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Adjuvant chemotherapy followed by goserelin compared with either modality alone: the impact on amenorrhea, hot flashes, and quality of life in premenopausal patients--the International Breast Cancer Study Group Trial VIII.
J Clin Oncol 2007; 25(3):263-70JC

Abstract

PURPOSE

The purpose of this article is to compare quality of life (QOL) and menopausal symptoms among premenopausal patients with lymph node-negative breast cancer receiving chemotherapy, goserelin, or their sequential combination, and to investigate differential effects by age.

PATIENTS AND METHODS

We evaluated QOL data from 874 pre- and perimenopausal women with lymph node-negative breast cancer who were randomly assigned to receive six courses of classical cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy, ovarian suppression with goserelin for 24 months, or six courses of classical CMF followed by 18 months of goserelin. We report QOL data collected during 3 years after random assignment in patients without disease recurrence.

RESULTS

Overall, patients receiving goserelin alone showed a marked improvement or less deterioration in QOL measures over the first 6 months than those patients treated with CMF. There were no differences at 3 years after random assignment according to treatment except for hot flashes. As reflected in the hot flashes scores, patients in all three treatment groups experienced induced amenorrhea, but the onset of ovarian function suppression was slightly delayed for patients receiving chemotherapy. Younger patients (< 40 years) who received goserelin alone returned to their premenopausal status at 6 months after the cessation of therapy, while those who received CMF showed marginal changes from their baseline hot flashes scores.

CONCLUSION

Age-adjusted risk profiles that consider patient-reported outcomes enable patients to adapt to their disease and treatment, such as considering the trade-offs between delayed endocrine symptoms, but higher risk of permanent menopause with chemotherapy, and immediate but reversible endocrine symptoms with goserelin, in younger premenopausal patients.

Authors+Show Affiliations

International Breast Cancer Study Group (IBCSG), Bern, Switzerland. juerg.bernhard@ibcsg.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17159194

Citation

Bernhard, Jürg, et al. "Adjuvant Chemotherapy Followed By Goserelin Compared With Either Modality Alone: the Impact On Amenorrhea, Hot Flashes, and Quality of Life in Premenopausal Patients--the International Breast Cancer Study Group Trial VIII." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 25, no. 3, 2007, pp. 263-70.
Bernhard J, Zahrieh D, Castiglione-Gertsch M, et al. Adjuvant chemotherapy followed by goserelin compared with either modality alone: the impact on amenorrhea, hot flashes, and quality of life in premenopausal patients--the International Breast Cancer Study Group Trial VIII. J Clin Oncol. 2007;25(3):263-70.
Bernhard, J., Zahrieh, D., Castiglione-Gertsch, M., Hürny, C., Gelber, R. D., Forbes, J. F., ... Coates, A. S. (2007). Adjuvant chemotherapy followed by goserelin compared with either modality alone: the impact on amenorrhea, hot flashes, and quality of life in premenopausal patients--the International Breast Cancer Study Group Trial VIII. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 25(3), pp. 263-70.
Bernhard J, et al. Adjuvant Chemotherapy Followed By Goserelin Compared With Either Modality Alone: the Impact On Amenorrhea, Hot Flashes, and Quality of Life in Premenopausal Patients--the International Breast Cancer Study Group Trial VIII. J Clin Oncol. 2007 Jan 20;25(3):263-70. PubMed PMID: 17159194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adjuvant chemotherapy followed by goserelin compared with either modality alone: the impact on amenorrhea, hot flashes, and quality of life in premenopausal patients--the International Breast Cancer Study Group Trial VIII. AU - Bernhard,Jürg, AU - Zahrieh,David, AU - Castiglione-Gertsch,Monica, AU - Hürny,Christoph, AU - Gelber,Richard D, AU - Forbes,John F, AU - Murray,Elizabeth, AU - Collins,John, AU - Aebi,Stefan, AU - Thürlimann,Beat, AU - Price,Karen N, AU - Goldhirsch,Aron, AU - Coates,Alan S, AU - ,, Y1 - 2006/12/11/ PY - 2006/12/13/pubmed PY - 2007/1/26/medline PY - 2006/12/13/entrez SP - 263 EP - 70 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 25 IS - 3 N2 - PURPOSE: The purpose of this article is to compare quality of life (QOL) and menopausal symptoms among premenopausal patients with lymph node-negative breast cancer receiving chemotherapy, goserelin, or their sequential combination, and to investigate differential effects by age. PATIENTS AND METHODS: We evaluated QOL data from 874 pre- and perimenopausal women with lymph node-negative breast cancer who were randomly assigned to receive six courses of classical cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy, ovarian suppression with goserelin for 24 months, or six courses of classical CMF followed by 18 months of goserelin. We report QOL data collected during 3 years after random assignment in patients without disease recurrence. RESULTS: Overall, patients receiving goserelin alone showed a marked improvement or less deterioration in QOL measures over the first 6 months than those patients treated with CMF. There were no differences at 3 years after random assignment according to treatment except for hot flashes. As reflected in the hot flashes scores, patients in all three treatment groups experienced induced amenorrhea, but the onset of ovarian function suppression was slightly delayed for patients receiving chemotherapy. Younger patients (< 40 years) who received goserelin alone returned to their premenopausal status at 6 months after the cessation of therapy, while those who received CMF showed marginal changes from their baseline hot flashes scores. CONCLUSION: Age-adjusted risk profiles that consider patient-reported outcomes enable patients to adapt to their disease and treatment, such as considering the trade-offs between delayed endocrine symptoms, but higher risk of permanent menopause with chemotherapy, and immediate but reversible endocrine symptoms with goserelin, in younger premenopausal patients. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/17159194/Adjuvant_chemotherapy_followed_by_goserelin_compared_with_either_modality_alone:_the_impact_on_amenorrhea_hot_flashes_and_quality_of_life_in_premenopausal_patients__the_International_Breast_Cancer_Study_Group_Trial_VIII_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2005.04.5393?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -