European journal of cancer : official journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Two years of adjuvant tamoxifen in premenopausal patients with breast cancer: a randomised, controlled trial with long-term follow-up.
Adjuvant tamoxifen treatment increases recurrence-free survival (RFS) and overall survival (OS) in early breast cancer, although in premenopausal patients the number of studies comparing tamoxifen vs no treatment are limited. We report herein the effect on RFS of adjuvant tamoxifen treatment in a multicentre trial of premenopausal patients with stage II breast cancer patients randomised between 1986 and 1991 to 2 years of tamoxifen treatment (n=276) or no treatment (n=288). ⋯ Tamoxifen treatment significantly increased RFS in patients with hormone receptor-positive (oestrogen receptor-positive (ER+) and/or progesterone receptor-positive (PR+)) tumours (Relative Risk (RR) 0.65; 95% Confidence Interval (CI): 0.48-0.89, P=0.006), and the beneficial effect of tamoxifen was extended to patients with indicators of poor prognosis, such as young age and nodal-positivity. PR status was a significant predictor of response to tamoxifen in multivariate models with testing of interactions of hormone receptor status and adjuvant therapy.
-
Nausea and vomiting are considered as two of the most distressing side-effects of chemotherapy. Chemotherapy-induced nausea and vomiting have been classified into acute, delayed and anticipatory based on the time of onset. The frequency of nausea and vomiting depends primarily on the emetogenic potential of the chemotherapeutic agents used. ⋯ The addition of neurokinin receptor (NK1 receptor)-antagonists to standard therapy significantly improves emesis protection in the acute and in particular in the delayed phase by approximately 20%. Due to these new developments, revised antiemetic guidelines have been set. Here, the most recent developments in antiemetic therapy, including these guidelines, are reviewed.
-
The aim of this study was to determine the treatment preferences (adjuvant goserelin or cyclophosphamide, methotrexate and fluorouracil (CMF) chemotherapy) of healthy premenopausal women should they hypothetically develop oestrogen-receptor (ER) positive early breast cancer. Two hundred pre or peri-menopausal women read two scenarios describing goserelin or chemotherapy. Information included: How and where treatments were administered, side-effects, their likely persistence and impact on fertility. ⋯ Primary reasons for preferring goserelin for were 105 (71%) avoidance of chemotherapy side-effects, especially hair loss, perceived convenience and less disruption to normal life 54 (36%). The minority who preferred chemotherapy, valued the treatment finishing more quickly. These results together with clinical trial data showing equivalence of goserelin with CMF regimens suggest that premenopausal women with ER-positive tumours should at least be offered the choice of either adjuvant hormone therapy or chemotherapy.
-
Ovarian cancer is one of the most aggressive gynaecological malignancies and most often the high mortality is a direct result of delays in diagnosis. The development of an ovarian cancer-specific biomarker for the early detection of disease has the capacity to improve the dismal survival rate. Currently, there are multiple investigations that are utilising both genomic and proteomic technologies to identify genes, gene products and proteins that may potentially identify diagnostic ovarian cancer biomarkers. Here, we review the studies that are involved in biomarker development for the detection of ovarian cancer.
-
We examined surgery and outcome in a population-based series of 2109 women newly diagnosed with ductal carcinoma in situ (DCIS) in 1995-2000 in New South Wales (NSW), Australia. The sole data source for the study was pathology records in the NSW Cancer Registry. Most DCIS was treated with breast-conserving surgery (BCS); use of breast conservation increased throughout the 6 years of the study. ⋯ Eighteen percent of women had lymph nodes removed, most often with mastectomy. The NSW Cancer Registry does not collect information about radiotherapy. Based on cancer registrations alone, 97.7% of women were free of ipsilateral invasive cancer after three years; more women who had mastectomy were cancer-free (100%) than women who had breast-conserving surgery (97.2%; P=0.05).