Adjuvant Chemotherapy in Early Breast Cancer: Optimal and Suboptimal Anthracycline-Containing Regimens
Adjuvant Chemotherapy in Early Breast Cancer: Optimal and Suboptimal Anthracycline-Containing Regimens
复制标题
早期乳腺癌的辅助化疗：最佳和次优的含蒽环类药物治疗方案
DOI：
--
复制
发表时间：
2003
影响因子：
3.8
通讯作者：
G. Cocconi
中科院分区：
文献类型：
--
作者：
G. Cocconi
我们推测，早期乳腺癌试验者的协作组概述发现，与传统的CMF联合方案相比，含有蒽环类药物的辅助剂方案的优势可能取决于试验组中服用蒽环类药物的‘添加’或‘替代’性质。这项研究的目的是探索这一假说。通过计算机和手工搜索的方法，我们确定了21项已发表的随机试验，比较了使用和不使用蒽环类药物的早期乳腺癌辅助化疗，并将它们分为使用蒽环类药物基本上是添加的或基本上是替代的。然后，根据试验结果在无病存活率或总体存活率方面是否显示出统计学上的显著差异而支持含蒽环类药物的方案，来判断试验结果是“阳性”还是“阴性”。在14项试验中，蒽环类药物基本上是“加法”的，其中8项是“阳性”的，7项是“替代的”，所有这些试验都是“阴性”的：这一差异具有统计学意义(P=0.018)。总而言之，这项试验分类试图测试一个非常简单的统一概念，目的是解释涉及在早期乳腺癌的辅助环境中使用蒽环类药物的试验的不同结果，与患者的预后显著相关。因此，似乎可以认为含有蒽环类药物的化疗方案是最佳的或次佳的，这取决于它们是否反映了服用蒽环类药物所提供的潜在益处。
We hypothesized that the advantage of adjuvant anthracycline-containing regimens over the conventional CMF combination found by the Early Breast Cancer Trialists' Collaborative Group overview may depend on the 'additive' or 'substitutive' nature of the administration of anthracycline in the experimental arm. The aim of this study was to explore this hypothesis.By means of computerized and hand searches, we identified 21 published randomized trials comparing early breast cancer adjuvant chemotherapies with and without anthracycline, and divided them into those in which the use of anthracycline was substantially 'additive' or substantially 'substitutive'. The trial results were then judged 'positive' or 'negative' depending on whether they showed statistically significant differences in disease-free or overall survival in favor of the anthracycline-containing regimen. Anthracycline was substantially 'additive' in 14 trials, eight of which were 'positive', and substantially 'substitutive' in seven, all of which were 'negative': this difference is statistically significant (P = 0.018).In conclusion this trial classification, an attempt to test a very simple unifying concept with the aim of explaining the different results of trials involving the administration of anthracyclines in the adjuvant setting of early breast cancer, significantly correlated with patient outcome. It therefore seems that anthracycline-containing chemotherapeutic regimens can be considered optimal or suboptimal depending on whether or not they reflect the potential benefit offered by anthracycline administration.
登录
查看更多内容
影响因子：
158.5
作者：
MUSS, HB;THOR, AD;HENDERSON, IC
通讯作者：
HENDERSON, IC
影响因子：
45.3
作者：
FISHER, B;REDMOND, C;SUTHERLAND, CM
通讯作者：
SUTHERLAND, CM
影响因子：
10.3
作者：
Paik, SM;Bryant, J;Wolmark, N
通讯作者：
Wolmark, N
影响因子：
10.3
作者：
Thor, AD;Berry, DA;Liu, ET
通讯作者：
Liu, ET