Medicinos teorija ir praktika 2016 m. 22 tomas Nr. 5
EXCLUSIVELY ORAL CONCURRENT CHEMO ENDOCRINE THERAPY IN PATIENTS WITH RECURRENT BREAST CANCER
Juliana Timovskaja, Oleksij Zotovas, Mykola Anikusko
Correspondence Address: email@example.com
Key words: recurrent breast cancer, palliative therapy, cytostatic therapy, chemoendocrine therapy, therapy with tegafur, anastrozole.
Aim of the study was to compare the effectiveness of different regimes of palliative therapy using tablet forms of drugs in patients with hormon-dependant Her-2/neu negative recurrent breast cancer who were randomised to three groups and treated exclusively with tablet forms of drugs form of drugs. The first group (A) of patients got palliative endocrine therapy with aromatase inhibitor anastrozole 1 mg daily. For one course of the therapy in this group of patients considered time period of 21 days. The second group (C+Ca) included patients in whom therapy is intended the combinations of capesetabine (2500 mg/m2 daily from 8th to 21th day) with cyclophosphamide (100 mg daily from 1st to 14th days 21-days cycle of therapy). The third group (T+A) included patients assigned to therapy with tegafur (1 200–1 600 mg a day from the 1st to 14th days of 21-days cycle of therapy) in combination with a daily intake of 1mg anastrozole – concurrent chemoendocrine therapy. In whom therapy was intended the combination of capecitabine (2 500 mg/m2 daily from 8th to 21th day) with cyclophosphamide (100mg daily from 1st to 14th days 21-days cycle of therapy). The third group (T+A) included patients assigned to
therapy with tegafur (1 200–1 600 mg a day from the 1st to 14th days of 21-days cycle of therapy) in combination with a daily intake of 1mg anastrozole – concurrent chemoendocrine therapy. We determined duration of progression free period - the time from start of the treatment in the study to detect the first sign of tumor progression against the background of cytostatic therapy (the method of Kaplan-Meier) and toxic manifestation of the therapy. The average duration of progression-free period in patients receiving tegafur concurrently with anastrozole (15,3 ± 2,1 months) was longer than the corresponding figure in group of patients taking mono endocrine therapy with anastrozole (9,4 ± 1,1 months) or combine tablet forms of cytostatics with cyclophosphamide and capecitabine (10,0 ± 1,2 months). Disease-free survival determined by Kaplan-Meier was higher in group of patients treated with tegafur combined with anastrazole
chemoendocrine therapy, compared with patients receiving anastrozole therapy alone or combination capecitabine with cyclophosphamide (p < 0.005). The frequency of adverse events in patients who received different types of palliative therapy using tablet forms of drugs forms of drugs was almost the same. There were toxic manifestation I and II grades of toxicity. The palliative concurrent chemoendocrinetherapy can be considered as an option choice therapy in patients with hormone-dependant Her-2/neu negative recurrent BC through adequate efficacy, favorable toxicity profile and the possibility of long-term outpatient use.
June 16, 2016 Accepted:
November 25, 2016