title: Results of two randomized trials evaluating adjuvant anthracycline-based chemotherapy in 1146 patients with early breast cancer.
abstract: Two randomized trials evaluated the effect of 6 courses of anthracycline-based chemotherapy in early breast cancer. A total of 1146 patients were included: 311 high-risk node-negative premenopausal patients and 835 high-risk node-negative or node-positive postmenopausal patients. Patients were randomized after surgery to receive either no chemotherapy (control group) or 6 courses of anthracycline-based chemotherapy (CT group). Postmenopausal patients received adjuvant tamoxifen for at least two years. Radiotherapy was delivered after completion of chemotherapy in the CT group. The 10-year disease-free survival (DFS) rates were 60% in the control group and 65% in the CT group (log-rank test, p = 0.01). The 10-year distant metastasis rates were 28% and 23% (p = 0.02), and the 10-year local recurrence rates were 12% and 10%, respectively (p = 0.24). Chemotherapy was significantly less effective in post-menopausal patients with estrogen receptor-positive tumors. Adjuvant anthracycline-based chemotherapy yielded a significant benefit for DFS by lowering the risk of distant metastases. After up to 10 years of follow-up, deferring radiotherapy after chemotherapy did not compromise local control.
authors.affiliation: Institut Gustave-Roussy, Villejuif, France. arriagada@igr.fr
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Arriagada
authors.forename: Marc
authors.initials: M
authors.lastname: Spielmann
authors.forename: Serge
authors.initials: S
authors.lastname: Koscielny
authors.forename: Thierry
authors.initials: T
authors.lastname: Le Chevalier
authors.forename: Thierry
authors.initials: T
authors.lastname: Delozier
authors.forename: Monique
authors.initials: M
authors.lastname: Rémé-Saumon
authors.forename: Muriel
authors.initials: M
authors.lastname: Ducourtieux
authors.forename: Thomas
authors.initials: T
authors.lastname: Tursz
authors.forename: Catherine
authors.initials: C
authors.lastname: Hill
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015411:Mastectomy, Modified Radical; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D017698:Postmenopause / Q000187:drug effects; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome; D016387:Women's Health
chemical_list: D018943:Anthracyclines