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Tailored fluorourac...
Tailored fluorouracil, epirubicin, and cyclophosphamide compared with marrow-supported high-dose chemotherapy as adjuvant treatment for high-risk breast cancer : A randomised trial
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Bergh, Jonas (författare)
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Wiklund, Tom (författare)
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Erikstein, Björn (författare)
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Lidbrink, Elisabet (författare)
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Lindman, Henrik (författare)
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Malmström, Per (författare)
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Kellokumpu-Lehtinen, Pirkko (författare)
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Bengtsson, Nils-Olof (författare)
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- Söderlund, Gustaf (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Onkologi,Onkologiska kliniken US
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Anker, Gun (författare)
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Wist, Erik (författare)
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Ottosson, Susanne (författare)
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Salminen, Eeva (författare)
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Ljungman, Per (författare)
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Holte, Harald (författare)
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Nilsson, Jonas (författare)
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Blomqvist, Carl (författare)
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Wilking, Nils (författare)
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(creator_code:org_t)
- 2000
- 2000
- Engelska.
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 356:9239, s. 1384-1391
- Relaterad länk:
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https://urn.kb.se/re...
Abstract
Ämnesord
Stäng
- Background: Chemotherapy drug distribution varies greatly among individual patients. Therefore, we developed an individualised fluorouracil, epirubicin, cyclophosphamide (FEC) regimen to improve outcomes in patients with high-risk early breast cancer. We then did a randomised trial to compare this individually tailored FEC regimen with conventional adjuvant chemotherapy followed by consolidation with high-dose chemotherapy with stem-cell support. Methods: 525 women younger than 60 years of age with high-risk primary breast cancer were randomised after surgery to receive nine cycles of tailored FEC to haematological equitoxicity with granulocyte colony-stimulating factor (G-CSF) support (n=251), or three cycles of FEC at standard doses followed by high-dose chemotherapy with cyclophosphamide, thiotepa, and carboplatin (CTCb), and peripheral-blood stem-cell or bone-marrow support (n=274). Both groups received locoregional radiation therapy and tamoxifen for 5 years. The primary outcome measure was relapse-free survival, and analysis was by intention to treat. Findings: At a median follow-up of 34.3 months, there were 81 breast-cancer relapses in the tailored FEC group versus 113 in the CTCb group (double triangular method p=0.04). 60 deaths occurred in the tailored FEC group and 82 in the CTCb group (log-rank p=0.12). Patients in the CTCb group experienced more grade 3 or 4 acute toxicity compared with the tailored FEC group (p<0.0001). Two treatment-related deaths (0.7%) occurred in the CTCb group. Six patients in the tailored FEC group developed acute myeloid leukaemia and three developed myelodysplastic syndrome. Interpretation: Tailored FEC with G-CSF support resulted in a significantly improved relapse-free survival and fewer grade 3 and 4 toxicities compared with marrow-supported high-dose chemotherapy with CTCb as adjuvant therapy of women with high-risk primary breast cancer.
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- MEDICINE
- MEDICIN
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- art (ämneskategori)
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- Av författaren/redakt...
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Bergh, Jonas
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Wiklund, Tom
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Erikstein, Björn
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Lidbrink, Elisab ...
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Lindman, Henrik
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Malmström, Per
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visa fler...
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Kellokumpu-Lehti ...
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Bengtsson, Nils- ...
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Söderlund, Gusta ...
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Anker, Gun
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Wist, Erik
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Ottosson, Susann ...
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Salminen, Eeva
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Ljungman, Per
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Holte, Harald
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Nilsson, Jonas
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Blomqvist, Carl
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Wilking, Nils
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visa färre...
- Artiklar i publikationen
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The Lancet
- Av lärosätet
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Linköpings universitet