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Predictors of reduced dose intensity in patients with early-stage breast cancer receiving adjuvant chemotherapy.

Publication ,  Journal Article
Shayne, M; Crawford, J; Dale, DC; Culakova, E; Lyman, GH; ANC Study Group,
Published in: Breast Cancer Res Treat
December 2006

BACKGROUND: This retrospective study was undertaken to define risk factors for reductions in dose intensity of adjuvant chemotherapy in women with early stage breast cancer (ESBC). METHODS: A nationwide survey of 190 community oncology practices was conducted between 1998 and 2002 with data collected retrospectively on 3,707 patients treated with adjuvant chemotherapy for ESBC. End points included reductions in dose intensity, delivered relative dose intensity (RDI) <85%, and the incidence of chemotherapy dose delays >/=7 days and dose reduction >/=15%. Demographic and clinical characteristics, incidence of febrile neutropenia (FN), and patterns of use of granulocyte colony-stimulating factor (G-CSF) were also assessed. RESULTS: Average RDI for all regimens was 88%, with 30% of patients receiving <85% of standard for their regimen. Seventeen percent of the reduction in average RDI was planned from the start of therapy, and 13% was unplanned. In univariate analysis, significant predictors of reduced RDI were: age >/=65 years (41%, P < 0.001), body surface area (BSA) >2 m(2) (37%, P < 0.001), negative lymph nodes (33%, P < 0.001), FN (36%, P = 0.013), and comorbidities (40%, P = 0.013), particularly renal disease (86%, P = 0.004). Dose reduction was less with prophylactic G-CSF (24%, P < 0.001). In multivariate analysis, significant independent predictors of reduced RDI included: advanced age, greater BSA, comorbidities, anthracycline-based regimens, a 28-day schedule and FN, while primary G-CSF prophylaxis was associated with a significant reduction in risk. CONCLUSION: A significant proportion of patients with potentially curable ESBC continue to experience planned and unplanned reductions in RDI.

Duke Scholars

Published In

Breast Cancer Res Treat

DOI

ISSN

0167-6806

Publication Date

December 2006

Volume

100

Issue

3

Start / End Page

255 / 262

Location

Netherlands

Related Subject Headings

  • United States
  • Treatment Outcome
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Radiotherapy, Adjuvant
  • Radiotherapy Dosage
  • Patient Selection
  • Oncology & Carcinogenesis
  • Odds Ratio
 

Citation

APA
Chicago
ICMJE
MLA
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Shayne, M., Crawford, J., Dale, D. C., Culakova, E., Lyman, G. H., & ANC Study Group, . (2006). Predictors of reduced dose intensity in patients with early-stage breast cancer receiving adjuvant chemotherapy. Breast Cancer Res Treat, 100(3), 255–262. https://doi.org/10.1007/s10549-006-9254-4
Shayne, Michelle, Jeffrey Crawford, David C. Dale, Eva Culakova, Gary H. Lyman, and Gary H. ANC Study Group. “Predictors of reduced dose intensity in patients with early-stage breast cancer receiving adjuvant chemotherapy.Breast Cancer Res Treat 100, no. 3 (December 2006): 255–62. https://doi.org/10.1007/s10549-006-9254-4.
Shayne M, Crawford J, Dale DC, Culakova E, Lyman GH, ANC Study Group. Predictors of reduced dose intensity in patients with early-stage breast cancer receiving adjuvant chemotherapy. Breast Cancer Res Treat. 2006 Dec;100(3):255–62.
Shayne, Michelle, et al. “Predictors of reduced dose intensity in patients with early-stage breast cancer receiving adjuvant chemotherapy.Breast Cancer Res Treat, vol. 100, no. 3, Dec. 2006, pp. 255–62. Pubmed, doi:10.1007/s10549-006-9254-4.
Shayne M, Crawford J, Dale DC, Culakova E, Lyman GH, ANC Study Group. Predictors of reduced dose intensity in patients with early-stage breast cancer receiving adjuvant chemotherapy. Breast Cancer Res Treat. 2006 Dec;100(3):255–262.
Journal cover image

Published In

Breast Cancer Res Treat

DOI

ISSN

0167-6806

Publication Date

December 2006

Volume

100

Issue

3

Start / End Page

255 / 262

Location

Netherlands

Related Subject Headings

  • United States
  • Treatment Outcome
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Radiotherapy, Adjuvant
  • Radiotherapy Dosage
  • Patient Selection
  • Oncology & Carcinogenesis
  • Odds Ratio