Optimal delivery of anthracycline-based chemotherapy in the adjuvant setting improves outcome of breast cancer patients
Optimal delivery of anthracycline-based chemotherapy in the adjuvant setting improves outcome of breast cancer patients
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DOI：
10.1007/s10549-008-0018-1
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发表时间：
2009-04-01
影响因子：
3.8
通讯作者：
Lluch, Ana
中科院分区：
文献类型：
--
作者：
Chirivella, Isabel;Bermejo, Begona;Lluch, Ana
评价蒽环类非紫杉类辅助化疗治疗早期乳腺癌的剂量反应效应。这是一项回顾性数据库分析。选择标准包括1980年至2000年接受蒽环类非紫杉烷类辅助化疗的早期乳腺癌患者。通过延迟周期数、延迟天数和相对剂量强度（RDI）（千分之85%，< 85%）评估化疗的输送情况。793例乳腺癌患者纳入研究。Kaplan-Meier无病生存期（DFS）受延迟周期数（P < 0.0001）、延迟天数（P < 0.0001）和RDI（P = 0.0029）的影响。Kaplan-Meier总生存期（OS）也受到延迟周期数（P = 0.0008）和天数（P = 0.0115）以及RDI（P = 0.0055）的影响。考克斯回归模型表明，当受影响的节点数量和激素受体状态得到控制，所有的研究变量保持其对DFS的意义，但不是OS。的剂量反应效应是一个关键因素，在蒽环类药物为基础的非紫杉烷类方案的辅助治疗早期乳腺癌的管理。如果可能，应避免延迟和/或减少化疗，以实现最大获益。
To evaluate the dose-response effect of an adjuvant anthracycline-based non-taxane chemotherapy in early breast cancer patients. This was a retrospective database analysis. Selection criteria included patients treated for early breast cancer from years 1980 to 2000 with an adjuvant anthracycline-based non-taxane chemotherapy. The delivery of chemotherapy was assessed through the number of delayed cycles, the number of delayed days and the relative dose intensity (RDI) administered (a parts per thousand yen85%, < 85%). Seven hundred and ninety-three breast cancer patients were included. The Kaplan-Meier disease-free survival (DFS) was affected by the number of delayed cycles (P < 0.0001), the number of delayed days (P < 0.0001) and the RDI (P = 0.0029). The Kaplan-Meier overall survival (OS) was also affected by the number of delayed cycles (P = 0.0008) and days (P = 0.0115), as well as the RDI (P = 0.0055). The Cox regression models showed that, when the number of nodes affected and the hormonal receptor status were controlled, all the study variables maintained their significance on DFS, but not on OS. The dose-response effect is a crucial factor in the administration of anthracycline-based non-taxane schedules for the adjuvant treatment of early breast cancer. Delays and/or reductions of chemotherapy should be avoided if possible to achieve the maximal benefit.