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新辅助化疗为无法手术的局部晚期乳腺癌创造了手术机会。

Neoadjuvant Chemotherapy Creates Surgery Opportunities For Inoperable Locally Advanced Breast Cancer.

机构信息

Center of Breast Disease, Southwest Hospital, The Third Military Medical University, Chongqing, 400038, China.

Department of Thyroid Breast Surgery, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, China.

出版信息

Sci Rep. 2017 Mar 22;7:44673. doi: 10.1038/srep44673.

Abstract

Neoadjuvant chemotherapy (NAC), the systematic chemotherapy given to patients with locally advanced and inoperable breast caner, has been proven to be of great clinical values. Many scientific reports confirmed NAC could effectively eliminate sub-clinical disseminated lesions of tumor, and improve long-term and disease-free survival rate of patients with locally advanced breast cancer (LABC); however, up to now, LABC is still a serious clinical issue given improved screening and early diagnosis. This study, with main focus on inoperable LABC, investigated the values of NAC in converting inoperable LABC into operable status and assessed the prognosis. Sixty-one patients with inoperable LABC were initially treated with neoadjuvant chemotherapy; their local conditions were improved to operable status. Radical surgery was exerted on 49 patients. Original chemotherapy was performed after surgery, followed by local radiotherapy. And endocrine therapy was optional according to the hormone receptor status. The quality of life for most patients with skin diabrosis was obviously improved because their local conditions were under control. For all recruited cases, the survival duration and life quality were significantly improved in patients who finished both NAC and surgery compared to those who did not. Further more, this study demonstrates improved prognostic consequences.

摘要

新辅助化疗(NAC),即给予局部晚期和不可手术的乳腺癌患者的系统性化疗,已被证明具有重要的临床价值。许多科学报告证实,NAC 可有效消除肿瘤的亚临床播散病变,并提高局部晚期乳腺癌(LABC)患者的长期无病生存率;然而,迄今为止,尽管通过改善筛查和早期诊断,LABC 仍然是一个严重的临床问题。本研究主要关注不可手术的 LABC,调查了 NAC 将不可手术的 LABC 转化为可手术状态的价值,并评估了预后。61 例局部晚期不可手术的 LABC 患者最初接受新辅助化疗;他们的局部情况改善至可手术状态。49 例患者接受了根治性手术。术后进行原始化疗,然后进行局部放疗。根据激素受体状态,内分泌治疗是可选的。由于局部情况得到控制,大多数皮肤溃疡患者的生活质量明显改善。对于所有入组病例,与未完成 NAC 和手术的患者相比,完成 NAC 和手术的患者的生存时间和生活质量均显著提高。此外,本研究表明预后结果得到改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8062/5361098/5f2a1bcd4fee/srep44673-f1.jpg

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