Hilaj Erina, Ymeri Alketa, Shpati Kleva P
Oncology, National Center of Continuing Education for Health Professionals, Tirana, ALB.
Oncology, University Hospital Center "Mother Theresa", Tirana, ALB.
Cureus. 2020 Feb 27;12(2):e7117. doi: 10.7759/cureus.7117.
Introduction This study aimed to analyze the impact of adding taxanes to anthracycline-based regimens on women diagnosed with breast cancer and treated with adjuvant chemotherapy. Methods This retrospective study included 559 female breast cancer patients who underwent adjuvant chemotherapy at the University Hospital Center "Mother Teresa" in Tirana, Albania from 2005 to 2011. Three hundred fifty-nine patients received an anthracycline-based regimen, and 200 received anthracycline-plus-taxane regimens. Common anthracycline-based regimens consisted of 5-fluorouracil 600 mg/m, doxorubicin 60 mg/m, cyclophosphamide 600 mg/m every three weeks for six cycles. Combined taxane-anthracycline regimens were anthracycline-based regimen in the first four cycles (doxorubicin 60 mg/m, cyclophosphamide 600 mg/m, docetaxel 80 mg/m) followed by either weekly paclitaxel or thrice-weekly docetaxel for four cycles. Results Overall, after a 5-year follow-up, it was found that 148 women in the taxanes-based regimen group (74%) did not experience relapse compared with 264 women in the anthracycline-based regimen group (73.5%). The relapse status was affected by hormonal status (p: <0.001) in the taxane-based regimen. In the anthracycline-based regimen patients, the relapse status was affected by hormone status and nodal involvement (p: <0.001). Conclusion The taxanes-plus-anthracycline regimen was slightly more effective than the anthracycline-based regimen for breast cancer patients in terms of avoiding relapse, but the difference was not statistically significant. Therefore, adding taxanes to adjuvant chemotherapy for women diagnosed with breast cancer is not beneficial for every subgroup. Hence, the future of breast cancer therapy remains chemotherapy individualized for each patient for optimal outcomes.
引言 本研究旨在分析在以蒽环类药物为基础的化疗方案中添加紫杉烷类药物对诊断为乳腺癌并接受辅助化疗的女性的影响。
方法 这项回顾性研究纳入了2005年至2011年期间在阿尔巴尼亚地拉那“圣德肋撒嬷嬷”大学医院中心接受辅助化疗的559例女性乳腺癌患者。359例患者接受了以蒽环类药物为基础的化疗方案，200例患者接受了蒽环类药物加紫杉烷类药物的化疗方案。常见的以蒽环类药物为基础的化疗方案包括每三周一次，共六个周期，每次给予氟尿嘧啶600mg/m²、多柔比星60mg/m²、环磷酰胺600mg/m²。联合紫杉烷类药物-蒽环类药物的化疗方案是在前四个周期采用以蒽环类药物为基础的化疗方案（多柔比星60mg/m²、环磷酰胺600mg/m²、多西他赛80mg/m²），随后每四周给予紫杉醇或每三周给予多西他赛，共四个周期。
结果 总体而言，经过5年的随访，发现以紫杉烷类药物为基础的化疗方案组中有148名女性（74%）未出现复发，而以蒽环类药物为基础的化疗方案组中有264名女性（73.5%）未出现复发。在以紫杉烷类药物为基础的化疗方案中，复发状态受激素状态影响（p值：<0.001）。在以蒽环类药物为基础的化疗方案患者中，复发状态受激素状态和淋巴结受累情况影响（p值：<0.001）。
结论 在避免复发方面，紫杉烷类药物加蒽环类药物的化疗方案对乳腺癌患者的疗效略优于以蒽环类药物为基础的化疗方案，但差异无统计学意义。因此，在诊断为乳腺癌的女性辅助化疗中添加紫杉烷类药物并非对每个亚组都有益。因此，乳腺癌治疗的未来仍然是为每个患者制定个体化化疗方案以实现最佳疗效。
