Garg Amit K, Buchholz Thomas A
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA,
Ann Surg Oncol. 2015 May;22(5):1434-40. doi: 10.1245/s10434-015-4402-x. Epub 2015 Mar 2.
Neoadjuvant chemotherapy is a standard treatment option for patients with locally advanced operable breast cancer and is increasingly used in early breast cancer. Initial randomized trials of neoadjuvant chemotherapy established equivalency to adjuvant chemotherapy in terms of survival, but they also demonstrated improved rates of breast conservation and the ability to modify the risk of locoregional recurrence after a favorable response to chemotherapy. High-quality nonrandomized data have helped to tailor radiotherapy treatment recommendations after neoadjuvant chemotherapy and breast-conserving surgery or mastectomy. Results from an ongoing phase 3 randomized trial (NSABP B-51/RTOG 1304) will help to clarify the value of locoregional radiotherapy for patients with clinical N1 disease that becomes node negative after neoadjuvant chemotherapy.
新辅助化疗是局部晚期可手术乳腺癌患者的标准治疗选择，且在早期乳腺癌中的应用越来越广泛。新辅助化疗的初始随机试验证实了其在生存方面与辅助化疗等效，但也显示出保乳率提高，以及在化疗反应良好后降低局部区域复发风险的能力。高质量的非随机数据有助于制定新辅助化疗联合保乳手术或乳房切除术后的放疗治疗建议。一项正在进行的3期随机试验（NSABP B-51/RTOG 1304）的结果将有助于阐明新辅助化疗后临床N1疾病转为淋巴结阴性的患者进行局部区域放疗的价值。
