Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N2, Canada.
Department of Medical Oncology, Tom Baker Cancer Center, 1331 29 ST NW, Calgary, AB T2N 4N2, Canada.
Curr Oncol. 2021 Mar 4;28(2):1137-1142. doi: 10.3390/curroncol28020109.
Uncertainty exists around the need to include an anthracycline if taxane-based adjuvant chemotherapy is being used for human epidermal growth factor receptor-2 (HER2) negative and axillary lymph node negative (LNN) breast cancer. We identified all patients who were diagnosed with HER2-negative, LNN breast cancer treated with docetaxel-cyclophosphamide for four cycles (DC4) or an anthracycline-taxane (AT) regimen following surgical resection in Alberta from 2008 through 2012. We used propensity score methods to match each patient treated with AT to up to four patients treated with DC4 on potentially confounding clinicopathologic and treatment variables. We compared the 10-year invasive disease free survival (iDFS), breast cancer specific-survival (BCSS) and overall survival (OS) and assessed the effect of the type of adjuvant chemotherapy on these outcomes using Cox regression. Of the 726 eligible patients, 657 (90.5%) were treated with DC4 and 69 (9.5%) were treated with AT. Matching created a group of 202 women treated with DC4 and eliminated differences in clinicopathologic and treatment factors. There was no statistically significant difference for the treatment effects of matched DC4 patients compared to the AT patients on iDFS (75.7% vs. 76.8%, = 0.75; hazard ratio (HR) = 1.05, 95% CI = 0.65 to 1.8), BCSS (88.1% vs. 87%, = 0.8; HR = 0.91, 95% CI = 0.42 to 1.9), or OS (87.1% vs. 86.9%, = 0.96; HR = 0.98, 95% CI = 0.46 to 2.1). Four cycles of DC as compared with an AT regimen yielded similar 10-year iDFS, BCSS and OS amongst patients with HER2-negative, LNN breast cancer.
对于人表皮生长因子受体 2（HER2）阴性和腋窝淋巴结阴性（LNN）乳腺癌患者，如果使用紫杉烷类辅助化疗，是否需要包含蒽环类药物仍存在不确定性。我们确定了所有在 2008 年至 2012 年期间在艾伯塔省接受手术切除后接受多西他赛-环磷酰胺 4 个周期（DC4）或蒽环类药物-紫杉烷（AT）方案治疗的 HER2 阴性、LNN 乳腺癌患者。我们使用倾向评分方法，将每个接受 AT 治疗的患者与最多 4 个接受 DC4 治疗的患者进行匹配，匹配的因素为潜在混杂的临床病理和治疗变量。我们比较了 10 年无侵袭性疾病生存（iDFS）、乳腺癌特异性生存（BCSS）和总生存（OS），并使用 Cox 回归评估辅助化疗类型对这些结局的影响。在 726 名合格患者中，657 名（90.5%）接受 DC4 治疗，69 名（9.5%）接受 AT 治疗。匹配创建了一组 202 名接受 DC4 治疗的女性，并消除了临床病理和治疗因素的差异。在 iDFS（75.7% vs. 76.8%， = 0.75；风险比（HR）= 1.05，95%CI = 0.65 至 1.8）、BCSS（88.1% vs. 87%， = 0.8；HR = 0.91，95%CI = 0.42 至 1.9）和 OS（87.1% vs. 86.9%， = 0.96；HR = 0.98，95%CI = 0.46 至 2.1）方面，匹配的 DC4 患者与 AT 患者的治疗效果无统计学显著差异。与 AT 方案相比，接受 4 个周期 DC 治疗的 HER2 阴性、LNN 乳腺癌患者 10 年 iDFS、BCSS 和 OS 相似。
