Effect of glucocorticoid use on survival in patients with stage I–III breast cancer

Ching Hung Lin, Po Ya Chuang, San Lin You, Chun Ju Chiang, Chiun Sheng Huang, Ming Yang Wang, Ming Chao, Yen Shen Lu, Ann Lii Cheng, Chao Hsiun Tang

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: Glucocorticoids (GCs) are commonly used in breast cancer patients to ameliorate emesis induced by chemotherapy. Some preclinical studies have suggested that systemic GCs might promote survival of estrogen receptor (ER)-negative breast cancer cells. This study aims to clarify their clinical effect on patient survival. Methods: A total of 18,596 women with newly diagnosed stage I–III breast cancer in 2002–2006 were identified from the Taiwan Cancer Database and drug treatment was examined from the Taiwan National Health Insurance Claims Database. Of these, 3989 who did not receive adjuvant chemotherapy (non-chemotherapy cohort) and 3237 patients who received six cycles of adjuvant anthracycline-based chemotherapy (anthracycline cohort) were included. The impact of GC use on survival was analyzed separately in these two cohorts using Cox proportional hazards models. Results: In the non-chemotherapy cohort, GC use was associated with aggressive clinicopathological features of breast cancer. High-dose GC was associated with shorter overall survival in univariate analysis but not in multivariate analysis. In the anthracycline cohort, multivariate analysis showed that GC use at each dose level was significantly associated with longer breast cancer-specific survival (HR 0.65, 0.70, and 0.70 for low-dose, median-dose, and high-dose GC, respectively) and overall survival (HR 0.72, 0.76, and 0.73, respectively) when compared with those receiving no GC. The associations were significant in both ER-positive and ER-negative subgroups for breast cancer-specific survival, and in ER-negative subgroup for overall survival. Conclusion: Concomitant use of GC improved survival in patients receiving adjuvant anthracycline-based chemotherapy for stage I–III breast cancer.

Original languageEnglish
Pages (from-to)225-234
Number of pages10
JournalBreast Cancer Research and Treatment
Volume171
Issue number1
DOIs
Publication statusPublished - Aug 1 2018

Fingerprint

Glucocorticoids
Breast Neoplasms
Survival
Anthracyclines
Estrogen Receptors
Taiwan
Drug Therapy
Multivariate Analysis
Pharmaceutical Databases
National Health Programs
Adjuvant Chemotherapy
Proportional Hazards Models
Vomiting
Cohort Studies
Databases
Neoplasms

Keywords

  • Adjuvant chemotherapy
  • Breast cancer
  • Glucocorticoid
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Effect of glucocorticoid use on survival in patients with stage I–III breast cancer. / Lin, Ching Hung; Chuang, Po Ya; You, San Lin; Chiang, Chun Ju; Huang, Chiun Sheng; Wang, Ming Yang; Chao, Ming; Lu, Yen Shen; Cheng, Ann Lii; Tang, Chao Hsiun.

In: Breast Cancer Research and Treatment, Vol. 171, No. 1, 01.08.2018, p. 225-234.

Research output: Contribution to journalArticle

Lin, CH, Chuang, PY, You, SL, Chiang, CJ, Huang, CS, Wang, MY, Chao, M, Lu, YS, Cheng, AL & Tang, CH 2018, 'Effect of glucocorticoid use on survival in patients with stage I–III breast cancer', Breast Cancer Research and Treatment, vol. 171, no. 1, pp. 225-234. https://doi.org/10.1007/s10549-018-4787-x
Lin, Ching Hung ; Chuang, Po Ya ; You, San Lin ; Chiang, Chun Ju ; Huang, Chiun Sheng ; Wang, Ming Yang ; Chao, Ming ; Lu, Yen Shen ; Cheng, Ann Lii ; Tang, Chao Hsiun. / Effect of glucocorticoid use on survival in patients with stage I–III breast cancer. In: Breast Cancer Research and Treatment. 2018 ; Vol. 171, No. 1. pp. 225-234.
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abstract = "Purpose: Glucocorticoids (GCs) are commonly used in breast cancer patients to ameliorate emesis induced by chemotherapy. Some preclinical studies have suggested that systemic GCs might promote survival of estrogen receptor (ER)-negative breast cancer cells. This study aims to clarify their clinical effect on patient survival. Methods: A total of 18,596 women with newly diagnosed stage I–III breast cancer in 2002–2006 were identified from the Taiwan Cancer Database and drug treatment was examined from the Taiwan National Health Insurance Claims Database. Of these, 3989 who did not receive adjuvant chemotherapy (non-chemotherapy cohort) and 3237 patients who received six cycles of adjuvant anthracycline-based chemotherapy (anthracycline cohort) were included. The impact of GC use on survival was analyzed separately in these two cohorts using Cox proportional hazards models. Results: In the non-chemotherapy cohort, GC use was associated with aggressive clinicopathological features of breast cancer. High-dose GC was associated with shorter overall survival in univariate analysis but not in multivariate analysis. In the anthracycline cohort, multivariate analysis showed that GC use at each dose level was significantly associated with longer breast cancer-specific survival (HR 0.65, 0.70, and 0.70 for low-dose, median-dose, and high-dose GC, respectively) and overall survival (HR 0.72, 0.76, and 0.73, respectively) when compared with those receiving no GC. The associations were significant in both ER-positive and ER-negative subgroups for breast cancer-specific survival, and in ER-negative subgroup for overall survival. Conclusion: Concomitant use of GC improved survival in patients receiving adjuvant anthracycline-based chemotherapy for stage I–III breast cancer.",
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T1 - Effect of glucocorticoid use on survival in patients with stage I–III breast cancer

AU - Lin, Ching Hung

AU - Chuang, Po Ya

AU - You, San Lin

AU - Chiang, Chun Ju

AU - Huang, Chiun Sheng

AU - Wang, Ming Yang

AU - Chao, Ming

AU - Lu, Yen Shen

AU - Cheng, Ann Lii

AU - Tang, Chao Hsiun

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N2 - Purpose: Glucocorticoids (GCs) are commonly used in breast cancer patients to ameliorate emesis induced by chemotherapy. Some preclinical studies have suggested that systemic GCs might promote survival of estrogen receptor (ER)-negative breast cancer cells. This study aims to clarify their clinical effect on patient survival. Methods: A total of 18,596 women with newly diagnosed stage I–III breast cancer in 2002–2006 were identified from the Taiwan Cancer Database and drug treatment was examined from the Taiwan National Health Insurance Claims Database. Of these, 3989 who did not receive adjuvant chemotherapy (non-chemotherapy cohort) and 3237 patients who received six cycles of adjuvant anthracycline-based chemotherapy (anthracycline cohort) were included. The impact of GC use on survival was analyzed separately in these two cohorts using Cox proportional hazards models. Results: In the non-chemotherapy cohort, GC use was associated with aggressive clinicopathological features of breast cancer. High-dose GC was associated with shorter overall survival in univariate analysis but not in multivariate analysis. In the anthracycline cohort, multivariate analysis showed that GC use at each dose level was significantly associated with longer breast cancer-specific survival (HR 0.65, 0.70, and 0.70 for low-dose, median-dose, and high-dose GC, respectively) and overall survival (HR 0.72, 0.76, and 0.73, respectively) when compared with those receiving no GC. The associations were significant in both ER-positive and ER-negative subgroups for breast cancer-specific survival, and in ER-negative subgroup for overall survival. Conclusion: Concomitant use of GC improved survival in patients receiving adjuvant anthracycline-based chemotherapy for stage I–III breast cancer.

AB - Purpose: Glucocorticoids (GCs) are commonly used in breast cancer patients to ameliorate emesis induced by chemotherapy. Some preclinical studies have suggested that systemic GCs might promote survival of estrogen receptor (ER)-negative breast cancer cells. This study aims to clarify their clinical effect on patient survival. Methods: A total of 18,596 women with newly diagnosed stage I–III breast cancer in 2002–2006 were identified from the Taiwan Cancer Database and drug treatment was examined from the Taiwan National Health Insurance Claims Database. Of these, 3989 who did not receive adjuvant chemotherapy (non-chemotherapy cohort) and 3237 patients who received six cycles of adjuvant anthracycline-based chemotherapy (anthracycline cohort) were included. The impact of GC use on survival was analyzed separately in these two cohorts using Cox proportional hazards models. Results: In the non-chemotherapy cohort, GC use was associated with aggressive clinicopathological features of breast cancer. High-dose GC was associated with shorter overall survival in univariate analysis but not in multivariate analysis. In the anthracycline cohort, multivariate analysis showed that GC use at each dose level was significantly associated with longer breast cancer-specific survival (HR 0.65, 0.70, and 0.70 for low-dose, median-dose, and high-dose GC, respectively) and overall survival (HR 0.72, 0.76, and 0.73, respectively) when compared with those receiving no GC. The associations were significant in both ER-positive and ER-negative subgroups for breast cancer-specific survival, and in ER-negative subgroup for overall survival. Conclusion: Concomitant use of GC improved survival in patients receiving adjuvant anthracycline-based chemotherapy for stage I–III breast cancer.

KW - Adjuvant chemotherapy

KW - Breast cancer

KW - Glucocorticoid

KW - Survival

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