol). 2014 Nov;26(11):692-6. doi: 10.1016/j.clon.2014.05.002. Epub 2014 Jun 6.
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.
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.
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.
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.
早期乳腺癌老年女性辅助化疗使用率低的情况屡有报道。其原因之一可能是发热性中性粒细胞减少的风险，或者认为老年患者可能无法完成规定的化疗疗程。在常规临床实践中，尚无关于这些不良结局的数据。
我们确定了2006年至2012年间在英国7个癌症中心接受早期乳腺癌新辅助或辅助化疗的128例70岁及以上患者。收集了有关标准临床和病理变量以及治疗毒性和结局的数据。
24例患者（19%）发生发热性中性粒细胞减少。总体而言，27例患者（21%）未完成计划的治疗。发热性中性粒细胞减少发作的患者化疗中断更为常见（46%对16%，P = 0.004）。30例患者（23%）因化疗相关并发症入院。无治疗相关死亡。
70岁及以上接受乳腺癌辅助化疗的女性发热性中性粒细胞减少和治疗中断率较高。应密切关注该患者群体的治疗方案选择及支持性治疗的使用。
