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

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.

To establish tolerance of chemotherapy in different age groups, as well as outcomes.

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.

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.

No statistically significant difference in tolerance to chemotherapy was found across different age groups, even when comorbidities were factored in.