Benefit Analysis Of Prolonged Endocrine Drugs In The Treatment Of Hormone Receptor Positive Early Breast Cancer:Meta Analysis

Objective: To investigate whether prolonged adjuvant endocrine therapy can improve the prognosis of early breast cancer patients with hormone receptor positive.Provide reference for clinical treatment programs.Methods: Comprehensive and systematic search of English words in English database,Chinese search terms in Chinese database to clinical studies and reports published before May 2018.Then Literature was selected strictly according to the selection criteria and relevant data were extracted.And the RevMan 5.3 software meta-analysis was used to provide by the Cochrane network.Results: A total of 13 randomized controlled trials involving 32280 patients were included.Meta-analysis results showed that the patients prolonged endocrine therapy did not benefit from total survival OS(HR=0.97,95% CI 0.88-1.07;P=0.54).On the other hand,prolonged endocrine therapy can improve disease-free survival(HR=0.81,95% CI 0.72-0.92;P=0.0008)and breast cancer-specific survival(HR=0.87,95% CI 0.79-0.96;P=0.004)of the early breast cancer patients.Subgroup analysis,prolonged tamoxifen group in total survival OS(HR=1.01,95%CI 0.86-1.17;P=0.93),disease-free survival DFS(HR=0.98,95% CI 0.81-1.17;P=0.80 There are no benefit,there is benefit in breast cancer-specific survival BCSS(HR=0.88,95% CI 0.80-0.97;P=0.008);Prolonged aromatase inhibitor group did not benefit from total survival OS(HR=0.96,95% CI 0.84-1.09;P=0.53),breast cancer-specific survival BCSS(HR=0.62,95% CI 0.36-1.07;P=0.08),and benefited from disease-free survival DFS(HR=0.74,95% CI 0.66-0.83;P<0.00001)Lymph node-positive patients,prolonged endocrine therapy to benefit from disease-free survival.However,prolonged endocrine therapy could increase endometrial cancer events(OR=1.92,95% CI 1.44-2.57;P<0.00001)and bone related events(OR=1.60,95% CI 1.35-1.90;P<0.00001)at same time..Conclusion: Prolonged endocrine therapy can benefit early breast cancer patients with hormone receptor-positive,but will also increase the incidence ofendometrial cancer and bone related events.