Use of hormonal therapy in senior breast cancer patients treated with or without radiotherapy

Current Oncology

A. Ramjaun²  N. Trabulsi³  K.E. Reidel²  N. Mayo¹  S.P. Krotneva²  A.N. Meguerditchian²  R. Tamblyn²  T. Eguale² 

[1] McGill University,;McGill University;McGill University, King Abdul-Aziz University

关键词: Adjuvant endocrine therapy;    persistence;    adherence;    radiotherapy;    breast cancer;    seniors;   

DOI  :  

学科分类：肿瘤学

来源: Multimed, Inc.

【 摘 要 】

Purpose Breast cancer treatment guidelines state that radiotherapy (rt) can reasonably be omitted in selected women 70 years of age and older if they take adjuvant endocrine therapy (aet) for 5 years. We aimed to assess persistence and adherence to aet in women 70 years of age and older, and to examine differences between rt receivers and non-receivers. Methods Quebec’s medical service and pharmacy claims databases were used to identify seniors undergoing breast-conserving surgery (1998–2005) and initiating aet. Cox proportional hazards models were used to identify predictors of aet non-persistence. Results Of 3180 women who initiated aet (mean age: 77.5 years), 28% did not receive rt. During the subsequent 5 years, 32% of patients who initiated aet did not persist, 2% filled only a single prescription, and 22% switched medications. Compared with rt receivers, non-receivers discontinued more often (35.5% vs. 30.1%) and earlier (1.4 years vs. 1.6 years). They also became nonadherent earlier (medication possession ratio < 80% at year 3 vs. at year 5). Predictors of nonpersistence included rt omission [hazard ratio (hr): 1.26; 95% confidence interval (ci): 1.09 to 1.46]; age (hr per decade increase: 1.15; 95% ci: 1.01 to 1.31); new medications (hr per medication: 1.01; 95% ci: 1.00 to 1.02); and hospitalizations during aet, (hr per hospitalization: 1.08; 95% ci: 1.05 to 1.11). In a subanalysis of rt non-receivers, significant predictors included hospitalizations (hr: 1.07; 95% ci: 1.02 to 1.12) and medications at aet start (hr: 0.94; 95% ci: 0.91 to 0.97). Conclusions Suboptimal use of aet was observed in at least one third of women. In rt non-receivers, aet use was worse than it was in rt receivers. Initiation of new medications and hospitalizations increased the risk of non-persistence.  Normal 0 false false false EN-CA JA AR-SA

【 授权许可】

Unknown