Factors Influencing Decision-Making for or against Adjuvant and Neoadjuvant Chemotherapy in Postmenopausal Hormone Receptor-Positive Breast Cancer Patients in the EvAluate-TM Study.

Autor:	Gaß P; Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany., Fasching PA; Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany., Fehm T; Universitäts-Frauenklinik Düsseldorf, Düsseldorf, Germany; Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard-Karls-Universität Tübingen, Tübingen, Germany., de Waal J; Frauenklinik im Klinikum Dachau, Dachau, Germany., Rezai M; Luisenkrankenhaus Düsseldorf, Düsseldorf, Germany., Baier B; Frauenklinik im Klinikum Dachau, Dachau, Germany., Baake G; Onkologische Praxis Pinneberg, Pinneberg, Germany., Kolberg HC; Marienhospital Bottrop, Bottrop, Germany., Guggenberger M; Klinikum Tuttlingen, Tuttlingen, Germany., Warm M; Brustzentrum, Universitäts-Frauenklinik Köln, Cologne, Germany; Brustzentrum, Klinken der Stadt Köln, Holweide, Cologne, Germany., Harbeck N; Brustzentrum, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Universität München, und CCC, Munich, Germany., Wuerstlein R; Brustzentrum, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Universität München, und CCC, Munich, Germany., Deuker JU; Vinzenzkrankenhaus Hannover, Hanover, Germany., Dall P; Frauenklinik, Städtisches Klinikum Lüneburg, Lüneburg, Germany., Richter B; Elblandkliniken Meißen-Radebeul, Meißen, Germany., Wachsmann G; Kreiskrankenhaus Böblingen, Böblingen, Germany., Brucker C; Universitätsklinik für Frauenheilkunde, Paracelsus Medizinische Privatuniversität, Nuremberg, Germany., Siebers JW; Frauenklinik der St. Josefsklinik, Offenburg, Germany., Fersis N; Frauenklinik, Klinikum Bayreuth, Bayreuth, Germany., Kuhn T; Karl-Olga-Krankenhaus, Stuttgart, Germany., Wolf C; Medizinisches Zentrum Ulm, Ulm, Germany., Vollert HW; Klinikum Friedrichshafen, Friedrichshafen, Germany., Breitbach GP; Gynäkologie und Geburtshilfe, Städtisches Klinikum, Neunkirchen, Germany., Janni W; Frauenklinik des Universitätsklinikums Ulm, Ulm, Germany., Landthaler R; Gynäkologische Praxis in der Kreisklinik Krumbach, Krumbach, Germany., Kohls A; Evangelisches Krankenhaus Ludwigsfelde-Teltow, Teltow, Germany., Rezek D; Marien-Hospital, Wesel, Germany., Noesselt T; Klinik für Gynäkologie und Geburtshilfe, Sana Klinikum Hameln-Pyrmont, Hameln, Germany., Fischer G; Landkreis Mittweida Krankenhaus, Mittweida, Germany., Henschen S; Johanniter Krankenhaus Genthin Stendal, Stendal, Germany., Praetz T; Caritas-Krankenhaus, Bad Mergentheim, Germany., Heyl V; Schwerpunkt-Medizin für minimal invasive Chirurgie, Senologie und Onkologie Mainz, Mainz, Germany., Kühn T; Frauenklinik, Städtische Kliniken, Esslingen a.N., Germany., Krauss T; Frauenklinik, Klinikum Passau, Passau, Germany., Thomssen C; Frauenklinik, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany., Hohn A; Städtisches Krankenhaus Kiel, Kiel, Germany., Tesch H; Onkologie Bethanien, Frankfurt/M., Germany., Mundhenke C; Frauenklinik, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Germany., Hein A; Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany., Rauh C; Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany., Bayer CM; Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany., Jacob A; Novartis Pharma GmbH, Nuremberg, Germany., Schmidt K; Novartis Pharma GmbH, Nuremberg, Germany., Belleville E; Clin-Sol GmbH, Würzburg, Germany., Hadji P; Klinik für Gynäkologie und Geburtshilfe, Krankenhaus Nordwest, Frankfurt/M., Germany., Brucker SY; Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard-Karls-Universität Tübingen, Tübingen, Germany., Beckmann MW; Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany; Frauenklinik, St. Theresien-Krankenhaus, Nuremberg, Germany., Wallwiener D; Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard-Karls-Universität Tübingen, Tübingen, Germany., Kümmel S; Brustzentrum, Kliniken Essen Mitte, Evangelische Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany., Löhberg CR; Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany; Frauenklinik, St. Theresien-Krankenhaus, Nuremberg, Germany.
Jazyk:	angličtina
Zdroj:	Breast care (Basel, Switzerland) [Breast Care (Basel)] 2016 Oct; Vol. 11 (5), pp. 315-322. Date of Electronic Publication: 2016 Oct 27.
DOI:	10.1159/000452468
Abstrakt:	Background: Decision-making for or against neoadjuvant or adjuvant chemotherapy in postmenopausal patients with hormone receptor-positive breast cancer does not follow any clear guidelines, and some patients may unnecessarily undergo chemotherapy and be exposed to the associated toxicity. The aim of this study was to identify the patient population for whom this issue may bear relevance. Methods: Patients being treated with letrozole in the prospective multicenter noninterventional EvAluate-TM study were recruited. The percentage of patients receiving chemotherapy and factors associated with chemotherapy administration were identified. Results: In all, 3,924 (37.4%) patients received chemotherapy before treatment with letrozole. Of these, 293 (20%) underwent neoadjuvant therapy. Younger age was predictive for both adjuvant and neoadjuvant therapy. Overall, decisions in favor of administering chemotherapy are more likely to be made in patients with a higher body mass index (BMI), and neoadjuvant chemotherapy is administered at a higher rate in women with a lower BMI. Concomitant medication influenced the overall decision-making regarding chemotherapy, irrespective of whether it was given on a neoadjuvant or adjuvant basis. Conclusion: There is an ongoing debate as to whether all of the many patients who receive chemotherapy actually benefit from it. Neoadjuvant chemotherapy is frequently administered in this patient population, and this should encourage further research to resolve current clinical and research issues.
Databáze:	MEDLINE
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