https://scholars.lib.ntu.edu.tw/handle/123456789/580066
標題: | Effect of glucocorticoid use on survival in patients with stage I–III breast cancer | 作者: | CHING-HUNG LIN Chuang P.-Y. You S.-L. CHUN-JU CHIANG CHIUN-SHENG HUANG Wang M.-Y. Chao M. YEN-SHEN LU ANN-LII CHENG Tang C.-H. |
公開日期: | 2018 | 出版社: | Springer New York LLC | 卷: | 171 | 期: | 1 | 起(迄)頁: | 225-234 | 來源出版物: | Breast Cancer Research and Treatment | 摘要: | Purpose: Glucocorticoids (GCs) are commonly used in breast cancer patients to ameliorate emesis induced by chemotherapy. Some preclinical studies have suggested that systemic GCs might promote survival of estrogen receptor (ER)-negative breast cancer cells. This study aims to clarify their clinical effect on patient survival. Methods: A total of 18,596 women with newly diagnosed stage I–III breast cancer in 2002–2006 were identified from the Taiwan Cancer Database and drug treatment was examined from the Taiwan National Health Insurance Claims Database. Of these, 3989 who did not receive adjuvant chemotherapy (non-chemotherapy cohort) and 3237 patients who received six cycles of adjuvant anthracycline-based chemotherapy (anthracycline cohort) were included. The impact of GC use on survival was analyzed separately in these two cohorts using Cox proportional hazards models. Results: In the non-chemotherapy cohort, GC use was associated with aggressive clinicopathological features of breast cancer. High-dose GC was associated with shorter overall survival in univariate analysis but not in multivariate analysis. In the anthracycline cohort, multivariate analysis showed that GC use at each dose level was significantly associated with longer breast cancer-specific survival (HR 0.65, 0.70, and 0.70 for low-dose, median-dose, and high-dose GC, respectively) and overall survival (HR 0.72, 0.76, and 0.73, respectively) when compared with those receiving no GC. The associations were significant in both ER-positive and ER-negative subgroups for breast cancer-specific survival, and in ER-negative subgroup for overall survival. Conclusion: Concomitant use of GC improved survival in patients receiving adjuvant anthracycline-based chemotherapy for stage I–III breast cancer. ? 2018, Springer Science+Business Media, LLC, part of Springer Nature. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85046887848&doi=10.1007%2fs10549-018-4787-x&partnerID=40&md5=acdcfca71ce72ba97f875b70d17b4e58 https://scholars.lib.ntu.edu.tw/handle/123456789/580066 |
ISSN: | 0167-6806 | DOI: | 10.1007/s10549-018-4787-x | SDG/關鍵字: | anthracycline; glucocorticoid; antineoplastic agent; glucocorticoid; tumor marker; adjuvant therapy; adult; Article; breast cancer; cancer grading; cancer prognosis; cancer size; cancer specific survival; cancer staging; cancer survival; clinical feature; cohort analysis; controlled study; drug dose comparison; drug efficacy; drug megadose; drug use; estrogen receptor negative breast cancer; estrogen receptor positive breast cancer; female; histopathology; human; low drug dose; major clinical study; multiple cycle treatment; overall survival; priority journal; survival time; Taiwan; aged; breast tumor; cancer staging; health survey; middle aged; mortality; pathology; prognosis; treatment outcome; young adult; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Breast Neoplasms; Female; Glucocorticoids; Humans; Middle Aged; Neoplasm Staging; Prognosis; Public Health Surveillance; Taiwan; Treatment Outcome; Young Adult |
顯示於: | 醫學系 |
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