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KMID : 0939920160480041351
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대한암학회지
2016 Volume.48 No. 4 p.1351 ~ p.1362
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Survival Outcome of Combined GnRH Agonist and Tamoxifen Is Comparable to That of Sequential Adriamycin and Cyclophosphamide Chemotherapy Plus Tamoxifen in Premenopausal Patients with Lymph-Node?Negative, Hormone-Responsive, HER2-Negative, T1-T2 Breast Cancer
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Sohn Gui-Yun
Ahn Sei-Hyun
Kim Hee-Jeong
Son Byung-Ho
Lee Jong-Won
Ko Beom-Seok
Lee Yu-Ra
Lee Sae-Byul
Baek Seung-Hee
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Abstract
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Purpose : The purpose of this study was to compare treatment outcomes between combined gonadotropin-releasing hormone agonist and tamoxifen (GnRHa+T) and sequential adriamycin and cyclophosphamide chemotherapy and tamoxifen (AC->T) in premenopausal patients with hormone-responsive, lymph-node?negative breast cancer.
Materials and Methods : In total, 994 premenopausal women with T1-T2, lymph-node?negative, hormone-receptor-positive, HER2-negative breast cancer between January 2003 and December 2008 were included in this retrospective cohort study. GnRHa+T and AC->T were administered to 608 patients (61.2%) and 386 patients (38.8%), respectively. Propensity score matching and inverse probability weighting were applied to the original cohort, and 260 patients for each treatment arm were included in the final analysis. Recurrence-free, cancer-specific, and overall survival was compared between the two treatment groups.
Results : A total of 994 patients were followed up for a median of 7.4 years (range, 0.5 to 11.4 years). The 5-year follow-up rate was 98.7%, and 13 patients were lost to follow-up. In propensity-matched cohorts (n=520), there was no difference in recurrence-free, cancer-specific, and overall survival rates between the two treatment groups (p=0.306, p=0.212, and p=0.102, respectively), and this was maintained after applying inverse probability weighting.
Conclusion : GnRHa+T is a reasonable alternative to AC->T in patients with premenopausal, hormone-responsive, HER2-negative, lymph-node?negative, T1-T2 breast cancer.
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KEYWORD
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Breast neoplasms, Premenopause, Chemotherapy, Drug therapy, Tamoxifen
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