Henry Leonard R, Stojadinovic Alexander, Swain Sandra M, Prindiville Sheila, Cordes Rose, Soballe Peter W
Division of Surgical Oncology, Department of Surgery, National Naval Medical Center, Bethesda, Maryland, USA.
J Surg Oncol. 2009 May 1;99(6):319-23. doi: 10.1002/jso.21244.
The Oncotype Dx Recurrence Score (RS), is often employed in patients with estrogen receptor-positive, node negative (ER+LN-) breast cancer. We investigated the impact of the RS on actual chemotherapy administration and the effect of the assay on a panel of breast oncology experts.
The prospective adjuvant chemotherapy recommendations (prior to RS) and actual adjuvant therapy (after RS) for consecutive patients with ER+LN- breast cancer were recorded. After 6 months and with the same information, a panel of five experts made adjuvant therapy recommendations with and without RS and rated the strength of their recommendations. Rates of panel consensus, recommendation changes, and changes in recommendation strength were compared.
There were 29 patients (28 women). RS results altered the plan for chemotherapy in 9 patients (31%); 7 of 13 patients (54%) initially recommended for chemotherapy did not receive it, and 2 of 16 (13%) received chemotherapy following initial recommendations against it. RS results changed the panel's chemotherapy recommendation in 7 patients (24%): 5 of 12 (42%) recommendations for changed to against, and 2 of 17 (12%) recommendations against changed to for chemotherapy. RS increased consensus by the panel 10%, but did not increase the reported strength in chemotherapy recommendations.
RS results were associated with real-world decision changes in 31% of patients and 24% of panel recommendations and increased panel consensus by 10%. However RS did not increase the strength of panelist's recommendations.
Oncotype Dx复发评分（RS）常用于雌激素受体阳性、淋巴结阴性（ER+LN-）乳腺癌患者。我们研究了RS对实际化疗应用的影响以及该检测对一组乳腺肿瘤学专家的作用。
记录连续的ER+LN-乳腺癌患者的前瞻性辅助化疗建议（RS检测前）和实际辅助治疗情况（RS检测后）。6个月后，利用相同信息，一组五名专家在有和没有RS结果的情况下做出辅助治疗建议，并对建议的力度进行评分。比较专家组的共识率、建议变化以及建议力度的变化。
共有29例患者（28名女性）。RS结果改变了9例患者（31%）的化疗方案；最初建议化疗的13例患者中有7例（54%）未接受化疗，而最初不建议化疗的16例患者中有2例（13%）接受了化疗。RS结果改变了7例患者（24%）的专家组化疗建议：12例建议化疗的患者中有5例（42%）改为不建议化疗，17例不建议化疗的患者中有2例（12%）改为建议化疗。RS使专家组的共识率提高了10%，但并未提高所报告的化疗建议力度。
RS结果与31%的患者以及24%的专家组建议中的实际决策改变相关，并使专家组共识率提高了10%。然而，RS并未提高专家组成员建议的力度。
