TY - JOUR
T1 - Adjuvant chemotherapy followed by goserelin compared with either modality alone
T2 - The impact on amenorrhea, hot flashes, and quality of life in premenopausal patients - The international breast cancer study group trial VIII
AU - Bernhard, Jürg
AU - Zahrieh, David
AU - Castiglione-Gertsch, Monica
AU - Hürny, Christoph
AU - Gelber, Richard D.
AU - Forbes, John F.
AU - Murray, Elizabeth
AU - Collins, John
AU - Aebi, Stefan
AU - Thürlimann, Beat
AU - Price, Karen N.
AU - Goldhirsch, Aron
AU - Coates, Alan S.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2007/1/20
Y1 - 2007/1/20
N2 - Purpose: The purpose of this article is to compare quality of life (QOL) and menopausal symptoms among premenopausal patients with lymph node-negative breast cancer receiving chemotherapy, goserelin, or their sequential combination, and to investigate differential effects by age. Patients and Methods: We evaluated QOL data from 874 pre- and perimenopausal women with lymph node-negative breast cancer who were randomly assigned to receive six courses of classical cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy, ovarian suppression with goserelin for 24 months, or six courses of classical CMF followed by 18 months of goserelin. We report QOL data collected during 3 years after random assignment in patients without disease recurrence. Results: Overall, patients receiving goserelin alone showed a marked improvement or less deterioration in QOL measures over the first 6 months than those patients treated with CMF. There were no differences at 3 years after random assignment according to treatment except for hot flashes. As reflected in the hot flashes scores, patients in all three treatment groups experienced induced amenorrhea, but the onset of ovarian function suppression was slightly delayed for patients receiving chemotherapy. Younger patients (< 40 years) who received goserelin alone returned to their premenopausal status at 6 months after the cessation of therapy, while those who received CMF showed marginal changes from their baseline hot flashes scores. Conclusion: Age-adjusted risk profiles that consider patient-reported outcomes enable patients to adapt to their disease and treatment, such as considering the trade-offs between delayed endocrine symptoms, but higher risk of permanent menopause with chemotherapy, and immediate but reversible endocrine symptoms with goserelin, in younger premenopausal patients.
AB - Purpose: The purpose of this article is to compare quality of life (QOL) and menopausal symptoms among premenopausal patients with lymph node-negative breast cancer receiving chemotherapy, goserelin, or their sequential combination, and to investigate differential effects by age. Patients and Methods: We evaluated QOL data from 874 pre- and perimenopausal women with lymph node-negative breast cancer who were randomly assigned to receive six courses of classical cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy, ovarian suppression with goserelin for 24 months, or six courses of classical CMF followed by 18 months of goserelin. We report QOL data collected during 3 years after random assignment in patients without disease recurrence. Results: Overall, patients receiving goserelin alone showed a marked improvement or less deterioration in QOL measures over the first 6 months than those patients treated with CMF. There were no differences at 3 years after random assignment according to treatment except for hot flashes. As reflected in the hot flashes scores, patients in all three treatment groups experienced induced amenorrhea, but the onset of ovarian function suppression was slightly delayed for patients receiving chemotherapy. Younger patients (< 40 years) who received goserelin alone returned to their premenopausal status at 6 months after the cessation of therapy, while those who received CMF showed marginal changes from their baseline hot flashes scores. Conclusion: Age-adjusted risk profiles that consider patient-reported outcomes enable patients to adapt to their disease and treatment, such as considering the trade-offs between delayed endocrine symptoms, but higher risk of permanent menopause with chemotherapy, and immediate but reversible endocrine symptoms with goserelin, in younger premenopausal patients.
UR - http://www.scopus.com/inward/record.url?scp=33846903312&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33846903312&partnerID=8YFLogxK
U2 - 10.1200/JCO.2005.04.5393
DO - 10.1200/JCO.2005.04.5393
M3 - Article
C2 - 17159194
AN - SCOPUS:33846903312
SN - 0732-183X
VL - 25
SP - 263
EP - 270
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 3
ER -