Abstract
The prognostic role of drug-induced amenorrhea (DIA) was restrospectively evaluated in 221 out of 254 consecutive premenopausal patients treated with adjuvant CMF or a CMF-containing regimen; 33 patients were eliminated because of lack of menstrual data. All patients had metastatic axillary nodes; drug regimens were: CMF x 9 courses +/- Tamoxifen (TM) and CMF x 6 courses; median age was 43 (range 26-54). Premenopausal status was defined as last normal menses within the 6 weeks preceding initiation of chemotherapy: DIA as cessation of menses for at least 3 months not later than 3 months from the end of chemotherapy. DIA occurred in 166,221 (75.1%) patients and was strictly related to the age of the patients; also, the older the patients the shorter the time required to develop DIA. At median follow up of 69 months, Mantel-Byar analysis showed a longer disease free survival (DFS) for patients who developed DIA as compared with non amenorrheic women (P less than 0.001). DIA prognostic value was independent of age, number of involved nodes, tumour size and number of CMF cycles, as assessed by the Cox model (RH 0.43, 95% C.I. 0.24-0.77), in which DIA was entered as a time dependent covariate.
Highlights
The aim of our study was to evaluate, restrospectively, if the development of drug-induced amenorrhea is associated with a prolongation of disease free survival (DFS) in a series of consecutive cases of homogeneous premenopausal, node-positive patients with early breast cancer, treated with adjuvant CMF-containing regimens between 1978 and 1989
Time to onset of drug-induced amenorrhea (DIA) ranged between -21 and 342 days from the beginning of cytotoxic chemotherapy
No significant correlation was found between DIA and number of involved axillary nodes or tumour size, while occurrence of amenorrhea was significantly associated with number of CMF cycles (Table II)
Summary
The aim of our study was to evaluate, restrospectively, if the development of drug-induced amenorrhea is associated with a prolongation of DFS in a series of consecutive cases of homogeneous premenopausal, node-positive patients with early breast cancer, treated with adjuvant CMF-containing regimens between 1978 and 1989
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