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炎性乳腺癌——比较术前多西紫杉醇-表柔比星方案与常规含蒽环类化疗方案的有效性,以达到临床获益和完全病理缓解。

Inflammatory breast cancer-comparing the effectivity of preoperative docetaxel-epirubicine protocol to conventional antracycline-containing chemotherapy to achieve clinical benefit and complete pathological response.

机构信息

Department of Chemotherapy B and Clinical Pharmacology, National Institute of Oncology, Budapest, Hungary.

出版信息

Pathol Oncol Res. 2011 Sep;17(3):541-50. doi: 10.1007/s12253-010-9344-9. Epub 2010 Dec 14.

Abstract

Our retrospective analysis compared the effectiveness of conventional antracycline-containing protocols (A+) and docetaxel/epirubicine (TE) as primary systemic chemotherapies (PSCT) for inflammatory breast cancer (IBC). Seventy IBC patients received either A + (n = 48) or TE (n = 22) as PSCT. The objective clinical response and clinical benefit rate of treated patients were 54.3% (A+: 54,2% vs. TE: 54,5%; p = 0,28) and 92.8% (A+: 91,7% vs. TE: 95,5%; p = 0,57), respectively. The clinical complete response rate (cCR) was 23.2% (A+: 27,1% vs. TE:4,5%; χ (2) = 4,79; p = 0,03) with 7.14% (A+: 10,4% vs. TE:0%; χ (2) = 2,47; p = 0,12) of pathological complete responses (pCR). The median progression free (PFS)/local progression free (LPFS)/overall survival (OS) was 2.0/5.4/4.0 years, respectively. Patients achieving cCR had a tendency for better survival parameters than patients with less than cCR. Response rates or survival data were not statistically different in the two chemotherapy (CT) treatment groups. The survival was not influenced by the number of CT cycles in either protocols. In this set of patients, the clinical efficacy of the two alternative primary systemic chemotherapies (A + and TE) is equivalent in the treatment of inflammatory breast cancer (IBC), despite of the significant difference in favour of A + noticed in CRs. Six cycles of CT could be enough for patients achieving CR, however sequential pre- and/or postoperative CT with non cross-resistant drugs should be considered for non-responders.

摘要

我们的回顾性分析比较了传统含蒽环类药物方案(A+)和多西紫杉醇/表柔比星(TE)作为炎性乳腺癌(IBC)一线全身化疗(PSCT)的有效性。70 例 IBC 患者分别接受 A+(n=48)或 TE(n=22)作为 PSCT。治疗患者的客观临床缓解率和临床获益率分别为 54.3%(A+:54.2%vs.TE:54.5%;p=0.28)和 92.8%(A+:91.7%vs.TE:95.5%;p=0.57)。临床完全缓解率(cCR)为 23.2%(A+:27.1%vs.TE:4.5%;χ2=4.79;p=0.03),病理完全缓解率(pCR)为 7.14%(A+:10.4%vs.TE:0%;χ2=2.47;p=0.12)。无进展生存(PFS)/局部无进展生存(LPFS)/总生存(OS)中位数分别为 2.0/5.4/4.0 年。达到 cCR 的患者的生存参数倾向于优于未达到 cCR 的患者。两组化疗(CT)治疗组的缓解率或生存数据无统计学差异。两种方案的生存均不受 CT 周期数的影响。在这组患者中,两种替代一线全身化疗(A+和 TE)在治疗炎性乳腺癌(IBC)方面的临床疗效相当,尽管在 CR 方面 A+明显占优。对于达到 CR 的患者,6 个周期的 CT 可能就足够了,然而对于无反应者,应考虑使用非交叉耐药药物进行术前和/或术后序贯 CT。

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