There is evidence to suggest that when less than 85% of the planned curative intent chemotherapy dose is given there is a reduction in relapse free survival. Our aim was to determine the proportion of patients undergoing curative intent treatment for breast and colorectal cancer at our institution who received less than 85% of the intended total chemotherapy dose and the reasons for this reduction.
Hospital record systems were utilised to identify all patients treated with curative intent chemotherapy for breast or colorectal cancer at Fiona Stanley Hospital (FSH) between February and August 2016. Clinic notes and chemotherapy charts were reviewed to obtain data on treatment dose, dose reductions and documentation regarding why dose reduction occurred. Total planned chemotherapy dose for each patient was calculated as well as total chemotherapy dose given, and overall percentage reduction in dose.
25 patients with colorectal cancer and 95 patients with breast cancer were identified. 20% and 9% of patients with colorectal and breast cancer respectively received less than 85% of the planned dose. In all cases the reasons for dose reductions were documented. The most common reasons for dose reduction were fatigue, diarrhoea and peripheral neuropathy in patients with colorectal cancer and febrile neutropenia, diarrhoea and fatigue in breast cancer patients.
Dose reductions leading to below 85% of intended total dose were more frequent in our colorectal patients than breast cancer patients, which was similar to published data. The reason for dose reduction was documented in all cases with reasons similar to published findings. This information will assist with support and management of future patients to enable patients to receive actual chemotherapy doses as close to intended dosing as possible.