Tolerance of chemotherapy in breast cancer patients in different age groups: A single-centre South African study

Abstract

BACKGROUND: Tolerance of chemotherapy is a special concern in older patients, owing to comorbidities and lower physical reserves compared with younger patients. There has been no substantial research done locally regarding chemotherapy tolerance. OBJECTIVE: To establish tolerance of chemotherapy in different age groups, as well as outcomes. METHODS: This was a single-centre, retrospective, descriptive analysis of prospectively collected data at Grey's Hospital (KwaZulu-Natal, South Africa). It included all patients who received chemotherapy as part of their breast cancer management from January 2016 to December 2018, stratified into three age groups. RESULTS: The 463 patients were divided into three age groups; <60 years (n=306; 66.1%), 60 - 64 years (n=48; 10.4%) and ≥65 years (n=109; 23.8%). Of these patients, 247 (53.3%) had comorbidities. Most patients (357 (77.1%)) had an Eastern Corporate Oncology Group performance status of 0. No difference was noted in the age groups for tumour stage and receptor status. The majority of patients had stage 3 disease (42.1%). Most patients received an anthracycline-based regimen (78.2%). An anthracycline-free regimen was more frequently given with advancing age. Regarding standard dosing, 452 patients (98.7%) received this, while 41 patients (8.9%) had dose delays, reduction and early discontinuation, with no significant difference across age groups. Haematological adverse events occurred in 25.7%, and 4.3% had non-haematological adverse events. There was no significant difference between the age groups for adverse events. CONCLUSION: No statistically significant difference in tolerance to chemotherapy was found across different age groups, even when comorbidities were factored in.