Combined-modality treatment for isolated recurrences of breast carcinoma

Autor: C R N Shu-Wan Kau, Kristine R. Broglio, Gabriel N. Hortobagyi, Vicente Valero, L D O Richard Theriault, Edgardo Rivera, Massimo Cristofanilli, Aman U. Buzdar, Emer O. Hanrahan, Guosheng Yin
Rok vydání: 2005
Předmět:
Zdroj: Cancer. 104:1158-1171
ISSN: 1097-0142
0008-543X
Popis: BACKGROUND In three prospective, single-arm studies, the authors previously showed an improved outcome for anthracycline-naive patients with isolated sites of recurrent breast carcinoma (BC) who were treated with doxorubicin-based chemotherapy after local therapy (surgery and/or radiotherapy). In the current report, the initial results are presented from a Phase II trial of docetaxel (100 mg/m2 every 21 days for 6 cycles) given after local therapy for recurrent BC (Stage IV BC with no evidence of clinically measurable disease) in patients who received prior adjuvant anthracycline-based chemotherapy, and the authors provide an update of the 3 previous studies. An analysis of prognostic factors for these patients also is presented. METHODS Eligibility criteria for all studies included histologic proof of recurrent BC that had been resected and/or irradiated with curative intent. Survival was calculated using the Kaplan–Meier method. Univariate survival analyses were performed to test for associations between patient characteristics and outcome (log-rank test). Cox proportional hazards models were used to determine the multivariable correlations between patient characteristics and outcome. RESULTS The median follow-up for the docetaxel-based trial (n = 26 patients) was 45 months. Early outcomes for this study are promising. The median disease-free survival (DFS) was 44 months, and the 3-year DFS and overall survival (OS) rates were 58% and 87%, respectively. In the 3 doxorubicin-based studies, the median follow-up was 121.5 months for all living patients, and the estimated 20-year DFS and OS rates were both 26%. On multivariable analysis of patients from all 4 studies, the only significant prognostic factor for DFS and OS (P = 0.0006) was the number of involved axillary lymph nodes at initial diagnosis. CONCLUSIONS A proportion of patients with isolated BC recurrences achieved prolonged DFS with combined-modality treatment. Patients who receive anthracycline-based chemotherapy at primary diagnosis may benefit from local treatment followed by docetaxel-based chemotherapy for isolated recurrences. The only significant independent prognostic factor was the number of involved axillary lymph nodes at initial diagnosis. Cancer 2005. © 2005 American Cancer Society.
Databáze: OpenAIRE
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