CHU Limoges, Hopital Mère-Enfant, Institut du Sein, av Larrey, Limoges F-87000, France.
Eur J Surg Oncol. 2012 Oct;38(10):902-9. doi: 10.1016/j.ejso.2012.05.009. Epub 2012 Jun 15.
The aim of this study was to assess the efficacy of Lanreotide Autogel 90 mg PR to prevent lymphorrhea after axillary dissection in breast cancer.
A Phase III double-blind, randomized, placebo-controlled trial was performed between April 1st, 2008, and December 31st, 2010. The primary endpoint was the lymphorrhea volume (ml) in the axillary drain during the first four postoperative days. The secondary end points were the number of days until axillary drain removal, hospital stay duration (days), lymphorrhea volume (ml) up to days 15, 30 and 180, number of cases with seroma aspiration and number of seroma aspirations, evaluation of wound, arm pain and mobility on days 15, 30 and 180.
A total of 148 patients were recruited for the study. Altogether 145 patients were randomized and analysed on an intention-to-treat basis. On the day before surgery 73 patients received the placebo and 72 patients received lanreotide. At four postoperative days, there was a tendency towards a reduction of the lymphorrhea volume in the lanreotide group (median 292 ml, range 1-965 ml) as compared to the placebo group (median 337 ml, range 0-1230 ml), although it was not statistically significant (p = 0.18). There was no significant difference for the secondary end points. In the group with axillary dissection performed alone (n = 24), the lymphorrhea volume was shown to be significantly reduced in the lanreotide group, (p = 0.035) as compared to the placebo group.
Our study did not identify any overall significant reduction of lymphorrhea on lanreotide.
本研究旨在评估兰瑞肽聚乙二醇长效微球 90mg 预防性治疗乳腺癌腋窝清扫术后淋巴漏的疗效。
一项于 2008 年 4 月 1 日至 2010 年 12 月 31 日进行的 III 期、双盲、随机、安慰剂对照试验。主要终点为术后第 1-4 天腋窝引流管中淋巴漏的体积(ml)。次要终点为拔管时间、住院时间(天)、术后第 15、30 和 180 天的淋巴漏体积(ml)、需要抽液的病例数和抽液次数、术后第 15、30 和 180 天伤口、手臂疼痛和活动度的评估。
共纳入 148 例患者。共有 145 例患者按意向治疗原则进行随机分组和分析。手术前一天,73 例患者接受安慰剂,72 例患者接受兰瑞肽。术后第 4 天,兰瑞肽组的淋巴漏体积(中位数 292ml,范围 1-965ml)较安慰剂组(中位数 337ml,范围 0-1230ml)有降低趋势,但差异无统计学意义(p = 0.18)。次要终点无显著差异。在单独行腋窝清扫术的患者(n = 24)中,兰瑞肽组的淋巴漏体积明显低于安慰剂组(p = 0.035)。
本研究未发现兰瑞肽能显著减少总体淋巴漏。