Meme kanserinin adjuvan tedavisinde taksanların rolünün araştırılması
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Date
2011
Authors
Şahin, Serkan
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Meme kanseri dünyada kadınlar arasında en sık görülen tümör olup, kadınlarda görülen kanserlerin yaklaşık %30' unu oluşturmaktadır. Meme kanseri tedavisinde taksanlı bileşiklerin kullanılması sayesinde hastaların sağkalım süreleri uzamıştır.Bu çalışmada, Uludağ Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Bölümü'nde Ocak 2003 ile Aralık 2008 yılları arasında takip edilen adjuvan kemoterapi alan 236 meme kanserli hasta retrospektif olarak incelendi. Hastaların 151 tanesine 5-Florourasil, Epirubisin, Siklofosfamid oluşan kemoterapi (FEC 100 rejimi ) ve 85 tanesine taksanlı rejim kemoterapisi verilmişti. Hastalarda yaş, menapoz durumu, operasyon tipi, tümör patolojisi, tümör, nod, metastaz, hormon reseptörleri ve HER-2 durumu, radyoterapi ve hormonoterapi alıp almadığı, nüks ve ölüm durumu gibi faktörler incelendi. FEC alan 151 hasta ve taksanlı rejim alan 85 hasta 5 yıllık hastalıksız sağkalım (HSK) ve 5 yıllık genel sağkalım (GSK) açısından değerlendirildi.FEC grubunda medyan yaş 53 (en küçük 27 en büyük 77) ve ortalama takip süresi 5,4 yıldı. Taksan grubunda medyan yaş 55 ( en küçük 29 en büyük 82) ve ortalama takip süresi 4,6 yıldı.Menapozda olmak veya menapozda olmamak FEC ve Taksan rejimleri için anlamlı bulunmadı.Hormon reseptör pozitif olmak veya hormon reseptör negatif olmak FEC ve taksan rejimleri için istetistiksel anlamlı bulunmadı.FEC grubunda HER-2 pozitif veya negatif hastalar ile taksan grubunda HER-2 pozitif veya negatif hastalar kıyaslandı. HSK ve GSK farkı istatiksel olarak saptanmadı.FEC ve Taksan grubunun lenf nodu tutulumlarına göre karşılaştırılmasında HSK ve GSK farkı istatiksel olarak saptanmadı.FEC grubu evre 1 hastalar ile taksan grubu evre 1 hastalar, FEC grubu evre 2 hastalar ile taksan grubu evre 2 hastalar, FEC grubu evre 3 hastalar ile taksan grubu evre 3 hastalar kıyaslandı. HSK ve GSK farkı istatiksel olarak saptanmadı. Evre 3 hasta grubundan HER-2 negatifleri kıyaslamamızda taksan lehine istatistiki anlam oluştu.Sonuç olarak 151 FEC hastası ve 85 taksan hastasında değişkenlere göre yapılan 5 yıllık HSK ve GSK arasında evre 3 ve HER-2 negatif hastalar dışında anlamlı fark saptanmadı. HER-2 negatifliği antrasiklin tedavisi için olumsuz faktör olarak bulundu.Günümüzde erken evre meme kanseri tedavisinde taksanlı rejimler veya antrasiklin bileşiklerinin kullanımı hala tartışılmaktadır. Meme kanserinde genomik çalışmaların artması ve bireye özgü tedavi modalitelerinin gelişimi ile bu sorulara daha net cevap verebileceğimiz aşikardır.
Breast cancer is the most common type of tumor present in women and, it is 30% of all cancer types of women, approximately.Using compounds with taxane for breast cancer treatment, survival levels of patients have increased.In this trial, 236 patients with breast cancer recieving adjuvant chemotherapy observed between 2003 January-2008 December has been investigated retrospectively at Uludag University Medical Faculty,Department of Medical Onchology.151 patients were given chemotherapy of 5-fluorouracil,Epirubicin,Cyclophosphamide(FEC 100 regimen) and 85 patients were given taxane containing regimen.Age,menapausal status,type of operation,tumor pathology,tumor,node,metastasis,hormonal receptors and HER-2 status,recurrency,death and radiotherapy or/and hormonotherapy exposure were kind of factors investigated.151 patients taking FEC and 85 patients with taxane containing regimen were evaluated by 5 years of disease free survival(DFS) and 5 years of overall survival(OS).In FEC group, median age was 53(youngest 27 and oldest 77) and average observation interval was 5,4 years.In taxane group,median age was 55(youngest 29 and oldest 82) and average observation interval was 4,6 years.Being in menopausal term or not was not considered significant for both FEC and Taxane regimens.Having positive or negative hormonal receptor status was not considered statistically significant for both FEC and Taxane regimens.HER-2 positive or negative patients in FEC group and HER-2 positive or negative patients in Taxane group were compared. The difference between DFS and OS was not statistically determined.Involvement of lymph nodes status of FEC and Taxane groups were compared and the difference between DFS and OS was not statistically determined.Stage 1 patients in FEC group and stage 1 patients in Taxane group,stage 2 patients in FEC group and stage 2 patients in Taxane group,stage 3 patients in FEC group and stage 3 patients in Taxane group were compared.The difference between DFS and OS was not statistically determined.Comparison of HER-2 negative patients in stage 3 group were statistically significant in favor of taxanes.Consequently,considering the variables in 151 patients of FEC group and 85 patients of Taxane group, the difference between 5 years of DFS and OS was not significant except stage 3 and HER-2 negative patients.HER-2 negativity fas found an unfavorable factor for anthracycline treatment.At present,using taxane regimens or anthracycline compounds for early breast cancer treatment is still being discussed.Obviously,we will have better answers with the raise in genomic trials for breast cancer and the treatment modalities specific to the individuals.
Breast cancer is the most common type of tumor present in women and, it is 30% of all cancer types of women, approximately.Using compounds with taxane for breast cancer treatment, survival levels of patients have increased.In this trial, 236 patients with breast cancer recieving adjuvant chemotherapy observed between 2003 January-2008 December has been investigated retrospectively at Uludag University Medical Faculty,Department of Medical Onchology.151 patients were given chemotherapy of 5-fluorouracil,Epirubicin,Cyclophosphamide(FEC 100 regimen) and 85 patients were given taxane containing regimen.Age,menapausal status,type of operation,tumor pathology,tumor,node,metastasis,hormonal receptors and HER-2 status,recurrency,death and radiotherapy or/and hormonotherapy exposure were kind of factors investigated.151 patients taking FEC and 85 patients with taxane containing regimen were evaluated by 5 years of disease free survival(DFS) and 5 years of overall survival(OS).In FEC group, median age was 53(youngest 27 and oldest 77) and average observation interval was 5,4 years.In taxane group,median age was 55(youngest 29 and oldest 82) and average observation interval was 4,6 years.Being in menopausal term or not was not considered significant for both FEC and Taxane regimens.Having positive or negative hormonal receptor status was not considered statistically significant for both FEC and Taxane regimens.HER-2 positive or negative patients in FEC group and HER-2 positive or negative patients in Taxane group were compared. The difference between DFS and OS was not statistically determined.Involvement of lymph nodes status of FEC and Taxane groups were compared and the difference between DFS and OS was not statistically determined.Stage 1 patients in FEC group and stage 1 patients in Taxane group,stage 2 patients in FEC group and stage 2 patients in Taxane group,stage 3 patients in FEC group and stage 3 patients in Taxane group were compared.The difference between DFS and OS was not statistically determined.Comparison of HER-2 negative patients in stage 3 group were statistically significant in favor of taxanes.Consequently,considering the variables in 151 patients of FEC group and 85 patients of Taxane group, the difference between 5 years of DFS and OS was not significant except stage 3 and HER-2 negative patients.HER-2 negativity fas found an unfavorable factor for anthracycline treatment.At present,using taxane regimens or anthracycline compounds for early breast cancer treatment is still being discussed.Obviously,we will have better answers with the raise in genomic trials for breast cancer and the treatment modalities specific to the individuals.
Description
Keywords
Meme kanseri, Paklitaksel kemoterapisi, Dosetaksel kemoterapisi, Breast cancer, Chemotherapy paclitaxel, Chemotherapy, Docetaxel
Citation
Şahin, S. (2011). Meme kanserinin adjuvan tedavisinde taksanların rolünün araştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.