Doxorubicin-based adjuvant chemotherapy in elderly breast cancer patients: the M.D. Anderson experience, with long-term follow-up.
BACKGROUND
The purpose of this study was to evaluate the clinical outcome of doxorubicin-based adjuvant chemotherapy in elderly breast cancer patients and to compare results in elderly patients with those in younger patients.


METHODS
We retrospectively reviewed the records of all patients aged 50 years or older treated in trials of doxorubicin-based adjuvant chemotherapy between 1974 and 1988. Old age was not an exclusion criterion for these trials. Patient characteristics, hematologic and nonhematologic side effects, patterns of recurrence, and causes of death were determined for patients aged 50-64 years and for patients aged 65 years or older, and results were compared between these two groups. Kaplan-Meier survival curves were plotted, and tested by the generalized Wilcoxon test.


RESULTS
A total of 390 patients aged 50 years or older were treated with doxorubicin-based adjuvant chemotherapy during the study period. Of these, 325 were aged 50-64 years (group 1), and 65 were aged 65 years or older (group 2). The median follow-up period for group 1 was 185 months (range 29-272+ months), and the median follow-up period for group 2 was 169 months (range 128-240+ months). There were no statistically significant differences between the two groups with respect to performance status, hormone receptor profile, tumor size, nodal status, or type of locoregional therapy. There also were no statistically significant differences between the two groups in recurrence patterns, disease-free survival, or overall survival. The granulocyte and platelet nadirs of cycles 1, 3, and 6 were similar between the two groups. No cumulative hematologic side effects were seen in either group. The occurrence of second malignancies was extremely low in both groups. In both groups, the majority of deaths were due to progression of disease.


CONCLUSIONS
Adjuvant doxorubicin-based chemotherapy is well tolerated in elderly breast cancer patients who have good performance status and normal cardiac ejection fraction. Adjuvant doxorubicin-based chemotherapy in these patients results in disease-free and overall survival rates similar to those seen in younger patients.
Ibrahim
N K
NK
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA. nibrahim@mdanderson.org
Buzdar
A U
AU
Asmar
L
L
Theriault
R L
RL
Hortobagyi
G N
GN
D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies; D013318:Stroke Volume
D000970:Antineoplastic Agents; D004317:Doxorubicin