Factors Influencing Decision-Making for or against Adjuvant and Neoadjuvant Chemotherapy in Postmenopausal Hormone Receptor-Positive Breast Cancer Patients in the EvAluate-TM Study

被引：6

作者：

Gass, Paul ^{[1
]}

Fasching, Peter A. ^{[1
]}

Fehm, Tanja ^{[2
,3
]}

de Waal, Johann ^{[4
]}

Rezai, Mahdi ^{[5
]}

Baier, Bernd ^{[4
]}

Baake, Gerold ^{[6
]}

Kolberg, Hans-Christian ^{[7
]}

Guggenberger, Martin ^{[8
]}

Warm, Mathias ^{[9
,10
]}

Harbeck, Nadia ^{[11
,12
]}

Wuerstlein, Rachel ^{[11
,12
]}

Deuker, Joerg-Uwe ^{[13
]}

Dall, Peter ^{[14
]}

Richter, Barbara ^{[15
]}

Wachsmann, Grischa ^{[16
]}

Brucker, Cosima ^{[17
]}

Siebers, Jan W. ^{[18
]}

Fersis, Nikos ^{[19
]}

Kuhn, Thomas ^{[20
]}

Wolf, Christopher ^{[21
]}

Vollert, Hans-Walter ^{[22
]}

Breitbach, Georg-Peter ^{[23
]}

Janni, Wolfgang ^{[24
]}

Landthaler, Robert ^{[25
]}

Kohls, Andreas ^{[26
]}

Rezek, Daniela ^{[27
]}

Noesselt, Thomas ^{[28
]}

Fischer, Gunnar ^{[29
]}

Henschen, Stephan ^{[30
]}

Praetz, Thomas ^{[31
]}

Heyl, Volker ^{[32
]}

Kuehn, Thorsten ^{[33
]}

Krauss, Thomas ^{[34
]}

Thomssen, Christoph ^{[35
]}

Hohn, Andre ^{[36
]}

Tesch, Hans ^{[37
]}

Mundhenke, Christoph ^{[38
]}

Hein, Alexander ^{[1
]}

Rauh, Claudia ^{[1
]}

Bayer, Christian M. ^{[1
]}

Jacob, Adib ^{[39
]}

Schmidt, Katja ^{[39
]}

Belleville, Erik ^{[40
]}

Hadji, Peymann ^{[41
]}

Brucker, Sara Y. ^{[3
]}

Beckmann, Matthias W. ^{[1
,43
]}

Wallwiener, Diethelm ^{[3
]}

Kuemmel, Sherko ^{[42
]}

Loehberg, Christian R. ^{[1
,43
]}

机构：

[1] Friedrich Alexander Univ Erlangen Nuremberg, Erlangen Univ Hosp, Comprehens Canc Ctr Erlangen EMN, Dept Gynecol & Obstet, Erlangen, Germany

[2] Univ Frauenklin Dusseldorf, Dusseldorf, Germany

[3] Eberhard Karls Univ Tubingen, Univ Klinikum Tubingen, Dept Frauengesundheit, Tubingen, Germany

[4] Frauenklin Klinikum Dachau, Dachau, Germany

[5] Luisenkrankenhaus Dusseldorf, Dusseldorf, Germany

[6] Onkol Praxis Pinneberg, Pinneberg, Germany

[7] Marienhosp Bottrop, Bottrop, Germany

[8] Klinikum Tuttlingen, Tuttlingen, Germany

[9] Univ Frauenklin Koln, Brustzentrum, Cologne, Germany

[10] Brustzentrum, Klinken Stadt Koln, Cologne, Germany

[11] Klinikum Univ Munchen, Klin & Poliklin Frauenheilkunde & Geburtshilfe, Brustzentrum, Munich, Germany

[12] CCC, Munich, Germany

[13] Vinzenzkrankenhaus Hannover, Hannover, NH, Germany

[14] Stadt Klinikum Luneburg, Frauenklin, Luneburg, Germany

[15] Elblandkliniken Meissen Radebeul, Meissen, Germany

[16] Kreiskrankenhaus Boblingen, Boblingen, Germany

[17] Univ Klin Frauenheilkunde, Paracelsus Med Privatuniv, Nurnberg, Germany

[18] Frauenklin St Josefsklin, Offenburg, Germany

[19] Klinikum Bayreuth, Frauenklin, Bayreuth, Germany

[20] Karl Olga Krankenhaus, Stuttgart, Germany

[21] Med Zentrum Ulm, Ulm, Germany

[22] Klinikum Friedrichshafen, Friedrichshafen, Germany

[23] Stadt Klinikum, Gynakol & Geburtshilfe, Neunkirchen, Germany

[24] Frauenklin Univ Klinikums Ulm, Ulm, Germany

[25] Gynakol Praxis Kreisklin Krumbach, Krumbach, Germany

[26] Evangel Krankenhaus Ludwigsfelde Teltow, Teltow, Germany

[27] Marien Hosp, Wesel, Germany

[28] Sana Klinikum Hameln Pyrmont, Klin Gynakol & Geburtshilfe, Hameln, Germany

[29] Landkreis Mittweida Krankenhaus, Mittweida, Germany

[30] Johanniter Krankenhaus Genthin Stendal, Stendal, Germany

[31] Caritas Krankenhaus, Bad Mergentheim, Germany

[32] Schwerpunkt Med Minimal Invas Chirurg Senol & Onk, Mainz, Germany

[33] Stadt Kliniken, Frauenklin, Esslingen An, Germany

[34] Klinikum Passau, Frauenklin, Passau, Germany

[35] Martin Luther Univ Halle Wittenberg, Frauenklin, Halle, Saale, Germany

[36] Stadt Krankenhaus Kiel, Kiel, Germany

[37] Onkol Bethanien, Frankfurt, Germany

[38] Univ Klinikum Schleswig Holstein Campus Kiel, Frauenklin, Kiel, Germany

[39] Novartis Pharma GmbH, Nurnberg, Germany

[40] Clin Sol GmbH, Wurzburg, Germany

[41] Krankenhaus NW Frankfurt, Klin Gynakol & Geburtshilfe, Frankfurt, Germany

[42] Evangel Huyssens Stiftung Knappschaft GmbH, Brustzentrum, Kliniken Essen Mitte, Essen, Germany

[43] St Theresien Krankenhaus, Frauenklin, Nurnberg, Germany

来源：

BREAST CARE | 2016年 / 11卷 / 05期

关键词：

Oncology; Breast cancer; Postmenopausal; Chemotherapy; Decision-making; INTERNATIONAL EXPERT CONSENSUS; RECURRENCE SCORE ASSAY; PRIMARY THERAPY; RANDOMIZED-TRIAL; HIGHLIGHTS; WOMEN; TAMOXIFEN; STRATEGIES; IMPACT; VALIDATION;

D O I：

10.1159/000452468

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Decision-making for or against neoadjuvant or adjuvant chemotherapy in postmenopausal patients with hormone receptor-positive breast cancer does not follow any clear guidelines, and some patients may unnecessarily undergo chemotherapy and be exposed to the associated toxicity. The aim of this study was to identify the patient population for whom this issue may bear relevance. Methods: Patients being treated with letrozole in the prospective multicenter noninterventional EvAluate-TM study were recruited. The percentage of patients receiving chemotherapy and factors associated with chemotherapy administration were identified. Results: In all, 3,924 (37.4%) patients received chemotherapy before treatment with letrozole. Of these, 293 (20%) underwent neoadjuvant therapy. Younger age was predictive for both adjuvant and neoadjuvant therapy. Overall, decisions in favor of administering chemotherapy are more likely to be made in patients with a higher body mass index (BMI), and neoadjuvant chemotherapy is administered at a higher rate in women with a lower BMI. Concomitant medication influenced the overall decision-making regarding chemotherapy, irrespective of whether it was given on a neoadjuvant or adjuvant basis. Conclusion: There is an ongoing debate as to whether all of the many patients who receive chemotherapy actually benefit from it. Neoadjuvant chemotherapy is frequently administered in this patient population, and this should encourage further research to resolve current clinical and research issues. (C) 2016 S. Karger GmbH, Freiburg

引用

页码：315 / 322

页数：8

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