title: Pegylated Liposomal Doxorubicin as Adjuvant Therapy for Stage I-III Operable Breast Cancer.
abstract: BACKGROUND
  Conventional anthracyclines play an essential role for the treatment of breast cancer and have potent cytotoxic activity, but are associated with severe toxicity. In metastatic breast cancer, pegylated liposomal doxorubicin (PLD) is a formulation with efficacy similar to conventional doxorubicin but with reduced toxicity. This multicenter study evaluated the efficacy and safety of PLD-based adjuvant chemotherapy for women with stage I-III operable breast cancer.
  
  
  METHODS
  One hundred and eighty women with stage I-III breast cancer who received PLD-based adjuvant chemotherapy at six different Institutions in Taiwan from February 2002 to March 2008 were included and followed-up until April 2015. Treatment efficacy was determined by disease-free survival (DFS) rate and safety was evaluated by adverse events.
  
  
  RESULTS
  The 5- and 10-year DFS rates were 76.3 and 72.6%, respectively. Univariate analysis revealed that tumor size >5 cm (p=0.045; hazard ratio=3.31) and stage III (hazard ratio=3.54; p=0.019) were each associated with shorter DFS. Only stage III (hazard ratio=5.60; p=0.018) retained statistical significance with regard to DFS in the multivariate analysis. Grade 3/4 hematological toxicity was neutropenia (n=13; 7.2%). The women receiving PLD had low-grade 3 or 4 nausea/vomiting, mucositis, and alopecia. Grade 3 hand-foot syndrome occurred in three patients (1.7%).
  
  
  CONCLUSIONS
  PLD could be considered an effective and safe alternative to conventional anthracyclines in the treatment of stage I-III operable breast cancer.
authors.affiliation: Department of Hematology-Oncology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan, R.O.C. Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan, R.O.C.
authors.forename: Yin-Che
authors.initials: YC
authors.lastname: Lu
authors.affiliation: Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C.
authors.forename: F U
authors.initials: FU
authors.lastname: Ou-Yang
authors.affiliation: Breast Center, Taiwan Adventist Hospital, Taipei, Taiwan, R.O.C.
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Hsieh
authors.affiliation: Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan, R.O.C. Department of Surgery, Cheng Ching General Hospital, Taichung, Taiwan, R.O.C.
authors.forename: King-Jen
authors.initials: KJ
authors.lastname: Chang
authors.affiliation: Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan, R.O.C.
authors.forename: Dar-Ren
authors.initials: DR
authors.lastname: Chen
authors.affiliation: Department of Surgery, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan, R.O.C.
authors.forename: Chi-Wen
authors.initials: CW
authors.lastname: Tu
authors.affiliation: Department of Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C. lohcym64@yahoo.com.tw mifeho@kmu.edu.tw.
authors.forename: Hwei-Chung
authors.initials: HC
authors.lastname: Wang
authors.affiliation: Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C. Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan, R.O.C. lohcym64@yahoo.com.tw mifeho@kmu.edu.tw.
authors.forename: Ming-Feng
authors.initials: MF
authors.lastname: Hou
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D000903:Antibiotics, Antineoplastic; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin
keywords: Breast cancer; adjuvant chemotherapy; pegylated liposomal doxorubicin