Taguchi Tetsuya
Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Gan To Kagaku Ryoho. 2012 Jun;39(6):876-81.
In the beginning, neoadjuvant chemotherapy (NAC) is part of the multidisciplinary treatment of locally advanced breast cancer. Many clinical trials in the past have developed the usefulness of anthracycline containing NAC for operable breast cancer. The majority of trials have proven survival rates equivalent to adjuvant chemotherapy with increased breast conservation rates, and have also shown that a pathological complete response (pCR) after NAC is associated with improved survival. Taxanes have been introduced into clinical trials of NAC with increased pCR rates. However, there was no significant difference in overall survival among the regimens which added taxanes to neoadjuvant anthracycline. In this paper, the problems of NAC up to the present and the development of new regimens are discussed. We also discuss the new concept of NAC which might revolutionize what we know about NAC.
最初，新辅助化疗（NAC）是局部晚期乳腺癌多学科治疗的一部分。过去许多临床试验已证实含蒽环类药物的NAC对可手术乳腺癌的有效性。大多数试验已证明其生存率与辅助化疗相当，且保乳率有所提高，还表明NAC后的病理完全缓解（pCR）与生存率改善相关。紫杉烷已被引入NAC临床试验，pCR率有所提高。然而，在新辅助蒽环类药物方案中添加紫杉烷的各方案之间总生存率并无显著差异。本文讨论了截至目前NAC存在的问题以及新方案的进展。我们还讨论了可能彻底改变我们对NAC认知的NAC新概念。
