Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Breast Cancer (Dove Med Press). 2015 Jan 20;7:37-41. doi: 10.2147/BCTT.S73997. eCollection 2015.
We previously studied the noninferiority of anastrozole (ANZ) versus ANZ followed by letrozole (A-LTZ) due to reimbursement policy. We found that patients with A-LTZ had better overall survival (OS) than did patients with ANZ alone. This study aimed to prove that patients with A-LTZ also had better OS than patients with letrozole (LTZ) alone.
All medical records of the breast cancer patients taking LTZ with or without ANZ between 2004 and 2013 were reviewed. All patients were divided into two groups: the LTZ group included patients treated with LTZ alone, and the A-LTZ group included patients treated with ANZ who were automatically changed to LTZ due to change of the reimbursement policy.
From 359 cases, there were 179 cases in the LTZ group and 180 cases in the A-LTZ group. The mean age of patients in the LTZ group was 53.7 years and in the A-LTZ group was 54.2 years. The distribution of clinical stages among the LTZ group versus the A-LTZ group was 21 versus 4 (stage 1), 86 versus 116 (stage 2), 55 versus 46 (stage 3), and 17 versus 14 (stage 4), respectively. Among the LTZ patients, 63.7% took aromatase inhibitor monotherapy and 36.3% had a switching strategy, while in the A-LTZ group, 53.9% took AI monotherapy and 46.1% had a switching strategy. OS of the A-LTZ group was longer than that of the LTZ group.
The patients in A-LTZ, taking ANZ followed by LTZ had better OS than those in LTZ, taking LTZ alone.
我们之前曾根据报销政策研究过阿那曲唑（ANZ）与阿那曲唑序贯来曲唑（A-LTZ）的非劣效性。我们发现 A-LTZ 组的患者总生存期（OS）优于 ANZ 单药组。本研究旨在证明 A-LTZ 组的患者 OS 也优于来曲唑（LTZ）单药组。
回顾了 2004 年至 2013 年间服用 LTZ 联合或不联合 ANZ 的乳腺癌患者的所有病历。所有患者分为两组：LTZ 组包括仅接受 LTZ 治疗的患者，A-LTZ 组包括因报销政策变化而自动转为 LTZ 治疗的接受 ANZ 治疗的患者。
在 359 例患者中，LTZ 组 179 例，A-LTZ 组 180 例。LTZ 组患者的平均年龄为 53.7 岁，A-LTZ 组为 54.2 岁。LTZ 组与 A-LTZ 组的临床分期分布分别为 21 例与 4 例（1 期）、86 例与 116 例（2 期）、55 例与 46 例（3 期）和 17 例与 14 例（4 期）。在 LTZ 患者中，63.7%接受芳香化酶抑制剂单药治疗，36.3%采用了换药策略，而在 A-LTZ 组中，53.9%接受 AI 单药治疗，46.1%采用了换药策略。A-LTZ 组的 OS 长于 LTZ 组。
与 LTZ 单药治疗相比，接受 ANZ 序贯 LTZ 治疗的 A-LTZ 组患者的 OS 更好。
