A nation-wide multicenter 10-year (1999-2008) retrospective study of chemotherapy in Chinese breast cancer patients

Little information is available on the evolvement of chemotherapeutic regimens administered to Chinese females with breast cancer. We retrospectively analyzed demographic, pathological and chemotherapeutic data of 4211 breast cancer patients, who were randomly selected from representative hospitals of 7 traditional areas in China between 1999 and 2008. A total of 3271 cases (77.7%) received adjuvant chemotherapy, 558 (13.3%) received neoadjuvant chemotherapy, and 392 (9.3%) received chemotherapy for metastatic disease. In the adjuvant setting, higher percentage of patients with younger age, advanced stage, hormone receptor (HR) negative or HER2 positive disease received chemotherapy (P < 0.001). The use of CMF (cyclophosphamide, methotrexate and 5-fluorouracil) in adjuvant chemotherapy decreased significantly from 1999 to 2008, while the use of anthracycline-based (without taxanes) regimens increased in the first 5 years, followed by increased use of regimens containing both anthracyclines and taxanes. Women with locally advanced disease received more neoadjuvant chemotherapy. The percentage of neoadjuvant regimens containing anthracyclines and taxanes increased during this period. In first-line chemotherapy of metastatic disease, 87.5% of cases received combined chemotherapy, and platinum-based regimens were also major choices aside from anthracyclines and taxanes. In second-line chemotherapy, 80.3% received combined chemotherapy, and the combination of taxane and platinum was the most common choice. In conclusion, major changes have taken place in breast cancer chemotherapy in China during this 10-year interval, which reflected the incorporation of key evidence and guidelines into Chinese medical practice.