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Titolo:
Are medical oncologists biased in their treatment of the large woman with breast cancer ?
Autore:
Madarnas, Y; Sawka, CA; Franssen, E; Bjarnason, GA;
Indirizzi:
Univ Toronto, Fac Med, Toronto Sunnybrook Reg Canc Ctr, Div Med Oncol Hematol, Toronto, ON, Canada Univ Toronto Toronto ON Canada iv Med Oncol Hematol, Toronto, ON, Canada Univ Toronto, Fac Med, Toronto Sunnybrook Reg Canc Ctr, Div Clin Trials & Epidemiol, Toronto, ON, Canada Univ Toronto Toronto ON Canada n Trials & Epidemiol, Toronto, ON, Canada
Titolo Testata:
BREAST CANCER RESEARCH AND TREATMENT
fascicolo: 2, volume: 66, anno: 2001,
pagine: 123 - 133
SICI:
0167-6806(2001)66:2<123:AMOBIT>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
HIGH-DOSE CHEMOTHERAPY; BODY-SURFACE AREA; ADJUVANT CHEMOTHERAPY; ANTICANCER DRUGS; RANDOMIZED TRIAL; STAGE-II; TOXICITY; INTENSITY; OBESITY; CYCLOPHOSPHAMIDE;
Keywords:
body size; breast cancer; chemotherapy dosing; dose intensity; obesity; pharmacoepidemiology;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
49
Recensione:
Indirizzi per estratti:
Indirizzo: Madarnas, Y Kingston Reg Canc Ctr, Dept Hematol Oncol, 25 King St W, Kingston, ON K7L 5P9, Canada Kingston Reg Canc Ctr 25 King St W Kingston ON Canada K7L 5P9
Citazione:
Y. Madarnas et al., "Are medical oncologists biased in their treatment of the large woman with breast cancer ?", BREAST CANC, 66(2), 2001, pp. 123-133

Abstract

Purpose. Obesity and breast cancer are common conditions that often coexist. Concerns of relative overdosing of chemotherapy in the large cancer patient have led clinicians to apply empiric dose reductions, 'cap' the body surface area (BSA) at 2 m(2), or use ideal rather than actual body weight to calculate BSA. There are no data supporting or refuting these practices andtheir prevalence is unknown. We sought to determine the distribution of body size and prevalence of obesity in the breast cancer population of our cancer centre, and to determine clinician chemotherapy dosing practices in the era of modern adjuvant chemotherapy. Patients and methods. Women with invasive breast cancer receiving systemictherapy at our institution between 1980 and 1998 were identified and theirrecorded height and weight were used to calculate BSA and body mass index (BMI). We reviewed the first cycle adjuvant chemotherapy dosing practices from 1990-1998. The ideal dose of chemotherapy was calculated based on calculated BSA, and then contrasted with the actual dose received at cycle one. Discrepancies were recorded and categorized, using the largest single drug reduction if more than one drug was reduced. Results. Mean BMI in the systemic therapy population was 26.4 +/- 5.3 kg/m(2), 54% were overweight, 2% severely obese and 18% moderately so. Their mean BSA was 1.7 +/- 0.2 m(2) and only 5% had a BSA greater than or equal to2m(2). In the adjuvant chemotherapy subgroup, most patients received > 85% of their ideal dose. The mean dose reduction was 5.3 +/- 11.3% versus 9.9 +/- 11.3% in the BSA <2 and >2 m(2) groups, respectively (p = 0.02), and 4.3+/- 8.2% versus 6.7 +/- 13.1% in the BMI < 25 and greater than or equal to25 kg/m(2) groups, respectively (p = 0.008). While only 24% of chemotherapy dose reductions of greater than or equal to 15% were in the BSA greater than or equal to2 m(2) group, 76% were in the BMI greater than or equal to 25 kg/m(2) group. Conclusions. Obesity is prevalent in this breast cancer population. BSA isnot a sensitive index of large body size. We consistently detected more frequent empiric dose reductions at cycle one of adjuvant chemotherapy, with reductions of greater magnitude in the largest women (BSA greater than or equal to2 m(2)) and those who were overweight (BMI greater than or equal to 25 kg/m(2)).

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/01/20 alle ore 14:53:39