Azim Hamdy Abdel, Abdal-Kader Yasser Salah El Din, Mousa Mohamed Mahmoud, Malek Raafat Abdel, Abdalmassih Michael Kheir, Ibrahim Noha Yehia
Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt E-mail :
Asian Pac J Cancer Prev. 2015;16(1):65-9. doi: 10.7314/apjcp.2015.16.1.65.
To evaluate the impact of adding taxanes to anthracycline-based regimens in the adjuvant setting in localized young female breast cancer patients on the overall survival (OS) and the disease free survival (DFS).
This retrospective study included all female breast cancer patients who were candidates for adjuvant chemotherapy presenting to Kasr Al Ainy centre of clinical oncology and Cairo oncology centre (Cairo Cure) in the period from January 2005 till December 2010.
Our study included 865 patients, 732 of whom received anthracycline based regimens and 133 taxane based regimens. The mean age of patients was 39 years. After a median follow up of 50 months the median DFS was 48.4 months. Survival analysis indicated that the tumor size (>5cm vs. <5cm) p=0.001), nodal involvement (Yes vs. No) p=0.0001) and pathology (invasive lobular vs. ductal) p=0.048) affected DFS. As regards hormonal status, ER, PR and HER 2neu positive patients had longer DFS (p=0.001, 0.003, 0.106). On multivariate analysis DFS was affected by tumor size and lymph node involvement (p=0.014, 0.007). Subgroup analysis showed improvement in arms treated with taxanes in terms of DFS with positive Her2neu, ER and PR, but this was not statistically significant.
Adding adjuvant taxanes to anthracyclines is beneficial for treatment of localized breast cancer among all subgroups, especially higher risk groups .The type of adjuvant chemotherapy regimens and tumor characteristics have direct effects on DFS.
评估在局部晚期年轻女性乳腺癌患者的辅助治疗中,在基于蒽环类药物的方案中添加紫杉烷类药物对总生存期(OS)和无病生存期(DFS)的影响。
这项回顾性研究纳入了2005年1月至2010年12月期间在开罗艾因·卡斯尔临床肿瘤中心和开罗肿瘤中心(开罗治疗中心)接受辅助化疗的所有女性乳腺癌患者。
我们的研究纳入了865例患者,其中732例接受基于蒽环类药物的方案,133例接受基于紫杉烷类药物的方案。患者的平均年龄为39岁。中位随访50个月后,中位DFS为48.4个月。生存分析表明,肿瘤大小(>5cm对<5cm)(p = 0.001)、淋巴结受累情况(是对否)(p = 0.0001)和病理类型(浸润性小叶癌对导管癌)(p = 0.048)影响DFS。至于激素状态,雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体2(HER 2neu)阳性的患者DFS更长(p = 0.001、0.003、0.106)。多因素分析显示,DFS受肿瘤大小和淋巴结受累情况影响(p = 0.014、0.007)。亚组分析显示,在HER2neu、ER和PR阳性的患者中,接受紫杉烷类药物治疗的亚组在DFS方面有所改善,但无统计学意义。
在蒽环类药物基础上加用辅助性紫杉烷类药物对所有亚组,尤其是高风险组的局部乳腺癌治疗有益。辅助化疗方案的类型和肿瘤特征对DFS有直接影响。