A Validation Study On Efficacy Of Individualized Treatment Software For Breast Cancer Patients Receiving Postoperative Adjuvant Chemotherapy

Objective:Breast cancer is the most common malignancy in women, early breast cancer patients preferred mastectomy. Postoperative body still might have subclinical disease, local tumor recurrence or distant metastasis also could appear, so postoperative adjuvant therapy appears particularly important. Patients with breast cancer can derive significant benefit from a multidisciplinary treatment strategy including surgery, chemotherapy, radiotherapy and endocrine therapy, in order to get the best rate of tumor control. Multidisciplinary and individualized treatment mode significantly lows the recurrence rate and reduces mortality. In fact, a number of combination chemotherapeutic regimens could be appropriate when postoperative adjuvant chemotherapy is considered. Whether or not to recommend an adjuvant treatment and how to select an appropriate treatment, mainly depend on the decision of a doctor, so there will always be subjective errors. Consequently, inadequate treatment or overtreatment always occurs. On this background, Xin-En Huang of the Department of Chemotherapy in Jiangsu Cancer Hospital and Research Institute developed individualized treatment software based on clinical and laboratory parameters to recommend postoperative chemotherapy for breast cancer patients. The aim of the present study was to validate the clinical value of the software.Methods:Patients with histologically confirmed breast cancer after mastectomy who received postoperative chemotherapy in Jiangsu Cancer Hospital and Research Institute were recruited in this study. It was considered eligible if they met the following criteria:with whole medical record, including; age at diagnosis, tumor size, histological type, number of lymph node metastasis, vascular permeation, ER/PR status, HER-2 expression and survival time. All eligible patients were divided into three groups:group A, regimen of practical chemotherapy was consistent with software predication; group B, partly consistent with software predication; group C, inconsistent with software predication. Overall survival (OS) were compared among group A,B and C to determine the efficacy of individualized treatment software.Results:From November 1992 to July 2007,310 female breast cancer patients were recruited into this study. Numbers of patients in group A, B, and C are 112,106 and 89 respectively. The survival curves between group A and B (P=0.0004), and group A and C (P=0.0046) were significantly different, with prognosis of group A better than both group B and C.Conclusion:In fact, a number of combination chemotherapeutic regimens could be appropriate when postoperative adjuvant chemotherapy is considered. Whether or not to recommend an adjuvant treatment and how to select an appropriate treatment, mainly depend on the decision of a doctor, so there will always be subjective errors. Consequently, inadequate treatment or overtreatment always occurs. Through survival analysis of 310 breast cancer patients in our study, it demonstrates that CAP can assist making an objective decision, prolonging the survival of breast cancer patients and greatly avoiding inadequate treatment or overtreatment. Our validation study confirms that individualized treatment software could provide important information on adjuvant chemotherapy for postoperative breast cancer patients, with strong clinical value.