内容紹介
A Retrospective Study of Tegafur/Uracil Compared with Cyclophosphamide, Methotrexate, and Fluorouracil as Adjuvant Chemotherapy in Patients with Node-Negative, Triple-Negative Breast Cancer
Summary
Japanese clinical trials of a tegafur/uracil(UFT)-based postoperative chemotherapy regimen compared with cyclophosphamide, methotrexate, and fluorouracil(CMF)treatment have shown that UFT is not inferior to CMF for the treatment of hormone receptor-positive breast cancer patients. However, the usefulness of UFT for hormone receptor-negative breast cancer, including the triple-negative subtype(hormone receptor-negative, human epidermal growth factor receptor 2[HER2]-negative), is unknown. The aim of this retrospective study was to examine the effectiveness of postoperative, adjuvant UFT compared to CMF when these regimens were given to women with node-negative, triple-negative breast cancer. We analyzed 50 women with node-negative, triple-negative breast cancer who were treated with six cycles of CMF(n=33)or two years of UFT(n=17)after surgery between January 2000 and December 2010. Although no significant differences were observed in relapse-free survival or overall survival in all patients, subset analysis of tumors of larger size(t2), higher nuclear grade(NG3), and with positivity for lymphovascular invasion showed that UFT was inferior to CMF. These results encourage caution regarding the choice of adjuvant UFT for node-negative, triple-negative breast cancer.
要旨
乳癌術後補助療法としてのtegafur/uracil(UFT)はcyclophosphamide/methotrexate/fluorouracil(CMF)レジメンに対し,ホルモン陽性乳癌に限り非劣勢が示されているが,トリプルネガティブ(TN)乳癌を含めたホルモン陰性乳癌での効果は結論がでていない。今回,リンパ節転移陰性(N0)TN乳癌に対するCMFとUFTの効果についてレトロスペクティブに比較検討を行った。症例は2000年1月～2010年12月までに当院にて手術を施行したN0のTN乳癌50例で,CMF施行群33例,UFT内服群が17例であった。全症例では統計的有意差はみられないものの,t2症例,核grade 3および脈管侵襲ありに限った場合,UFT群では無再発生存において予後不良であった。N0のTN乳癌に限定した場合では,UFT内服による術後補助療法はCMFと比較し再発予防効果が劣る可能性が示唆され,今後さらなる検討が必要である。
目次
Summary
Japanese clinical trials of a tegafur/uracil(UFT)-based postoperative chemotherapy regimen compared with cyclophosphamide, methotrexate, and fluorouracil(CMF)treatment have shown that UFT is not inferior to CMF for the treatment of hormone receptor-positive breast cancer patients. However, the usefulness of UFT for hormone receptor-negative breast cancer, including the triple-negative subtype(hormone receptor-negative, human epidermal growth factor receptor 2[HER2]-negative), is unknown. The aim of this retrospective study was to examine the effectiveness of postoperative, adjuvant UFT compared to CMF when these regimens were given to women with node-negative, triple-negative breast cancer. We analyzed 50 women with node-negative, triple-negative breast cancer who were treated with six cycles of CMF(n=33)or two years of UFT(n=17)after surgery between January 2000 and December 2010. Although no significant differences were observed in relapse-free survival or overall survival in all patients, subset analysis of tumors of larger size(t2), higher nuclear grade(NG3), and with positivity for lymphovascular invasion showed that UFT was inferior to CMF. These results encourage caution regarding the choice of adjuvant UFT for node-negative, triple-negative breast cancer.
要旨
乳癌術後補助療法としてのtegafur/uracil(UFT)はcyclophosphamide/methotrexate/fluorouracil(CMF)レジメンに対し,ホルモン陽性乳癌に限り非劣勢が示されているが,トリプルネガティブ(TN)乳癌を含めたホルモン陰性乳癌での効果は結論がでていない。今回,リンパ節転移陰性(N0)TN乳癌に対するCMFとUFTの効果についてレトロスペクティブに比較検討を行った。症例は2000年1月～2010年12月までに当院にて手術を施行したN0のTN乳癌50例で,CMF施行群33例,UFT内服群が17例であった。全症例では統計的有意差はみられないものの,t2症例,核grade 3および脈管侵襲ありに限った場合,UFT群では無再発生存において予後不良であった。N0のTN乳癌に限定した場合では,UFT内服による術後補助療法はCMFと比較し再発予防効果が劣る可能性が示唆され,今後さらなる検討が必要である。