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Adjuvant chemotherapy followed by goserelin versus either modality alone for premenopausal lymph node-negative breast cancer : a randomized trialInternational Breast Cancer Study GroupBackground: Although chemotherapy and ovarian function suppression are both effective adjuvant therapies for patients with early-stage breast cancer, little is known of the efficacy of their ... sequential combination. In an International Breast Cancer Study Group (IBCSG) randomized clinical trial (Trial VIII) for pre- and perimenopausal women with lymph node-negative breastcancer, we compared sequential chemotherapy followed by the gonadotropin-releasing hormone agonist goserelin with each modality alone. Methods: From March 1990 through October 1999, 1063 patients stratified by estrogen receptor (ER) status and radiotherapy plan were randomly assigned to receive goserelin for 24 months (n = 346), six courses of "classical" CMF (cyclophosphamide, methotrexate, 5-fluorouracil) chemotherapy (n = 360), or six courses of classical CMF followed by 18 months of goserelin (CMF --> goserelin; n = 357). A fourth arm (no adjuvant treatment) with 46 patients wasdiscontinued in 1992. Tumors were classified as ER-negative (30%), ER-positive (68%), or ER status unknown (3%). Twenty percent of patients were aged 39 years or younger. The median follow-up was 7 years. The primary outcome was diseasefree survival (DFS). Results: Patients with ER-negative tumors achieved better disease-free survival if they received CMF (5-year DFS for CMF = 84%, 95% confidence interval šCIđ = 77% to 91%; 5-year DFS for CMF --> goserelin = 88%, 95% CI = 82% to 94%) than if they received goserelin alone (5-year DFS = 73%, 95% CI = 64% to 81%). By contrast, for patients with ER-positive disease, chemotherapy alone and goserelin alone provided similar outcomes (5-year DFS for both treatment groups = 81%, 95% CI = 76% to 87% ), whereas sequential therapy (5-year DFS = 86%, 95% CI = 82% to 91% ) provided astatistically nonsignificant improvement compared with either modality alone,primarily because of the results among younger women. (Abstract truncated at 2000 characters).Vir: Journal of the National Cancer Institute. - ISSN 0027-8874 (Letn. 95, št. 24, 2003, str. 1833-1846)Vrsta gradiva - članek, sestavni delLeto - 2003Jezik - angleškiCOBISS.SI-ID - 17848793
Avtor
Goldhirsch, Aron |
Lindtner, Jurij |
Eržen, Darja, 1952- |
Majdič, Elga |
Štabuc, Borut |
Plesničar, Andrej, 1957- |
Golouh, Rastko |
Lamovec, Janez |
Jančar, Janez, 1945- |
Vrhovec, Ivan, 1943- |
Kramberger, Marta |
International Breast Cancer Study Group
Teme
Breast Neoplasms |
Drug Therapy |
Surgery |
Pathology |
Antineoplastic Agents, Hormonal |
Therapeutic Use |
Administration And Dosage |
Adverse Effects |
Antineoplastic Agents, Combined |
Therapeutic Use |
Administration And Dosage |
Goserelin |
Therapeutic Use |
Administration And Dosage |
Adverse Effects |
Methotrexate |
Administration And Dosage |
Adult |
Middle Age |
Treatment Outcome |
Incidence |
Survival Analysis |
Receptors, Estrogen |
Metabolism |
Amenorrhea |
Chemically Induced |
Lymphatic Metastasis |
Chemotherapy, Adjuvant |
Confidence Intervals |
Premenopause |
Fluorouracil |
Administration And Dosage |
Antineoplastiki hormonski |
Antineoplastiki sestavljeni |
Dojka, novotvorbe |
Gozerelin |
Metotreksat |
Amenoreja |
Fluorouracil |
Incidenca |
Kemoterapija pomožna |
Limfatična metastaza |
Odrasli |
Premenopavza |
Preživetje, analiza |
Receptorji estrogenski |
Srednja leta |
Zaupanje, intervali |
Zdravljenje, izid
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vir: Journal of the National Cancer Institute. - ISSN 0027-8874 (Letn. 95, št. 24, 2003, str. 1833-1846)
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Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
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Goldhirsch, Aron | ![]() |
Lindtner, Jurij | 05278 |
Eržen, Darja, 1952- | 14441 |
Majdič, Elga | 08751 |
Štabuc, Borut | 11949 |
Plesničar, Andrej, 1957- | 08288 |
Golouh, Rastko | 02686 |
Lamovec, Janez | 04376 |
Jančar, Janez, 1945- | 09170 |
Vrhovec, Ivan, 1943- | 07195 |
Kramberger, Marta | 14442 |
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