pT1a 和 pT1b 乳腺癌的辅助化疗：来自 NEMESI 研究的结果。
Adjuvant chemotherapy of pT1a and pT1b breast carcinoma: results from the NEMESI study.
机构信息
Oncologia Medica, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera di Perugia, Perugia, Italy.
出版信息
BMC Cancer. 2012 Apr 30;12:158. doi: 10.1186/1471-2407-12-158.
BACKGROUND
The prognosis of pT1a-pT1b breast cancer (BC) used to be considered very good, with a 10-y RFS of 90%. However, some retrospective studies reported a 10-y RFS of 81%-86% and suggested benefit from adjuvant systemic therapy.
METHODS
To evaluate the variables that determined the choice of adjuvant chemotherapy and the type of chemotherapy delivered in pT1a-pT1b BC, we analysed the small tumours enrolled in the NEMESI study.
RESULTS
Out of 1,894 patients with pathological stage I-II BC enrolled in NEMESI, 402 (21.2%) were pT1a-pT1b. Adjuvant chemotherapy was delivered in 127/402 (31.59%). Younger age, grading G3, high proliferative index, ER-negative and HER2-positive status were significantly associated with the decision to administer adjuvant chemotherapy. An anthracycline without taxane regimen was administered in 59.1% of patients, anthracycline with taxane in 24.4%, a CMF-like regimen in 14.2% and taxane in 2.4%. Adjuvant chemotherapy was administered in 88.4% triple-negative and 73.46% HER2-positive pT1a-pT1b BC. Adjuvant trastuzumab was delivered in 30/49 HER2-positive BC (61.2%).
CONCLUSIONS
Adjuvant chemotherapy was delivered in 31.59% T1a-pT1b BC treated at 63 Italian oncological centres from January 2008 to June 2008. The choice to deliver chemotherapy was based on biological prognostic factors. Anthracycline-based chemotherapy was administered in 83.5% patients.
背景
pT1a-pT1b 期乳腺癌（BC）的预后曾经被认为非常好，10 年无复发生存率（RFS）为 90%。然而，一些回顾性研究报告称 10 年 RFS 为 81%-86%，并提示辅助全身治疗获益。
方法
为了评估决定 pT1a-pT1b BC 辅助化疗选择和化疗类型的变量，我们分析了 NEMESI 研究中纳入的小肿瘤。
结果
在 NEMESI 纳入的 1894 例病理分期 I-II 期 BC 患者中，402 例（21.2%）为 pT1a-pT1b。402 例患者中有 127 例（31.59%）接受了辅助化疗。年轻、G3 分级、高增殖指数、ER 阴性和 HER2 阳性状态与辅助化疗决策显著相关。88.4%的三阴性和 73.46%的 HER2 阳性 pT1a-pT1b BC 患者接受了辅助化疗。49 例 HER2 阳性 BC 中有 30 例（61.2%）接受了辅助曲妥珠单抗治疗。
结论
2008 年 1 月至 2008 年 6 月，63 家意大利肿瘤中心治疗的 31.59%的 pT1a-pT1b BC 接受了辅助化疗。化疗的选择基于生物学预后因素。83.5%的患者接受了基于蒽环类药物的化疗。
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