新辅助治疗乳腺癌的病理反应和生存：30 年研究。
Pathological response and survival after neoadjuvant therapy for breast cancer: a 30-year study.
机构信息
Department of Medical Oncology, Georges-François Leclerc Cancer Center, Dijon, France.
出版信息
Breast. 2013 Jun;22(3):301-8. doi: 10.1016/j.breast.2012.07.012. Epub 2012 Aug 3.
PURPOSE OF THE RESEARCH
HER2-positive and triple-negative breast cancer (TNBC) still have a poor prognosis. Pathological complete response (pCR) is usually considered a surrogate marker for outcome. The aim of this study was to reconsider these parameters on a large population after a long follow-up. 348 patients with unilateral breast cancer who received neoadjuvant treatment at our institution over 30 years were included.
RESULTS
Patients were classified according to hormonal receptors (HR) and HER2. Median follow-up was 7 years. pCR was significantly lower in HR+/HER2- tumors (P < 0.0001). The 7-year OS rates were 76.1% (HR+/HER2-), 60.1% (TNBC), 72.4% (HR+/HER2+), and 49.9% (HR-/HER2+). Disease-free survival (DFS) and OS differed significantly according to pCR. Among HER2+ patients, pCR rate, DFS and OS were greater with trastuzumab.
CONCLUSIONS
TNBC and HR-/HER2+ tumors have the worst outcome. pCR remains a significant prognostic factor. Trastuzumab strongly improves pCR and survival in HER2+ tumors.
研究目的
HER2 阳性和三阴性乳腺癌（TNBC）的预后仍然较差。病理完全缓解（pCR）通常被认为是预后的替代标志物。本研究的目的是在经过长时间随访后，在大人群中重新考虑这些参数。
共纳入 348 例在我院接受新辅助治疗的单侧乳腺癌患者，随访时间超过 30 年。
结果
患者根据激素受体（HR）和 HER2 进行分类。中位随访时间为 7 年。HR+/HER2-肿瘤的 pCR 显著降低（P<0.0001）。7 年 OS 率分别为 76.1%（HR+/HER2-）、60.1%（TNBC）、72.4%（HR+/HER2+）和 49.9%（HR-/HER2+）。pCR 显著影响疾病无进展生存期（DFS）和 OS。在 HER2+患者中，曲妥珠单抗治疗可提高 pCR 率、DFS 和 OS。
结论
TNBC 和 HR-/HER2+肿瘤的预后最差。pCR 仍然是一个重要的预后因素。曲妥珠单抗可显著提高 HER2+肿瘤的 pCR 率和生存率。
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