Effects Of Adjuvant Chemotherapy Including Paclitaxel For Operable Breast Cancer On Disease Free Survival

Background:Breast cancer is the most common malignant tumor for the women. There are 1.3 million newly cases in the world every year and 4 million women die of breast cancer. The incidence of breast cancer has been a rising tendency, and age of onset has been descending year by year for the past few years. But the mortality of breast cancer has been descending since 1990s.It has been considered to the development of combined modality therapy, especially for the adjuvant chemotherapy, in addition to the early diagnosis. Breast cancer is a systemic disease, it may exist micro-metastasis which can not been detected, and a part of postoperative patients still appear to recurrence and metastasis. So the aim of breast cancer is com-bined modality therapy of the early breast cancer, and adjuvant chemo-therapy plays an important role. The aim of adjuvant chemotherapy is to annihilation the micro-metastasis and remainder. EBCTCG meta-analysis show adjuvant chemotherapy can cut down the recurrence and extend life span of breast cancer. Along with the appearance of paclitaxel, the effect of adjuvant chemotherapy in breast cancer has been improved.Objective:To investigate the effects of adjuvant chemotherapy including paclitaxel for breast cancer of theⅡstage on disease free survi-val.Methods:From January 2004 to January 2009,202 cases of posto-perative breast cancer were followed up, and the relationship between clinical feature,hormone receptor,regimen and recurrent metastatic rate, disease free survival were analyzed retrospectively. Result:1. Following up to March 2010,the total recurrent metastatic rate is 21.3%(43/202), the median disease free survival is 538 days. For the patients received anthracycline-based combinations or pulsed paclitaxel, the recurrent metastatic rate is 29.4% and 13% respectively, (P=0.004) The mean disease free survival of the two groups is 542 days and 699 days.2. In women who had hormone-receptor-poor, or were either younger than 50 years or older than 50 years, the regimen including paclitaxel produces substantial and definite reductions in the risks of recurrence. And the reductions are also significant among women weather having menopause or not.. But the ER-positive and/or PR-positive breast cancer is opposite.3. In women who are TNMⅢ, the regimen including paclitaxel produces substantial and definite reductions in the risks of recurrence (23.1% versus 56%).The reduction on disease free survival has no statistical significance.4. The regimen which paclitaxel sequenting produces substantial and definite reductions in the risks of recurrence(P< 0.001).But it is not benefit for the patient who received the regimen of TA,so analyzed furtherly, the risks of recurrence on the breast cancer of TNM III can reduce significantly。5. Compared to anthracycline-based combinations, the regimen including paclitaxel produces substantial and definite reductions in the risks of recurrence weather plus paclitaxel or docetaxel.Conclusion:1. The regimen including paclitaxel produces substantial and definite reductions in the risks of recurrence.These benefits appeare to be largely irrespective of age, menopausal status and the kind of medicine.2. In women who had hormone-receptor-poor, the regimen including paclitaxel produces substantial and definite reductions in the risks of recurrence.In contrast, In women who had hormone-receptor-positive, these benefits do not appeared significantly. The study shows effects of adjuvant chemotherapy relate to the hormone-receptor statues.3. The regimen which paclitaxel sequenting produces substantial and definite reductions in the risks of recurrence(P<0.001).But it is not benefit for the patient who received the regimen of TA,so analyzed further, the risks of recurrence on the breast cancer of TNMⅢcan reduce signi-ficantly.Then the date shows the breast cancer with high risk of recurrence can benefit from adjuvant chemotherapy including paclitaxel.4. Compared to anthracycline-based combinations, the regimen including paclitaxel produces substantial and definite reductions in the risks of recurrence weather plus paclitaxel or docetaxel.