Discussion:Arlon/09-0120508
De Wicri Luxembourg
<record>
<inist h6="B">
<pA>
<fA01 i1="01" i2="1">
<s0>0732-183X</s0>
</fA01>
<fA03 i2="1">
<s0>J. clin. oncol.</s0>
</fA03>
<fA05>
<s2>27</s2>
</fA05>
<fA06>
<s2>5</s2>
</fA06>
<fA08 i1="01" i2="1" l="ENG">
<s1>Long-Term Benefit of High-Dose Epirubicin in Adjuvant Chemotherapy for Node-Positive Breast Cancer : 15-Year Efficacy Results of the Belgian Multicentre Study</s1>
</fA08>
<fA11 i1="01" i2="1">
<s1>DEAZAMBUJA (Evandro)</s1>
</fA11>
<fA11 i1="02" i2="1">
<s1>PAESMANS (Marianne)</s1>
</fA11>
<fA11 i1="03" i2="1">
<s1>BEAUDUIN (Marc)</s1>
</fA11>
<fA11 i1="04" i2="1">
<s1>VINDEVOGHEL (Anita)</s1>
</fA11>
<fA11 i1="05" i2="1">
<s1>CORNEZ (Nathalie)</s1>
</fA11>
<fA11 i1="06" i2="1">
<s1>FINET (Claude)</s1>
</fA11>
<fA11 i1="07" i2="1">
<s1>RIES (Fernand)</s1>
</fA11>
<fA11 i1="08" i2="1">
<s1>CLOSON-DEJARDIN (Marie Thérèse)</s1>
</fA11>
<fA11 i1="09" i2="1">
<s1>KERGER (Joseph)</s1>
</fA11>
<fA11 i1="10" i2="1">
<s1>GOBERT (Philippe)</s1>
</fA11>
<fA11 i1="11" i2="1">
<s1>FOCAN (Christian)</s1>
</fA11>
<fA11 i1="12" i2="1">
<s1>TAGNON (Alain)</s1>
</fA11>
<fA11 i1="13" i2="1">
<s1>DOLCI (Stella)</s1>
</fA11>
<fA11 i1="14" i2="1">
<s1>NOGARET (Jean M.)</s1>
</fA11>
<fA11 i1="15" i2="1">
<s1>DI LEO (Angela)</s1>
</fA11>
<fA11 i1="16" i2="1">
<s1>PICCART-GEBHART (Martine J.)</s1>
</fA11>
<fA14 i1="01">
<s1>Institut Jules Bordet and Université Libre de Bruxelles</s1>
<s2>Brussels</s2>
<s3>BEL</s3>
</fA14>
<fA14 i1="02">
<s1>Hopital de Jolimont-Lobbes</s1>
<s3>BEL</s3>
</fA14>
<fA14 i1="03">
<s1>Centre Hospitalier Universitaire de Tivoli</s1>
<s2>La Louvière</s2>
<s3>BEL</s3>
</fA14>
<fA14 i1="04">
<s1>Clinique Sainte Elisabeth</s1>
<s2>Namur</s2>
<s3>BEL</s3>
</fA14>
<fA14 i1="05">
<s1>Hôpital de Braine L'Alleud</s1>
<s2>Waterloo</s2>
<s3>BEL</s3>
</fA14>
<fA14 i1="06">
<s1>Centre Hospitalier Universitaire de Liège</s1>
<s3>FRA</s3>
</fA14>
<fA14 i1="07">
<s1>Centre Hospitalier Chrétien</s1>
<s2>Liège</s2>
<s3>BEL</s3>
</fA14>
<fA14 i1="08">
<s1>Service d'Oncologie, Cliniques Universitaires Université Catholique de Louvain</s1>
<s2>Godinne</s2>
<s3>BEL</s3>
</fA14>
<fA14 i1="09">
<s1>Clinique Saint-Joseph</s1>
<s2>Arlon</s2>
<s3>BEL</s3>
</fA14>
<fA14 i1="10">
<s1>Réseau Hospitalier de Médecine Sociale</s1>
<s2>Tournai</s2>
<s3>BEL</s3>
</fA14>
<fA14 i1="11">
<s1>Programa de Pós-graduação em Medicina: Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul</s1>
<s2>Porto Alegre</s2>
<s3>BRA</s3>
</fA14>
<fA14 i1="12">
<s1>Centre Hospitalier de Luxembourg</s1>
<s3>LUX</s3>
</fA14>
<fA14 i1="13">
<s1>Hospital of Prato</s1>
<s2>Prato</s2>
<s3>ITA</s3>
</fA14>
<fA20>
<s1>720-725</s1>
</fA20>
<fA21>
<s1>2009</s1>
</fA21>
<fA23 i1="01">
<s0>ENG</s0>
</fA23>
<fA43 i1="01">
<s1>INIST</s1>
<s2>20094</s2>
<s5>354000185427620120</s5>
</fA43>
<fA44>
<s0>0000</s0>
<s1>© 2009 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45>
<s0>22 ref.</s0>
</fA45>
<fA47 i1="01" i2="1">
<s0>09-0120508</s0>
</fA47>
<fA60>
<s1>P</s1>
</fA60>
<fA61>
<s0>A</s0>
</fA61>
<fA64 i1="01" i2="1">
<s0>Journal of clinical oncology</s0>
</fA64>
<fA66 i1="01">
<s0>USA</s0>
</fA66>
<fC01 i1="01" l="ENG">
<s0>Purpose The 4-year results of this trial demonstrated that a higher dose of epirubicin with cyclophosphamide (HEC) is superior to a lower dose of epirubicin, 60 mg/m<sup>2</sup>(EC), for event-free survival (EFS; 27% reduction), but is not superior to classical oral cyclophosphamide, methotrexate, and fluorouracil (CMF) in the adjuvant treatment of node-positive breast cancer. Herein we report the 15-year data on efficacy and long-term toxicity of this three-arm Belgian multi-center trial. Patients and Methods Between March 1988 and December 1996, 777 eligible patients were randomly assigned to six cycles of CMF, eight cycles of EC, or eight cycles HEC. Results The 15-year EFS was 45% for patients who received CMF, 39% for patients who received EC, and 50% for patients who received HEC. The hazard ratios (HR) were 0.77 for HEC versus EC (95% Cl, 0.60 to 0.98; P = .03), 0.90 for HEC versus CMF (P = .39), and 0.86 for EC versus CMF (P = .21). No difference in overall survival (OS) was seen. Cardiac toxicity was more frequent with HEC than with CMF (11 patients v 1 patient; P = .006), but no more than with EC (P = .21). Conclusion Treatment with HEC demonstrated superior EFS when compared with lower-dose epirubicin. However, we do not recommend the use of HEC regimen in daily clinical practice, mainly because of the higher risk of cardiotoxicity related to the cumulative doses of epirubicin and the lack of superiority of anthracyclines over CMF in our study.</s0>
</fC01>
<fC02 i1="01" i2="X">
<s0>002B04</s0>
</fC02>
<fC02 i1="02" i2="X">
<s0>002B20E02</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE">
<s0>Epirubicine</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG">
<s0>Epirubicin</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA">
<s0>Epirubicina</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE">
<s0>Long terme</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG">
<s0>Long term</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA">
<s0>Largo plazo</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE">
<s0>Dose forte</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG">
<s0>High dose</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA">
<s0>Dosis fuerte</s0>
<s5>03</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE">
<s0>Cancer du sein</s0>
<s2>NM</s2>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG">
<s0>Breast cancer</s0>
<s2>NM</s2>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA">
<s0>Cáncer del pecho</s0>
<s2>NM</s2>
<s5>04</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE">
<s0>Traitement adjuvant</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG">
<s0>Adjuvant treatment</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA">
<s0>Tratamiento adyuvante</s0>
<s5>05</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE">
<s0>Efficacité traitement</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG">
<s0>Treatment efficiency</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA">
<s0>Eficacia tratamiento</s0>
<s5>06</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE">
<s0>Chimiothérapie</s0>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG">
<s0>Chemotherapy</s0>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA">
<s0>Quimioterapia</s0>
<s5>07</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE">
<s0>Belgique</s0>
<s2>NG</s2>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG">
<s0>Belgium</s0>
<s2>NG</s2>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA">
<s0>Belgica</s0>
<s2>NG</s2>
<s5>08</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE">
<s0>Cancérologie</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG">
<s0>Cancerology</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA">
<s0>Cancerología</s0>
<s5>09</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE">
<s0>Anticancéreux</s0>
<s5>25</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG">
<s0>Antineoplastic agent</s0>
<s5>25</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA">
<s0>Anticanceroso</s0>
<s5>25</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE">
<s0>Traitement</s0>
</fC07>
<fC07 i1="01" i2="X" l="ENG">
<s0>Treatment</s0>
</fC07>
<fC07 i1="01" i2="X" l="SPA">
<s0>Tratamiento</s0>
</fC07>
<fC07 i1="02" i2="X" l="FRE">
<s0>Europe</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="02" i2="X" l="ENG">
<s0>Europe</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="02" i2="X" l="SPA">
<s0>Europa</s0>
<s2>NG</s2>
</fC07>
<fC07 i1="03" i2="X" l="FRE">
<s0>Anthracyclines</s0>
<s5>37</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG">
<s0>Anthracyclins</s0>
<s5>37</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA">
<s0>Antraciclinas</s0>
<s5>37</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE">
<s0>Tumeur maligne</s0>
<s2>NM</s2>
<s5>38</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG">
<s0>Malignant tumor</s0>
<s2>NM</s2>
<s5>38</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA">
<s0>Tumor maligno</s0>
<s2>NM</s2>
<s5>38</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE">
<s0>Cancer</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="05" i2="X" l="ENG">
<s0>Cancer</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="05" i2="X" l="SPA">
<s0>Cáncer</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="06" i2="X" l="FRE">
<s0>Pathologie de la glande mammaire</s0>
<s2>NM</s2>
<s5>39</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG">
<s0>Mammary gland diseases</s0>
<s2>NM</s2>
<s5>39</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA">
<s0>Glándula mamaria patología</s0>
<s2>NM</s2>
<s5>39</s5>
</fC07>
<fC07 i1="07" i2="X" l="FRE">
<s0>Pathologie du sein</s0>
<s2>NM</s2>
<s5>40</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG">
<s0>Breast disease</s0>
<s2>NM</s2>
<s5>40</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA">
<s0>Seno patología</s0>
<s2>NM</s2>
<s5>40</s5>
</fC07>
<fN21>
<s1>082</s1>
</fN21>
<fN44 i1="01">
<s1>OTO</s1>
</fN44>
<fN82>
<s1>OTO</s1>
</fN82>
</pA>
</inist>
<server>
<NO>: PASCAL 09-0120508 INIST</NO>
<ET>Long-Term Benefit of High-Dose Epirubicin in Adjuvant Chemotherapy for Node-Positive Breast Cancer : 15-Year Efficacy Results of the Belgian Multicentre Study</ET>
<AU>DEAZAMBUJA (Evandro); PAESMANS (Marianne); BEAUDUIN (Marc); VINDEVOGHEL (Anita); CORNEZ (Nathalie); FINET (Claude); RIES (Fernand); CLOSON-DEJARDIN (Marie Thérèse); KERGER (Joseph); GOBERT (Philippe); FOCAN (Christian); TAGNON (Alain); DOLCI (Stella); NOGARET (Jean M.); DI LEO (Angela); PICCART-GEBHART (Martine J.)</AU>
<AF>Institut Jules Bordet and Université Libre de Bruxelles/Brussels/Belgique; Hopital de Jolimont-Lobbes/Belgique; Centre Hospitalier Universitaire de Tivoli/La Louvière/Belgique; Clinique Sainte Elisabeth/Namur/Belgique; Hôpital de Braine L'Alleud/Waterloo/Belgique; Centre Hospitalier Universitaire de Liège/France; Centre Hospitalier Chrétien/Liège/Belgique; Service d'Oncologie, Cliniques Universitaires Université Catholique de Louvain/Godinne/Belgique; Clinique Saint-Joseph/Arlon/Belgique; Réseau Hospitalier de Médecine Sociale/Tournai/Belgique; Programa de Pós-graduação em Medicina: Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul/Porto Alegre/Brésil; Centre Hospitalier de Luxembourg/Luxembourg; Hospital of Prato/Prato/Italie</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Journal of clinical oncology; ISSN 0732-183X; Etats-Unis; Da. 2009; Vol. 27; No. 5; Pp. 720-725; Bibl. 22 ref.</SO>
<LA>Anglais</LA>
<EA>Purpose The 4-year results of this trial demonstrated that a higher dose of epirubicin with cyclophosphamide (HEC) is superior to a lower dose of epirubicin, 60 mg/m<sup>2</sup>(EC), for event-free survival (EFS; 27% reduction), but is not superior to classical oral cyclophosphamide, methotrexate, and fluorouracil (CMF) in the adjuvant treatment of node-positive breast cancer. Herein we report the 15-year data on efficacy and long-term toxicity of this three-arm Belgian multi-center trial. Patients and Methods Between March 1988 and December 1996, 777 eligible patients were randomly assigned to six cycles of CMF, eight cycles of EC, or eight cycles HEC. Results The 15-year EFS was 45% for patients who received CMF, 39% for patients who received EC, and 50% for patients who received HEC. The hazard ratios (HR) were 0.77 for HEC versus EC (95% Cl, 0.60 to 0.98; P = .03), 0.90 for HEC versus CMF (P = .39), and 0.86 for EC versus CMF (P = .21). No difference in overall survival (OS) was seen. Cardiac toxicity was more frequent with HEC than with CMF (11 patients v 1 patient; P = .006), but no more than with EC (P = .21). Conclusion Treatment with HEC demonstrated superior EFS when compared with lower-dose epirubicin. However, we do not recommend the use of HEC regimen in daily clinical practice, mainly because of the higher risk of cardiotoxicity related to the cumulative doses of epirubicin and the lack of superiority of anthracyclines over CMF in our study.</EA>
<CC>002B04; 002B20E02</CC>
<FD>Epirubicine; Long terme; Dose forte; Cancer du sein; Traitement adjuvant; Efficacité traitement; Chimiothérapie; Belgique; Cancérologie; Anticancéreux</FD>
<FG>Traitement; Europe; Anthracyclines; Tumeur maligne; Cancer; Pathologie de la glande mammaire; Pathologie du sein</FG>
<ED>Epirubicin; Long term; High dose; Breast cancer; Adjuvant treatment; Treatment efficiency; Chemotherapy; Belgium; Cancerology; Antineoplastic agent</ED>
<EG>Treatment; Europe; Anthracyclins; Malignant tumor; Cancer; Mammary gland diseases; Breast disease</EG>
<SD>Epirubicina; Largo plazo; Dosis fuerte; Cáncer del pecho; Tratamiento adyuvante; Eficacia tratamiento; Quimioterapia; Belgica; Cancerología; Anticanceroso</SD>
<LO>INIST-20094.354000185427620120</LO>
<ID>09-0120508</ID>
</server>
</record>
