Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Thorac Cancer. 2017 May;8(3):246-250. doi: 10.1111/1759-7714.12433. Epub 2017 Apr 12.
Two epirubicin and paclitaxel-based neoadjuvant chemotherapy regimens were compared in breast cancer patients.
We enrolled 309 breast cancer patients who received two types of regimens: cyclophosphamide + epirubicin dose-dense neoadjuvant chemotherapy followed by sequential postoperative paclitaxel single-drug medication, and paclitaxel + epirubicin standard neoadjuvant chemotherapy followed by two cycles of the same chemotherapy after surgery. The primary endpoint was a pathological complete response (pCR) and the secondary endpoints were disease-free and overall survival.
The median follow-up time was 65 months. The overall pCRs for pathological efficacy and efficacy of primary lesions were 14.4% and 29.3%, respectively (P < 0.001). The pCR of the paclitaxel + epirubicin group was significantly higher than in the cyclophosphamide + epirubicin group (17.3% vs. 9.2%; P = 0.0345), but the five-year disease-free survival rates in both groups were not significantly different (82.9% vs. 75.3%; P = 0.916).
The results of our study indicated that the timing of paclitaxel therapy, either preoperative or postoperative, does not affect survival times in breast cancer patients.
两种表阿霉素和紫杉醇为基础的新辅助化疗方案在乳腺癌患者中进行了比较。
我们纳入了 309 例接受两种方案治疗的乳腺癌患者：环磷酰胺+表阿霉素剂量密集型新辅助化疗，随后序贯术后紫杉醇单药治疗，和紫杉醇+表阿霉素标准新辅助化疗，术后再进行两周期相同的化疗。主要终点是病理完全缓解（pCR），次要终点是无病生存和总生存。
中位随访时间为 65 个月。病理疗效和原发病灶疗效的总体 pCR 分别为 14.4%和 29.3%（P<0.001）。紫杉醇+表阿霉素组的 pCR 明显高于环磷酰胺+表阿霉素组（17.3% vs. 9.2%；P=0.0345），但两组的 5 年无病生存率无显著差异（82.9% vs. 75.3%；P=0.916）。
本研究结果表明，紫杉醇治疗的时机，无论是术前还是术后，都不会影响乳腺癌患者的生存时间。
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