title: Is chemotherapy dose intensity adequate in breast cancer management in the Australian healthcare setting: a retrospective analysis.
abstract: OBJECTIVE
  To determine the adequacy of chemotherapy received dose intensity (RDI) in breast cancer treatment in a general population and to identify factors that influence RDI.
  
  
  METHODS
  A retrospective analysis of breast cancer patients who commenced a course of i.v. chemotherapy in 2008 was undertaken. Data were collected on patient and tumor characteristics, chemotherapy regimen, dose (including delays, reductions and the reasons for these), granulocyte colony-stimulating factor (G-CSF) use and febrile neutropenia incidence. RDI was calculated using the planned and actual dose received and time taken. A level of ≥85% RDI was considered acceptable for treatment given with curative intent.
  
  
  RESULTS
  In all, 131 patients (aged 28 to 77 years) received chemotherapy in adjuvant (n = 76, 58%), neoadjuvant (n = 11, 8%) and metastatic settings (n = 44, 34%). RDI did not reach 85% for 12% adjuvant, 36% neoadjuvant and 34% metastatic cases (χ(2) = 10.55, P = 0.005). Overall, 43% of patients received G-CSF.
  
  
  CONCLUSIONS
  Acceptable chemotherapy RDI was delivered for most patients in the adjuvant setting but not in the neoadjuvant setting. G-CSF treatment contributed to the optimization of dose intensity in the adjuvant setting only. Dose intensity in the metastatic setting was considered satisfactory where quality of life is the primary focus. Other factors can be modified to improve RDI.
authors.affiliation: Department of Medical Oncology, Eastern Health.
authors.forename: Susie
authors.initials: S
authors.lastname: Bae
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Yeung
authors.forename: Say
authors.initials: S
authors.lastname: Ng
authors.forename: Melinda
authors.initials: M
authors.lastname: Craike
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Livingston
authors.forename: Jacquie
authors.initials: J
authors.lastname: Chirgwin
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012189:Retrospective Studies