Economic Distress of Breast Cancer Patients Seeking Treatment at a Tertiary Cancer Center in Mumbai during COVID-19 Pandemic: A Cohort Study

e12034 Background: The use of scalp cooling devices (SCD) has been widely adopted for prevention against chemotherapy-induced alopecia (CIA). However, efficacy of SCD varies between different chemotherapy (CT) regimens. The aim of this study was to evaluate the effectiveness of SCD in breast cancer patients with different CT regimens treated in a tertiary cancer center in Monterrey, Mexico. Methods: All consecutive patients who used SCD were included. Data regarding treatment regimens and efficacy outcomes were prospectively collected. A descriptive analysis was performed to compare the effectiveness among the different CT regimens and sequences used. Results: We included a total of 49 patients with SCD usage from July 2016-January 2019. Table summarizes SCD efficacy, toxicities and CT regimens. In our study, 76% of patients had grade ≤1 CIA using SCD. 35% withdrew SCD use, with hair loss being the most common reason. 58% of patients who received upfront anthracycline-cyclophosphamide (AC) experienced grade 2 CIA. In contrast, no patients receiving taxane-only treatment had grade 2 CIA. Notably, only 3 of 16 patients (19%) who received upfront paclitaxel followed by anthracyclines developed grade 2 CIA. Conclusions: SCD proved to be highly effective in preventing grade 2 CIA with different CT regimens, including patients that received anthracycline-based regimens who started treatment with taxanes upfront. Accordingly, our results suggest that CT sequence, rather than type of CT agent may have a significant impact on the efficacy of SCD in CIA prevention. The results of larger studies are required to confirm our findings.[Table: see text]

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Preoperative Neoadjuvant Hormonal Therapy and Neoadjuvant Chemotherapy for Stage 3B and 4 Breast Cancer Patients in Dharmais Hospital-National Cancer Center, Indonesia: A Cohort Study

Indonesian Journal of Cancer ◽

10.33371/ijoc.v12i4.604 ◽

2019 ◽

Vol 12 (4) ◽

pp. 109

Author(s):

Ramadhan Karsono ◽

Denni Joko Purwanto ◽

Samuel J. Haryono ◽

Bambang Karsono ◽

Lenny Sari ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Cohort Study ◽

Neoadjuvant Chemotherapy ◽

Cancer Patients ◽

Hormonal Therapy ◽

Cancer Center ◽

Breast Cancer Patients ◽

Neoadjuvant Hormonal Therapy ◽

Significant Difference

Background: There are no data of efficacy comparison between primary systemic therapy in stage 3B and 4 breast cancer patients in Indonesia. This study compared long term outcomes of breast cancer patients treated with neoadjuvant hormonal therapy (NAHT) and those treated with neoadjuvant chemotherapy (NACT)Methods: This was a cohort study conducted from 2011 to 2017. A total of 122 patients with stage 3B and 4 breast cancer received NAHT (n = 62) or NACT (n = 60) within a 6 cycles for NACT and 6 months for NAHT were included. Patients were excluded if they had a mastectomy before treatment, were pregnant, had been given hormonal therapy or chemotherapy before, had a contra-indication of chemotherapy, had a contra-indication of salpingo-oophorectomy bilateral for premenopausal patients, and declined to enter this study. The primary outcome of this study was overall survival. The outcomes were analysed using Kaplan-Meier for survival analysis and cox proportional hazard regression to estimate the hazard ratio.Results: There was a statistically significant difference in overall survival (p = 0.038). Median overall survival for NAHT patients was 1265 days and for NACT patients was 654 days. The hazard ratio showed NACT patients had a higher risk than NAHT patients (1.7 95% CI 1.03 – 2.9). Pathological complete response rate was higher in the NACT group than in the NAHT group (3.3% vs. 0%).Conclusions: Neoadjuvant hormonal therapy was superior to neoadjuvant chemotherapy in term of overall survival.

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