Continuing chemotherapy or not after the induction treatment in advanced breast cancer patients clinical outcomes and oncologists' preferences M.A. Nooij a * manooij@lumc.nl , J.C.J.M. de Haes b, L.V.A.M. Beex c, J. Wildiers d, J. Klijn e, D. Becquart f, J. Jassem g, E. Engelsman h , L. Duchateau i and for the EORTC Breast Cancer Group a Department of Clinical Oncology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands b Medical Psychology, Amsterdam Medisch Centrum, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands c Department of Medical Oncology, University Hospital Nijmegen, G. Grooteplein Zuid 8, 6525 GA Nijmegen, The Netherlands d Department of Oncology, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium e Department of Internal Oncology, Daniel den Hoed Kliniek, Groene Hilledijk 301, 3075 EA Rotterdam, The Netherlands f Department of Radiotherapy-Oncology, Middelheim Hospital, Lindendreef 1, 2020 Antwerp, Belgium g Department of Oncology and Radiotherapy, Medical University of Gdansk, Debinki 7, 80-211 Gdansk, Poland h Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands i EORTC, Av. E. Mounier 83/11, 1200 Brussel, Belgium Abstract The optimal duration of cytostatic treatment for metastatic breast cancer is still a matter of debate. Possible gain in the duration of remission has to be weighed against the side-effects of treatment. Our aim was to define the optimal duration of cyclophosphamide, methotrexate, 5-fluorouracil (CMF) treatment by studying the time to treatment failure, overall survival and using a Q-TWiST analysis. The treating physician's opinion was asked. The European Organization for Research and Treatment of Cancer (EORTC) Breast Cancer Group conducted a randomised trial in 204 non-progressing metastatic breast cancer patients after induction chemotherapy (CMF) to stop or continue treatment. Progression-free (PFS) and overall survival (OS) were studied. To gain more insight into the burden of treatment-related side-effects, Q-TWiST was analysed. In addition, we asked for oncologists' preferences as patients are likely to be influenced by their physicians' opinion. Continuation of CMF had a significantly longer time to treatment failure (TTF) 5.2 versus 3.5 months (P=0.011). There was no overall survival (OS) difference 14.0 versus 14.4 months (P=0.77). Mean quality-adjusted survival time was equal to 8.4 months for no further treatment and decreased to 7.9 months for continuation of CMF (95% Confidence Interval (CI) of difference equals 0.5±2.5 months). Almost half of the oncologists said they would favour continuous treatment for a 3-month gain in time to progressiona difference which was not found in this study. Based on these data, an interruption of chemotherapy (CMF), if this is the wish of the patient, is justified. European Journal of Cancer, Vol. 39 (5) (2003) pp. 614-621 Ann's NOTE: This study was to determine if patient preference as to stopping chemotherapy was 'justified'. Every word of this abstract condemns the current system. It shows that doctors want to DO something, even if that offers less survival, less quality of life, than NOT doing something. Overall survival in this patient population was BETTER for those who did NOT continue chemotherapy. And quality-adjusted time was better too. However, almost half the oncologist STILL favored continuous treatment. Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.