Is adjuvant chemotherapy necessary in older patients with breast cancer?
Is adjuvant chemotherapy necessary in older patients with breast cancer?
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DOI：
10.1007/s12282-021-01329-7
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发表时间：
2022-05
期刊：
影响因子：
--
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中科院分区：
文献类型：
--
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由于缺乏对老年患者化疗疗效的临床试验，尚未制定最佳治疗策略。我们研究了辅助化疗是否能提高日本老年乳腺癌患者的生存率。我们回顾性分析了2008 - 2013年间8家医院年龄≥70岁的乳腺癌手术患者的资料。临床治疗及随访资料来源于患者的病历。共纳入1095例患者，其中905例纳入初始非匹配分析。中位年龄为75岁（70-93岁），随访时间为6.3岁。其中，127例（14%）患者接受了辅助化疗（化疗组），其余778例（86%）患者未接受辅助化疗（对照组）。化疗组更年轻（平均年龄73岁vs 76岁，P < 0.0001），病理肿瘤大小更大（平均mm 25.9 vs 19.9, P < 0.0001），转移性腋窝淋巴结更多（平均数量2.7 vs 0.7, P < 0.0001）。两组无病生存期（DFS）和总生存期（OS）差异无统计学意义（P = 0.783和P = 0.558）。经配对分析，辅助化疗显著延长DFS (P = 0.037)；然而，配对队列的OS差异无统计学意义（P = 0.333）。结果显示，辅助化疗与降低复发风险相关，但生存获益有限。在线版本包含补充材料，可在10.1007/s12282-021-01329-7获得。
Due to the lack of clinical trials on the efficacy of chemotherapy in older patients, an optimal treatment strategy has not been developed. We investigated whether adjuvant chemotherapy could improve the survival of older patients with breast cancer in Japan. We retrospectively analyzed data of patients with breast cancer aged ≥ 70 years who underwent breast cancer surgery in eight hospitals between 2008 and 2013. Clinical treatment and follow-up data were obtained from the patients’ medical electric records. A total of 1095 patients were enrolled, of which 905 were included in the initial non-matched analysis. The median age and follow-up period were 75 (range 70–93) and 6.3 years, respectively. Of these patients, 127 (14%) received adjuvant chemotherapy (Chemo group) while the remaining 778 (86%) did not (Control group). The Chemo group was younger (mean age in years 73 vs 76; P < 0.0001), had a larger pathological tumor size (mean mm 25.9 vs 19.9; P < 0.0001), and more metastatic axillary lymph nodes (mean numbers 2.7 vs 0.7; P < 0.0001) than the Control group. The disease-free survival (DFS) and overall survival (OS) did not differ significantly between the two groups (P = 0.783 and P = 0.558). After matched analyses, DFS was found to be significantly prolonged with adjuvant chemotherapy (P = 0.037); however, OS difference in the matched cohort was not statistically significant (P = 0.333). The results showed that adjuvant chemotherapy was associated with a reduced risk of recurrence, but survival benefits were limited. The online version contains supplementary material available at 10.1007/s12282-021-01329-7.
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DOI：
10.1200/jco.20.02514
发表时间：
2020-12-01
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Johnston SRD;Harbeck N;Hegg R;Toi M;Martin M;Shao ZM;Zhang QY;Martinez Rodriguez JL;Campone M;Hamilton E;Sohn J;Guarneri V;Okada M;Boyle F;Neven P;Cortés J;Huober J;Wardley A;Tolaney SM;Cicin I;Smith IC;Frenzel M;Headley D;Wei R;San Antonio B;Hulstijn M;Cox J;O'Shaughnessy J;Rastogi P;monarchE Committee Members and Investigators
通讯作者：
monarchE Committee Members and Investigators
影响因子：
45.3
作者：
Hurria, Arti;Levit, Laura A.;Cohen, Harvey J.
通讯作者：
Cohen, Harvey J.
影响因子：
168.9
作者：
Albain, K.;Anderson, S.;Arriagada, R.;Barlow, W.;Bergh, J.;Bliss, J.;Buyse, M.;Cameron, D.;Carrasco, E.;Clarke, M.;Correa, C.;Coates, A.;Collins, R.;Costantino, J.;Cutter, D.;Cuzick, J.;Darby, S.;Davidson, N.;Davies, C.;Davies, K.;Delmestri, A.;Di Leo, A.;Dowsett, M.;Elphinstone, P.;Evans, V.;Ewertz, M.;Gelber, R.;Gettins, L.;Geyer, C.;Goldhirsch, A.;Godwin, J.;Gray, R.;Gregory, C.;Hayes, D.;Hill, C.;Ingle, J.;Jakesz, R.;James, S.;Kaufmann, M.;Kerr, A.;MacKinnon, E.;McGale, P.;McHugh, T.;Norton, L.;Ohashi, Y.;Paik, S.;Pan, H. C.;Perez, E.;Peto, R.;Piccart, M.;Pierce, L.;Pritchard, K.;Pruneri, G.;Raina, V.;Ravdin, P.;Robertson, J.;Rutgers, E.;Shao, Y. F.;Swain, S.;Taylor, C.;Valagussa, P.;Viale, G.;Whelan, T.;Winer, E.;Wang, Y.;Wood, W.
通讯作者：
Wood, W.
影响因子：
45.3
作者：
Elkin, Elena B.;Hurria, Arti;Panageas, Katherine S.
通讯作者：
Panageas, Katherine S.
影响因子：
5.8
作者：
Derks, Marloes G. M.;van de Velde, Cornelis J. N.;Liefers, Gerrit-Jan
通讯作者：
Liefers, Gerrit-Jan