title: Study participation improves treatment strategies and individual patient care in participating centers.
abstract: BACKGROUND
  The ADEBAR study is a prospective multicenter Phase III trial to examine whether high-risk breast cancer patients > or =4 involved axillary lymph nodes) benefit from a sequential anthracycline-docetaxel regimen compared to standard chemotherapy with anthracyclines. With a median recruitment of 33 patients per month at 198 actively-recruiting centers, the ADEBAR study was the best recruiting study in Germany until the end of the trial.
  
  
  METHODS
  A standardized questionnaire was sent to all participating centers in order to determine the extent to which treatment strategies and patient care are affected by participation in the ADEBAR study. The questionnaire covered 5 areas of interest: previous inclusion of patients at the same tumor stage in other studies, the type of chemotherapy received by comparable patients previously outside the study, change in the intensity of medical care since participating in the ADEBAR study, the information gained through participation in the study and changes in the overall quality of medical care.
  
  
  RESULTS
  51.0% (n=98) of the questionnaires were returned, from which 3 were excluded from the analysis due to being incomplete. In the year preceding the ADEBAR study, 63.2% of participating centers had not entered their high-risk patients into a clinical trial. Before participating in the ADEBAR protocol, 44.2% of patients with the same indication had received inadequate therapy by today's standards, such as CMF, EC/CMF or 4x EC. 59.0% of the centers noted an increase in the intensity of patient care as a result of participation in the study, independent of the care provided purely because of the study. By being part of a research network, with a regular flow of information via newsletters, study meetings and the like, 80.0% noted an improvement in their professional knowledge in the field of breast cancer. Moreover, 31.6% of the centers reported an improvement in the overall quality of their patient care since the start of the trial.
  
  
  CONCLUSIONS
  The results of the survey demonstrate that both physicians and patients benefit from participation in clinical trials as this is associated with optimized decision-making as regards therapy and patient care.
authors.affiliation: Frauenklinik Innenstadt of the LMU Munich, Germany. wolfgang.janni@med.uni-muenchen.de
authors.forename: W
authors.initials: W
authors.lastname: Janni
authors.forename: M
authors.initials: M
authors.lastname: Kiechle
authors.forename: H
authors.initials: H
authors.lastname: Sommer
authors.forename: B
authors.initials: B
authors.lastname: Rack
authors.forename: K
authors.initials: K
authors.lastname: Gauger
authors.forename: M
authors.initials: M
authors.lastname: Heinrigs
authors.forename: D
authors.initials: D
authors.lastname: Steinfeld
authors.forename: D
authors.initials: D
authors.lastname: Augustin
authors.forename: W
authors.initials: W
authors.lastname: Simon
authors.forename: N
authors.initials: N
authors.lastname: Harbeck
authors.forename: K
authors.initials: K
authors.lastname: Friese
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage; D000077143:Docetaxel; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D015251:Epirubicin; D003520:Cyclophosphamide; D005472:Fluorouracil