Improved local control and disease-free survival after perioperative chemotherapy for early-stage breast cancer. A European Organization for Research and Treatment of Cancer Breast Cancer Cooperative Group Study
| Autor: | Tarek Sahmoud, J.-L. Floiras, P. C. Clahsen, C.J.H. van de Velde, F. Mignolet, Thierry Delozier, Jean-Pierre Julien |
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| Rok vydání: | 1996 |
| Předmět: |
Cancer Research
medicine.medical_specialty Cyclophosphamide medicine.medical_treatment Breast Neoplasms Disease-Free Survival Breast cancer Antineoplastic Combined Chemotherapy Protocols Humans Medicine Chemotherapy business.industry Standard treatment Cancer Perioperative Middle Aged medicine.disease Combined Modality Therapy Surgery Europe Postmenopause Methotrexate Premenopause Oncology Doxorubicin Fluorouracil Lymphatic Metastasis Female Cisplatin business medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 14:745-753 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | PURPOSE To investigate whether a short intensive course of perioperative polychemotherapy can change the course of early breast cancer. PATIENTS AND METHODS A total of 2,795 women with early breast cancer, stage I to IIIA, were randomized onto a trial (European Organization for Research and Treatment of Cancer [EORTC] 10854) to compare surgery followed by one course of perioperative chemotherapy versus surgery alone. Patients assigned to the chemotherapy arm received one course of fluorouracil 600 mg/m2, doxorubicin 50 mg/m2, and cyclophosphamide 600 mg/m2 (FAC) intravenously, within 24 hours after surgery. In both randomized treatment arms, a recommendation was made for premenopausal women with positive axillary nodes to receive prolonged courses of cyclophosphamide, methotrexate, and fluorouracil (CMF), according to the standard treatment for this subgroup. RESULTS At a median follow-up time of 41 months, local control was significantly better in the perioperative treatment arm as compared with the observation arm (hazards ratio, 0.60; 95% confidence interval, 0.44 to 0.83; P < .01). Disease-free survival was significantly prolonged in the chemotherapy arm (hazards ratio, 0.84; 95% confidence interval, 0.70 to 0.99; P = .04). Premenopausal node-negative patients especially showed an advantage for the perioperative chemotherapy arm. No advantage for perioperative chemotherapy was observed in premenopausal node-positive women who also had received prolonged chemotherapy. CONCLUSION We conclude that one course of perioperative FAC is able to improve local control and can prolong disease-free survival in women with early breast cancer. However, our results also suggest that a perioperative timing cannot improve the results of standard prolonged chemotherapy in premenopausal women with positive axillary nodes. |
| Databáze: | OpenAIRE |
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