关键词: 老年乳腺癌, 非蒽环类化疗方案, 安全性, 耐受性

Abstract:

Background and purpose: The incidence of breast cancer increases as patients age, elderly patients account for a large proportion. Due to the insufficient systemic therapy, more complications and poorly physical condition, the prognosis of elderly patients is often worse than the younger. The aim of this study was to investigate the safety and tolerance with non-anthracyclin regimen as adjuvant chemotherapy in elderly breast cancer patients. Methods: From Nov. 2008 to Jan. 2012, 56 patients (≥65 years) after surgical excision were enrolled into this study. The patients were divided into two groups: TC and PC groups. Each patient received 4 or 6 cycles of chemotherapy of PC (175 and 600 mg/m2, respectively; n=21) or TC (75 and 600 mg/m2, respectively; n=35), administered intravenously every 3 weeks, as adjuvant chemotherapy. Radiation therapy (as indicated) and endocrine therapy, for patients with hormone receptor-positive disease, were administered after completion of chemotherapy. Results: In this study, 50 patients completed chemotherapy as plan, the proportion of two groups were above 90%. After a median followup of 33 months, the median disease-free survival(DFS) and overall survival(OS) were not reached. The relapse-free rate and survival rate were 89.5% and 100% in the PC regime group, which were 90.3% and 96.8% in the TC regime group. Major toxicities included: neutropenia, leucopenia, alopecia, nausea, vomiting and various degree of peripheral neuropathy. The incidence of grade Ⅲ-Ⅳ neutropenia was 76.2% in PC group vs 48.6% in TC group (P=0.044). The most common cause for withdrawing from treatment was to be unable to tolerate the adverse effects. Conclusion: Adjuvant chemotherapy with paclitaxel and cyclophosphamide is safe, tolerable and promising for elderly breast cancer patients.

Key words: Elderly breast cancer, Non-anthracyclin regimens, Safety, Tolerance