Patient-Related Characteristics Associated with Treatment Modifications and Suboptimal Relative Dose Intensity of Neoadjuvant Chemotherapy in Patients with Breast Cancer—A Retrospective Study
Background: Reduced relative dose intensity (RDI) of neoadjuvant chemotherapy (NACT) in patients with breast cancer may compromise treatment outcome and survival. We examined patient-related characteristics associated with treatment modifications and suboptimal RDI and tumour response in patients wi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/9/2483 |
| _version_ | 1797602945667170304 |
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| author | Eva Kjeldsted Julie Gehl Dina Melanie Sørensen Alexey Lodin Silvia Gonzalez Ceballos Susanne Oksbjerg Dalton |
| author_facet | Eva Kjeldsted Julie Gehl Dina Melanie Sørensen Alexey Lodin Silvia Gonzalez Ceballos Susanne Oksbjerg Dalton |
| author_sort | Eva Kjeldsted |
| collection | DOAJ |
| description | Background: Reduced relative dose intensity (RDI) of neoadjuvant chemotherapy (NACT) in patients with breast cancer may compromise treatment outcome and survival. We examined patient-related characteristics associated with treatment modifications and suboptimal RDI and tumour response in patients with breast cancer. Methods: In this observational study, electronic medical records were reviewed retrospectively for female patients with breast cancer scheduled for NACT at a university hospital in Denmark between 2017 and 2019. The RDI (ratio of delivered dose intensity in relation to standard dose intensity) was calculated. Multivariate logistic regression analyses examined associations of sociodemographics, general health and clinical cancer characteristics with dose reductions, dose delays, discontinuation of NACT and suboptimal RDI < 85%. Results: Among 122 included patients, 43%, 42% and 28% experienced dose reductions, dose delays ≥3 days and discontinuation, respectively. A total of 25% received an RDI < 85%. Comorbidity, taking long-term medications and being overweight were statistically significantly associated with treatment modifications, while age ≥ 65 years and comorbidity were associated with RDI < 85%. Around one third of all patients had radiologic (36%) or pathologic (35%) complete tumour response, with no statistically significant differences by RDI < or ≥85% irrespective of breast cancer subtype. Conclusions: While most patients had RDI ≥85%, still one out of four patients received an RDI < 85%. Further investigations of possible supportive care initiatives to improve patients’ treatment tolerability are needed, particularly among subgroups of older age or with comorbidity. |
| first_indexed | 2024-03-11T04:22:43Z |
| format | Article |
| id | doaj.art-ece86de544504b01a703617d2ff2a8c4 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T04:22:43Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-ece86de544504b01a703617d2ff2a8c42023-11-17T22:40:21ZengMDPI AGCancers2072-66942023-04-01159248310.3390/cancers15092483Patient-Related Characteristics Associated with Treatment Modifications and Suboptimal Relative Dose Intensity of Neoadjuvant Chemotherapy in Patients with Breast Cancer—A Retrospective StudyEva Kjeldsted0Julie Gehl1Dina Melanie Sørensen2Alexey Lodin3Silvia Gonzalez Ceballos4Susanne Oksbjerg Dalton5Danish Research Center for Equality in Cancer (COMPAS), 4700 Næstved, DenmarkDepartment of Clinical Oncology and Palliative Care, Zealand University Hospital, 4700 Næstved, DenmarkDanish Research Center for Equality in Cancer (COMPAS), 4700 Næstved, DenmarkDepartment of Clinical Oncology and Palliative Care, Zealand University Hospital, 4700 Næstved, DenmarkAleris Hospital Ringsted, 4100 Ringsted, DenmarkDanish Research Center for Equality in Cancer (COMPAS), 4700 Næstved, DenmarkBackground: Reduced relative dose intensity (RDI) of neoadjuvant chemotherapy (NACT) in patients with breast cancer may compromise treatment outcome and survival. We examined patient-related characteristics associated with treatment modifications and suboptimal RDI and tumour response in patients with breast cancer. Methods: In this observational study, electronic medical records were reviewed retrospectively for female patients with breast cancer scheduled for NACT at a university hospital in Denmark between 2017 and 2019. The RDI (ratio of delivered dose intensity in relation to standard dose intensity) was calculated. Multivariate logistic regression analyses examined associations of sociodemographics, general health and clinical cancer characteristics with dose reductions, dose delays, discontinuation of NACT and suboptimal RDI < 85%. Results: Among 122 included patients, 43%, 42% and 28% experienced dose reductions, dose delays ≥3 days and discontinuation, respectively. A total of 25% received an RDI < 85%. Comorbidity, taking long-term medications and being overweight were statistically significantly associated with treatment modifications, while age ≥ 65 years and comorbidity were associated with RDI < 85%. Around one third of all patients had radiologic (36%) or pathologic (35%) complete tumour response, with no statistically significant differences by RDI < or ≥85% irrespective of breast cancer subtype. Conclusions: While most patients had RDI ≥85%, still one out of four patients received an RDI < 85%. Further investigations of possible supportive care initiatives to improve patients’ treatment tolerability are needed, particularly among subgroups of older age or with comorbidity.https://www.mdpi.com/2072-6694/15/9/2483breast neoplasmsneoadjuvant therapyguideline adherence |
| spellingShingle | Eva Kjeldsted Julie Gehl Dina Melanie Sørensen Alexey Lodin Silvia Gonzalez Ceballos Susanne Oksbjerg Dalton Patient-Related Characteristics Associated with Treatment Modifications and Suboptimal Relative Dose Intensity of Neoadjuvant Chemotherapy in Patients with Breast Cancer—A Retrospective Study Cancers breast neoplasms neoadjuvant therapy guideline adherence |
| title | Patient-Related Characteristics Associated with Treatment Modifications and Suboptimal Relative Dose Intensity of Neoadjuvant Chemotherapy in Patients with Breast Cancer—A Retrospective Study |
| title_full | Patient-Related Characteristics Associated with Treatment Modifications and Suboptimal Relative Dose Intensity of Neoadjuvant Chemotherapy in Patients with Breast Cancer—A Retrospective Study |
| title_fullStr | Patient-Related Characteristics Associated with Treatment Modifications and Suboptimal Relative Dose Intensity of Neoadjuvant Chemotherapy in Patients with Breast Cancer—A Retrospective Study |
| title_full_unstemmed | Patient-Related Characteristics Associated with Treatment Modifications and Suboptimal Relative Dose Intensity of Neoadjuvant Chemotherapy in Patients with Breast Cancer—A Retrospective Study |
| title_short | Patient-Related Characteristics Associated with Treatment Modifications and Suboptimal Relative Dose Intensity of Neoadjuvant Chemotherapy in Patients with Breast Cancer—A Retrospective Study |
| title_sort | patient related characteristics associated with treatment modifications and suboptimal relative dose intensity of neoadjuvant chemotherapy in patients with breast cancer a retrospective study |
| topic | breast neoplasms neoadjuvant therapy guideline adherence |
| url | https://www.mdpi.com/2072-6694/15/9/2483 |
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