Study Of Adjuvant Intensive Treatment Regimens For Breast Cancer

Objective: Adjuvant intensive treatment options for triple-negative breast cancer(TNBC)and Luminal type early breast cancer are highly controversial.We aimed to analyze the effect of capecitabine on survival and its safety in patients with early TNBC and the study of compliance and factors influencing the 3-month dose of goserelin in the intensive endocrine treatment of early premenopausal hormone receptor-positive breast cancer.Methods: In the first part,Pub Med,Embase and other databases and conference abstracts were searched to investigate neoadjuvant chemotherapy and adjuvant chemotherapy regimens for capecitabine-based and capecitabine-free TNBC patients.The combined hazard ratio(HRs)and odds ratio(OR)methods were used to calculate disease-free survival(DFS),overall survival(OS),and grade 3 or higher adverse events.In the second part,early premenopausal hormone receptor-positive female breast cancer patients requiring 3-month doses of goserelin treatment were collected from September 2017 to December 2021 at the Affiliated Hospital of Qinghai University according to the entry row criteria,and surveyed by adherence scale with χ2 test and one-and multi-factor logistic regression analysis.Results: A total of 9 studies with 3,842 patients with TNBC were included in Part I.Overall,there was significantly improved DFS(HR = 0.75,95% Confidence interval,CI,0.65-0.86,P < 0.001)and OS(HR = 0.63,95% CI,0.53-0.77,P < 0.001)with the capecitabine combination regimen in neoadjuvant and adjuvant chemotherapy.In subgroup analysis,the addition of capecitabine in the group(HR = 0.64,95% CI,0.53-0.78,P < 0.001),adjuvant chemotherapy in the group(HR = 0.73,95% CI,0.63-0.85,P < 0.001),and lymph node positive group(HR = 0.62,95% CI,0.44-0.86,P = 0.005)had significantly improved DFS.The capecitabine regimen was positively associated with the risk of developing Diarrhea(OR = 2.88,95% CI,2.23-3.74,P < 0.001),Dermatitis(OR = 2.01,95% CI,1.53-2.64,P < 0.001),and Hand-foot syndrome(OR= 8.67,95% CI,6.70-11.22,P < 0.001).A total of 46 patients with hormone receptorpositive early-stage breast cancer were included in the second part,which showed a median follow-up age of 46 years and an overall adherence rate of 100%,with a total of 39(84.78%)fully adherent and 7(15.22%)partially adherent.The results showed that adherence in breast cancer patients was related to the level of literacy(OR = 4.584,95% CI,1.321-15.906,P = 0.016).Conclusion: Part I,meta-analysis showed that neoadjuvant and adjuvant chemotherapy combined with capecitabine significantly improved DFS and OS in patients with early-stage TNBC,and significantly improved DFS in the subgroup with the addition of capecitabine,adjuvant chemotherapy,and positive lymph nodes group.part II,Adherence to intensive endocrine therapy with a 3-month dose of goserelin in early premenopausal hormone receptor-positive breast cancer was good.Univariate analysis and logistic regression analysis showed that literacy significantly affected medication adherence in breast cancer patients.