Faradmal Javad, Kazemnejad Anoshirvan, Khodabakhshi Reza, Gohari Mahmood-Reza, Hajizadeh Ebrahim
Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Asian Pac J Cancer Prev. 2010;11(2):353-8.
The main objective of the present study was to compare the effects of three common chemotherapy regimes in terms of disease-free survival (DFS) of breast cancer (BC) patients; the three explored regimes were taxane-based, anthracycline-based and CMF (cyclophosphamide methotrexate and 5-fluorouracil).
In this historical-cohort study, we obtained the information of 62 patients with confirmed BC in non-metastatic stage and followed them for 8 years. All the patients had undergone modified radical mastectomy surgery and had received adjuvant chemotherapy in three medical centers in Tehran, Iran. DFS was considered as the end-point. Afterwards, an extended log-logistic regression model was used to compare these regimes.
The mean (SD) age of patients was 49.0 (10.3) years. The median time of follow-up was 20.0 months and the probability of 5-years DFS was 0.48. Survival analysis indicated that the type of chemotherapy (OR(CMF vs. taxane) = 0.33, OR(anthracycline vs. taxane) = 0.74), grade (OR(III vs. I or II) = 0.35), tumor size (OR(>5 cm vs. <5 cm)= 0.179) and nodal involvements (OR(Yes vs. No)= 0.36) affected DFS.
The current study revealed that the efficacy of taxane-based, in terms of DFS, was more than CMF (p = 0.05). Moreover, taxane-based chemotherapy prolonged DFS more than anthracycline-based one although the difference was not significant (p= 0.63). Finally, considering the importance of tumor size, histological grade and number of involved lymph nodes in lengthening DFS, it is crucial to highlight the role of public education and screening programs in order to detect tumor in its early stages.
本研究的主要目的是比较三种常见化疗方案对乳腺癌（BC）患者无病生存期（DFS）的影响；所探究的三种方案分别是以紫杉烷为基础的、以蒽环类为基础的以及CMF（环磷酰胺、甲氨蝶呤和5-氟尿嘧啶）。
在这项历史性队列研究中，我们获取了62例确诊为非转移性阶段BC患者的信息，并对他们进行了8年的随访。所有患者均接受了改良根治性乳房切除术，并在伊朗德黑兰的三个医疗中心接受了辅助化疗。DFS被视为终点。之后，使用扩展的对数-逻辑回归模型来比较这些方案。
患者的平均（标准差）年龄为49.0（10.3）岁。中位随访时间为20.0个月，5年DFS概率为0.48。生存分析表明，化疗类型（OR（CMF对比紫杉烷）=0.33，OR（蒽环类对比紫杉烷）=0.74）、分级（OR（III级对比I级或II级）=0.35）、肿瘤大小（OR（>5 cm对比<5 cm）=0.179）和淋巴结受累情况（OR（是对比否）=0.36）影响DFS。
当前研究表明，就DFS而言，以紫杉烷为基础的方案的疗效优于CMF（p=0.05）。此外，以紫杉烷为基础的化疗比以蒽环类为基础的化疗更能延长DFS，尽管差异不显著（p=0.63）。最后，考虑到肿瘤大小、组织学分级和受累淋巴结数量对延长DFS的重要性，强调公众教育和筛查计划在早期发现肿瘤方面的作用至关重要。
