The Role of Chemoendocrine Agents in Postoperative Adjuvant Therapy for Breast Cancer: Meta-analysis of the First Collaborative Studies of Postoperative Adjuvant Chemoendocrine Therapy for Breast Cancer (ACETBC).

Abstract

The first collaborative studies of postoperative adjuvant chemoendocrine therapy for breast cancer (ACETBA) were carried out in 6 regions of Japan from 1982 to 1985, and the results were subjected to meta-analysis. Subjects consisted of stage II and IIIa cases who underwent radical mastectomy with Brt + Ax or more extensive resection for primary breast cancer. Regimen A consisted of tegafur (Futraful:FT) alone at 600 mg/day, and regimen B of FT at 600 mg/day with tamoxifen (TAM) at 20 mg/day. The duration of the treatment was one year in the Tohoku and Kinki regions, and 2 years in the other 4 regions. Meta-alalysis by Peto's method showed an odds reduction of 20+/- 7% (logrank test: P = 0.0069) for the 5-year overall survival rate in 4740 eligible patients, and 25 +/- 6%(logrank test: P <0.0001)for the 5-year disease-free survival rate. The odds reductions were both statistically significant, indicating that the adjuvantchemoendocrine therapy was effective. Subset analysis of data on 5-year disease-free survival showed that FT plus TAM therapy was better in ER-positive and post-menopausal patients, whether axillary lymph nodes were positive or negative.