Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Cancer Med. 2021 Oct;10(19):6744-6761. doi: 10.1002/cam4.4215. Epub 2021 Sep 2.
Anthracycline-based chemotherapy (ABC) is one of the standard therapies against breast cancer. However, few guidelines are currently available to optimize the use of ABC. Therefore, the present analysis aimed at determining the profile and treatment patterns of ABC and the association of clinicopathological characteristics with ABC selection.
We retrospectively analyzed the data of a nation-wide multicenter epidemiological study, which collected the medical records of breast cancer patients receiving chemotherapy in different settings from seven geographic regions in China (NCT03047889).
In total, 3393 patients were included, with 2917 treated with ABC. Among them, 553 (89.8%), 2165 (81.7%), and 814 (25.7%) were subjected to ABC as neoadjuvant, adjuvant, and advanced chemotherapy, respectively. The most frequently used regimens were anthracycline-taxane-based combinations for neo- and adjuvant chemotherapy, along with taxanes and oral fluorouracils for the palliative stages. In the overall cohort, patients aged < 40 or 40-65 (p < 0.001), in premenopause (p < 0.001), without comorbidities (p = 0.016), with invasive ductal carcinoma (p= 0.001), high lymph node involvement (p < 0.001), in the pTNM stage II, III, or IV versus stage I (p < 0.001), subjected to mastectomy (p < 0.001) or subjected to sentinel lymph node biopsy combined with axillary lymph node dissection (p = 0.044), or with a decreased disease-free survival (p < 0.001) were more likely to be recommended to ABC.
Taken together, ABC remained the mainstay of breast cancer treatment, especially in neo and adjuvant therapy. ABC was mainly used as a combination therapy, and the correlation between influencing factors and ABC choice varied during different settings, indicating the preference and different perspectives of medication considered by medical oncologists regarding the use ABC in China.
蒽环类药物化疗（ABC）是乳腺癌的标准治疗方法之一。然而，目前几乎没有可用的指南来优化 ABC 的使用。因此，本分析旨在确定 ABC 的概况和治疗模式，并确定临床病理特征与 ABC 选择的关联。
我们回顾性分析了一项全国多中心流行病学研究的数据，该研究收集了来自中国七个地理区域不同环境中接受化疗的乳腺癌患者的病历（NCT03047889）。
共纳入 3393 例患者，其中 2917 例接受 ABC 治疗。其中，553 例（89.8%）、2165 例（81.7%）和 814 例（25.7%）分别接受 ABC 作为新辅助、辅助和晚期化疗。最常用的方案是蒽环类药物-紫杉类药物联合用于新辅助和辅助化疗，以及紫杉类药物和口服氟尿嘧啶用于姑息治疗阶段。在整个队列中，年龄<40 岁或 40-65 岁（p<0.001）、绝经前（p<0.001）、无合并症（p=0.016）、浸润性导管癌（p=0.001）、淋巴结受累程度高（p<0.001）、pTNM 分期 II、III 或 IV 期与 I 期（p<0.001）、接受乳房切除术（p<0.001）或接受前哨淋巴结活检联合腋窝淋巴结清扫术（p=0.044）、或无病生存时间缩短（p<0.001）的患者更有可能被推荐使用 ABC。
总的来说，ABC 仍然是乳腺癌治疗的主要方法，尤其是在新辅助和辅助治疗中。ABC 主要用作联合治疗，不同治疗环境下影响因素与 ABC 选择的相关性不同，表明中国的肿瘤内科医生在使用 ABC 时的偏好和不同观点。
