Does timing of adjuvant chemotherapy for early breast cancer influence survival?
Does timing of adjuvant chemotherapy for early breast cancer influence survival?
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DOI：
10.1200/jco.2003.01.073
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发表时间：
2003-10-15
影响因子：
45.3
通讯作者：
Smith, IE
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文献类型：
--
作者：
Shannon, C;Ashley, S;Smith, IE
目的：从理论上讲，早期乳腺癌患者在手术后不久开始辅助化疗可能会受益，这将具有重要的临床意义。我们从一个大型的单中心数据库中解决了这个问题，在这个数据库中，大多数患者接受了蒽环类药物治疗。患者和方法：从皇家马斯登医院(英国伦敦)前瞻性维护的数据库中收集了1161名接受早期乳腺癌辅助化疗的患者，其中686名(59%)接受了蒽环类药物治疗，对这些患者进行了回顾性分析。比较368例术后21天内开始化疗的患者(A组)和793例术后21天或以上开始化疗的患者(B组)的无瘤生存率(DFS)和总生存率(OS)。中位随访时间为39个月(12~147个月)。结果：两组患者的5年DFS总体上无显著差异(A组为70%，B组为72%；P=.4)。同样，两组患者的5年生存率也没有差别(A组为82%，B组为84%；P=.2)，或化疗开始的间隔时间被视为一个连续变量时(P=0.4)。结论：我们还不能确定术后早期开始辅助化疗有任何显著的生存益处，无论是整体还是在任何一组患者中都是如此。(C)2003年，由美国临床肿瘤学会提供。
Purpose: Theoretically, patients with early breast cancer might benefit from starting adjuvant chemotherapy soon after surgery, and this would have important clinical implications. We have addressed this question from a large, single-center database in which the majority of patients received anthracyclines.Patients and Methods: A total of 1, 161 patients from a prospectively maintained database treated with adjuvant chemotherapy for early breast cancer at the Royal Marsden Hospital (London, United Kingdom), including 686 (59%) receiving anthracyclines, were retrospectively analyzed. The disease-free survival (DFS) and overall survival (OS) of the 368 patients starting chemotherapy within 21 days of surgery (group A) were compared with those of the 793 patients commencing chemotherapy greater than or equal to 21 days after surgery (group B). Median follow-up time was 39 months (range, 12 to 147 months).Results: No significant difference in 5-year DFS was found between the two groups overall (70% for group A v 72% for group B; P = .4) or in any subgroup. Likewise, there was no difference in 5-year OS (82% for group A v 84% for group B; P = .2) or when the interval to the start of chemotherapy was considered as a continuous variable (P = .4).Conclusion: We have been unable to identify any significant survival benefit from starting adjuvant chemotherapy early after surgery, either overall or in any subset of patients. (C) 2003 by American Society of Clinical Oncology.