Impact of timing of adjuvant chemothapy for early breast cancer: the Royal Marsden Hospital experience.

Autor: Okines AFC; The Royal Marsden NHS Foundation Trust, London and Surrey, UK. Alicia.Okines@rmh.nhs.uk., Kipps E; The Royal Marsden NHS Foundation Trust, London and Surrey, UK., Irfan T; The Royal Marsden NHS Foundation Trust, London and Surrey, UK., Coakley M; The Royal Marsden NHS Foundation Trust, London and Surrey, UK., Angelis V; The Royal Marsden NHS Foundation Trust, London and Surrey, UK., Asare B; The Royal Marsden NHS Foundation Trust, London and Surrey, UK., Mohammed K; The Royal Marsden NHS Foundation Trust, London and Surrey, UK., Walsh G; The Royal Marsden NHS Foundation Trust, London and Surrey, UK., Ring A; The Royal Marsden NHS Foundation Trust, London and Surrey, UK., Johnston SRD; The Royal Marsden NHS Foundation Trust, London and Surrey, UK., Parton M; The Royal Marsden NHS Foundation Trust, London and Surrey, UK., Turner NC; The Royal Marsden NHS Foundation Trust, London and Surrey, UK., Smith IE; The Royal Marsden NHS Foundation Trust, London and Surrey, UK.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2021 Jul; Vol. 125 (2), pp. 299-304. Date of Electronic Publication: 2021 May 20.
DOI: 10.1038/s41416-021-01428-4
Abstrakt: Background: The optimal time to deliver adjuvant chemotherapy has not been defined.
Methods: A retrospective study of consecutive patients receiving adjuvant anthracycline and/or taxane 1993-2010. Primary endpoint included 5-year disease-free survival (DFS) in patients commencing chemotherapy <31 versus ≥31 days after surgery. Secondary endpoints included 5-year overall survival (OS) and sub-group analysis by receptor status.
Results: We identified 2003 eligible patients: 1102 commenced chemotherapy <31 days and 901 ≥31 days after surgery. After a median follow-up of 115 months, there was no difference in 5-year DFS rate with chemotherapy <31 compared to ≥31 days after surgery in the overall population (81 versus 82% hazard ratio (HR) 1.15, 95% confidence interval (95% CI) 0.92-1.43, p = 0.230). The 5-year OS rate was similar in patients who received chemotherapy <31 or ≥31 days after surgery (90 versus 91%, (HR 1.21, 95% CI 0.89-1.64, p = 0.228). For 250 patients with triple-negative breast cancer OS was significantly worse in patients who received chemotherapy ≥31 versus <31 days (HR = 2.18, 95% CI 1.11-4.30, p = 0.02).
Discussion: Although adjuvant chemotherapy ≥31 days after surgery did not affect DFS or OS in the whole study population, in TN patients, chemotherapy ≥31 days after surgery significantly reduced 5-year OS; therefore, delays beyond 30 days in this sub-group should be avoided.
(© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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