局所再発後の化学療法は生存期間を延長する（Abstract # S3-2）

乳がんの局所または領域再発部位の外科的完全切除後の化学療法は生存率を上昇させた
Chemotherapy after complete surgical removal of local or regional breast cancer recurrence increased survival rates
術後補助化学療法は孤発性の局所または領域再発乳がん女性の無病生存率および全生存率を上昇させたとのデータが2012 CTRC-AACRサンアントニオ乳がんシンポジウムで発表された。研究者らは孤発性の局所または領域再発を有する患者162人を評価した；85人は術後補助化学療法を施行され、77人は施行されなかった。5年無病生存率は術後補助化学療法を施行された女性で69%であり、施行されなかった女性では57%であった。全生存率は化学療法を施行された患者で88%であり、施行されなかった患者では76%であった。エストロゲン受容体（ER）陰性乳がん女性において有益性が最も高く、5年無病生存率は化学療法を施行された群で67%であり、施行されなかった群では35%であった。さらに、これらの患者群においては、化学療法を施行された群の全生存率は79%であり、施行されなかった群では69%であった。ER陽性患者においては、5年無病生存率は化学療法を施行された群で70%であり施行されなかった群では69%であった。ER陽性患者全生存率は化学療法を施行された群で94%であり施行されなかった群では80%であった。
Full Text

Adjuvant chemotherapy led to higher rates of disease-free and overall survival for women with isolated local or regional recurrence of breast cancer, according to data presented at the 2012 CTRC-AACR San Antonio Breast Cancer Symposium.

Patients with isolated local and/or regional recurrence of their breast cancers are at high risk for developing metastases in other areas of the body. Some physicians administer chemotherapy to these patients after their recurrent tumors have been completely removed by surgery, but the efficacy of this treatment had not been studied until now.

"This is the first randomized controlled study that shows that adjuvant chemotherapy works in these patients," said Stefan Aebi, M.D., head of the division of medical oncology at Luzerner Kantonsspital in Luzern, Switzerland.

He and his colleagues from the Breast International Group, the National Surgical Adjuvant Breast and Bowel Project and the International Breast Cancer Study Group evaluated 162 patients with isolated local and regional recurrence; 85 received adjuvant chemotherapy and 77 did not.

Five-year disease-free survival rates were 69 percent for women who received adjuvant chemotherapy and 57 percent for those who did not. The overall survival rate was 88 percent for women who received chemotherapy compared with 76 percent for those who did not.

Women with estrogen receptor (ER)-negative breast cancer demonstrated the greatest benefit, with a five-year disease-free survival rate of 67 percent among those who received chemotherapy versus 35 percent among those who did not. In addition, within this group, overall survival rates were 79 percent among those who received chemotherapy and 69 percent among those who did not.

For patients with ER-positive disease, five-year disease-free survival was 70 percent for those who received chemotherapy versus 69 percent for those who did not. Overall survival was 94 percent for those patients with ER-positive disease who received chemotherapy versus 80 percent among those who did not.

Aebi recommended that physicians prescribe adjuvant chemotherapy for patients with isolated local and regional recurrence of breast cancer, especially if the recurrence is ER-negative and therefore not sensitive to endocrine therapy.

This research was funded by the National Cancer Institute, the Swiss Cancer League and other national cancer research agencies.