DOI: https://doi.org/10.26641/2307-0404.2016.2.72157

The influence of the hematological complications on the efficiency of the systemic therapy of breast cancer.

A. V. Prokhach

Abstract


The interest in studying the effect of haematological complications on survival of patients with solid tumors during chemotherapy has increased in recent years. The results of  various global studies are ambiguous and often opposite. The objectives of our study was to investigate the dynamics of hematological parameters during the course of chemotherapy, their impact on health outcomes and indicators of survival of patients. Retrospectively, medical records of 110 patients with inoperable breast cancer, who received palliative chemotherapy courses by the scheme taxanes + anthracyclines,were analyzed. Dynamics of neutrophils indicators, hemoglobin, platelets, tumor response according to RECIST criteria of 1.1., as well as the long-term outcomes were studied. It was found that the most intensivelylevel of hemoglobin reduced at the first cycle of treatment (81.1% of patients), later it stabilized (17.7-37.3%) (p<0.05). During the first treatment cycle neutropenia occursin 71.1-78.2% of patients, thrombocytopenia – in 3.6-5.55%. Later, thrombocytopenia rate reduced to 1.2-1.9%, neutropenia – to 58.3-63.5% (p<0.05). The presence of neutropenia causes significantly positive impact on the results of treatment of patients with metastatic breast cancer. In the presence of neutropenia during chemotherapy, indicators of general and disease-free survival arereliably higher.


Keywords


breast cancer; tumor response; neutropenia; anemia; thrombocytopenia

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References


Maio MDi, Gridelli C, Gallo C. Chemotherapy-induced neutropenia: a useful predictor of treatment efficacy? Nat Clin Pract Oncol. 2006;3(3):114-5.

Rogowski W, Jereczek-Fossa B, Tomczak-Ha-laburda J. Does the correlation between chemotherapy-induced leukopenia with response in locally advanced breast cancer exist? Reports of practical oncology and chemotherapy. 2003;8(2):264–5.

Eskander RN, Tewari KS. Impact of chemothe-rapy-induced neutropenia on survival in patients with breast, ovarian and cervical cancer: a systematic review. Journal of Hematological Malignancies. 2012;2(3):63-73.

Kumpulainen EJ, Hirvikoski PP, Johansson RT Neutropenia during adjuvant chemotherapy of breast cancer is not a predictor of outcome. Acta Oncol. 2009;48(8):1204-6.

Shitara K, Matsuo K, Oze I, Mizota A, Kondo C, Nomura M, et al. Meta-analysis of neutropenia or leuko-penia as a prognostic factor in patients with malignant disease undergoing chemotherapy. Cancer Chemother Pharmacol. 2011;68(2):301-7.

Cameron DA, Massie C, Kerr G. Moderate neu-tropenia with adjuvant CMF confers improved survival in early breast. Br J Cancer. 2003;89(10):1837-42.

Ozols R, Bundy B, Greer B, Fowler J, Clarke-Pearson D, Burger R, et al. Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study. J Clin Oncol. 2003;21(17):3194-200.

Ishitobi M, Komoike Y, Motomura K, Koyama H. Prognostic significance of neutropeniaon day one of anthracycline- based neoadjuvant chemotherapy in operable breast cancer. Oncology. 2010;78(3-4):213-9.

Han Y, Yu Z, Wen S. Prognostic value of che-motherapy-induced neutropenia in early-stage breast cancer. Breast Cancer Res Treat. 2012;131(2):483-90.

Moschetta M, Scardapane A, Lorusso V. Role of multidetector computed tomography in evaluating incidentally detected breast lesions. Tumori. 2015;101(4):455-60.


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