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Titolo:
EFFECTIVENESS OF ADJUVANT CHEMOTHERAPY IN COMBINATION WITH TAMOXIFEN FOR NODE-POSITIVE POSTMENOPAUSAL BREAST-CANCER PATIENTS
Autore:
CASTIGLIONEGERTSCH M; GOLDHIRSCH A; GUSTERSON B; BETTELHEIM R; REED R; GUSSET H; GEISER K; HURNY C; BERNHARD J; HANGARTNER A; MAIBACH R; PEDOWSKI R; GELBER R; PRICE K; PETERSON H; ZELEN M; ISLEY M; HINKLE R; KAY RG; HOLDAWAY IM; HARVEY VJ; JAGUSCH MF; NEAVE L; MASON BM; EVANS B; BENJAMIN CS; CARTER JF; GILLMAN JC; MACK D; BENSONCOOPER D; MONFARDINI S; GALLIGIONI E; CRIVELLARI D; BUONADONNA A; MASSARUT S; ROSSI C; CANDIANI E; CARBONE A; VOLPE R; TROVO MG; RONCADIN M; SANTINI GF; VILLALTA D; CORAN F; MORASSUT S; MARINI G; SIMONCINI E; MARPICATI P; ZANIBONI A; SARTORI U; BARNI A; CERUTTI L; ALGHISI A; RAFFAGLIO E; GARATTINI MP; ALBERTINI A; GRIGOLATO F; MORASSI L; BERGONZINI R; LAURIOLA C; GUDGEON A; DENT DM; TILTMAN A; HACKING A; DOWDLE E; STEYNOR P; TOOP J; SCHNURCH HG; MOSNY D; BENDER HG; BOJAR H; VERONESI A; FOLADORE S; PAMICH G; BIANCHI G; TORRETTA A; RUDENSTAM CM; WALLGREN A; PERSSON S; MATTSSON J; CAHLIN E; HAFSTROM LO; HOLMBERG S; HULTBORN R; COLLDAHLJADERSTROM G; GUSTAVSSON B; CARLSSON G; IVARSSON L; THOREN O; RUUSVIK O; NICKLASSON LG; DAHLIN S; KARLSSON G; LINDBERG B; SUNDBACK A; BERGEGARDH S; SALANDER H; ANDERSSON C; HESSMAN Y; NELZEN O; HEIDEMAN M; RAMHULT T; SVENSSON JH; LIDBERG P; BJORK S; LINDTNER J; ERZEN D; CERAR O; STABUC B; GOLOUH R; LAMOVEC J; SEBEK S; KRAMBERGER M; VRHOVEC I; CORTESFUNES H; MARTINEZTELLO F; MENDIOLA C; CRUZVIGO F; LARRODERA ML; SIERRA A; MIRANDA P; ALONSO S; COLLINS J; SNYDER R; GREGORY P; BURAS WI; GREEN M; GALE T; HENDERSON M; HART S; NEIL S; KITCHEN P; LOVELL R; MCLENNAN R; REED R; RUSSELL I; SCHWARZ M; BASSER R; ROBERTSON A; GILL P; CARTER ML; MALYCHA P; YEOH E; WARD G; LEONG ASY; LOMMAXSMITH J; HOOSFALL D; DANGELO R; BYRNE M; VANHAZEL G; DEWAR J; BUCK M; SHEINER HJ; INGRAM D; STERRETT G; HAHNEL R; FORBES JF; STEWARD J; DARBAR SW; BISHOP JM; SIMMS B; ZIOGAS V; TATTERSALL MHN; COATES A; NIESCHE F; WEST R; RENWICK S; DONOVAN J; DUVAL P; SIMES RJ; NG A; GLENN D; NORTH RA; BEITH J; OCONNOR RG; RICE M; STEVENS G; FEY M; BARTH A; DREHER E; ISENSCHMID M; SCHNEIDER H; BUSER K; LUDIN J; LUTHI JM; ALTERMATT HJ; LAISSUE JA; MARKWALDER R; BURGI H; SENN HJ; THURLIMANN B; JUNGI WF; MORANT R; OEHLSCHLEGEL C; HARDMEIER T; LUSCHER K; RIES G; TOPFER M; LORENZ U; BENZ D; SCHILTKNECHT O; SPATI B; SCHMID L; CAVALLI F; SESSA C; BRONZ L; MARTINELLI G; MULLER W; LUSCIETI P; PASSEGA E; PEDRINIS E; REY P; MARTINOLI S; SPINELLI A; GALFETTI MA; LOMBARDI A; PEDRAZZINI A; LOSA G; VARINI M; GINIER M; HERRMANN R; HARDER JF; LAFFER U; ALMENDRAL AC; EPPENBERGER U; TORHORST J; SIEGENTHALER P; PIGUET D; BARRELET V; BAUMANN RP; JOSS R; SAUTER C; METZGER U; ENGELER V; HALLER U; KOCHLI O; LEYVRAZ S; PEREY L; ANANI P; GOMEZ F; MIRIMANOFF RO; CHAPUIS G; DEGRANDI P; REYMOND P; ALBERTO P; SCHAFER P; KRAUER F; FORNI M; AAPRO M; EGELI R; MEGEVAND R; JACOTDESCOMBES E; SCHINDLER A; NOSEDA G; WEBER W; LEHMANN W;
Indirizzi:
INT BREAST CANC STUDY GRP,COORDINATING CTR,EFFINGERSTR 40 CH-3008 BERN SWITZERLAND DANA FARBER CANC INST BOSTON MA 02115 HARVARD UNIV,SCH MED BOSTON MA 00000 FRONTIER SCI & TECHNOL RES FDN INC AMHERST MA 00000 AUCKLAND BREAST CANC STUDY GRP AUCKLAND NEW ZEALAND CTR RIFERIMENTO ONCOL I-33081 AVIANO ITALY SPEDALI CIVIL BRESCIA I-25125 BRESCIA ITALY FDN BERETTA BRESCIA ITALY GROOTE SCHUUR HOSP ZA-7925 CAPE TOWN SOUTH AFRICA UNIV DUSSELDORF D-4000 DUSSELDORF GERMANY PRESIDIO OSPED GORIZIA ITALY W SWEDISH BREAST CANC STUDY GRP GOTHENBURG SWEDEN INST ONCOL LJUBLJANA SLOVENIA MADRID BREAST CANC GRP MADRID SPAIN ANTICANC COUNCIL VICTORIA MELBOURNE VIC AUSTRALIA ROYAL ADELAIDE HOSP ADELAIDE SA 5000 AUSTRALIA SIR CHARLES GAIRDNER HOSP NEDLANDS WA 6009 AUSTRALIA UNIV NEWCASTLE WARATAH AUSTRALIA UNIV SYDNEY SYDNEY NSW 2006 AUSTRALIA ROYAL PRINCE ALFRED HOSP SYDNEY NSW AUSTRALIA UNIV BERN,INSELSPITAL,SWISS GRP CLIN CANC RES CH-3010 BERN SWITZERLAND KANTONSSPITAL CH-9007 ST GALLEN SWITZERLAND OSPED SAN GIOVANNI BELLINZONA BELLINZONA SWITZERLAND HOP CADOLLES NEUCHATEL SWITZERLAND KANTONSSPITAL CH-4031 BASEL SWITZERLAND KANTONSSPITAL LUZERN SWITZERLAND KANTONSSPITAL ZURICH SWITZERLAND CTR HOP UNIV LAUSANNE SWITZERLAND UNIV GENEVA,HOP CANTONAL CH-1211 GENEVA SWITZERLAND SWISS CANC LEAGUE BERN SWITZERLAND
Titolo Testata:
Journal of clinical oncology
fascicolo: 4, volume: 15, anno: 1997,
pagine: 1385 - 1394
SICI:
0732-183X(1997)15:4<1385:EOACIC>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
GROWTH;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
22
Recensione:
Indirizzi per estratti:
Citazione:
M. Castiglionegertsch et al., "EFFECTIVENESS OF ADJUVANT CHEMOTHERAPY IN COMBINATION WITH TAMOXIFEN FOR NODE-POSITIVE POSTMENOPAUSAL BREAST-CANCER PATIENTS", Journal of clinical oncology, 15(4), 1997, pp. 1385-1394

Abstract

Purpose: Adjuvant tamoxifen has been shown to reduce relapse and mortality among node-positive postmenopausal breast cancer patients. The value of adding chemotherapy to tamoxifen is controversial. Patients and Methods: Between July 1986 and April 1993, 1,266 postmenopausal breast cancer patients with node-positive disease were randomly assigned to receive one of four adjuvant therapy regimens: (A) tamoxifen alone for 5 years; (B) tamoxifen plus three courses of early cyclophosphamide, methotrexate, and fluorouracil (CMF) on months 1, 2, and 3; (C) tamoxifen plus delayed single courses of CMF on months 9, 12, and 15; (D) tamoxifen plus early and delayed CMF on months 1, 2, 3, 9, 12, and 15. The two-by-two factorial design allowed two direct comparisons: earlyCMF (B and D) versus no early CMF (A and C), and delayed CMF (C and D) versus no delayed CMF (A and B). Estrogen receptor (ER) status was known for all patients and was used to stratify the randomization. A total of 1,212 patients (96%) were eligible and assessable. The median followup duration was 60 months. Results: The results of the two-by-twofactorial comparison were as follows: (1) early CMF added to tamoxifen significantly improved 5-year disease-free survival (DFS; 64% v 57%;hazards ratio [HR], 0.79; 95% confidence interval [CI], 0.66 to 0.95;P = .01); and (2) delayed CMF added to tamoxifen did not improve DFS (5-year DFS, 61% v 60%; HR, 0.97; 95% CI, 0.81 to 1.17; P = .77). For patients with ER-positive tumors, the addition of CMF, either early ordelayed or both, reduced the relative risk of relapse by 22% to 36%. In contrast, for patients with ER-negative tumors, tamoxifen with delayed CMF was associated with a nonsignificant increased risk of relapse(HR, 1.27; 95% CI, 0.92 to 1.76; P = .15). Conclusion: Postmenopausalpatients with node-positive breast cancer should be offered combination chemotherapy in addition to tamoxifen. Tamoxifen should not be initiated before CMF, as this might be detrimental, especially for patients with ER-negative tumors. (C) 1997 by American Society of Clinical Oncology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 12:08:20