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本文引用的文献

1
The value of completion axillary treatment in sentinel node positive breast cancer patients undergoing a mastectomy: a Dutch randomized controlled multicentre trial (BOOG 2013-07).前哨淋巴结阳性的乳腺癌患者行乳房切除术后完成腋窝治疗的价值:一项荷兰随机对照多中心试验(BOOG 2013 - 07)
BMC Cancer. 2015 Sep 3;15:610. doi: 10.1186/s12885-015-1613-2.
2
Three-Dimensional Breast Radiotherapy and the Elective Radiation Dose at the Sentinel Lymph Node Site in Breast Cancer.三维乳腺放射治疗与乳腺癌前哨淋巴结部位的选择性放射剂量
Ann Surg Oncol. 2015 Nov;22(12):3824-30. doi: 10.1245/s10434-015-4413-7. Epub 2015 Feb 24.
3
ESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer.欧洲放射肿瘤学会早期乳腺癌选择性放射治疗靶区勾画共识指南。
Radiother Oncol. 2015 Jan;114(1):3-10. doi: 10.1016/j.radonc.2014.11.030. Epub 2015 Jan 24.
4
Maastricht Delphi consensus on event definitions for classification of recurrence in breast cancer research.《马斯特里赫特关于乳腺癌研究中复发分类事件定义的德尔菲共识》
J Natl Cancer Inst. 2014 Nov 7;106(12). doi: 10.1093/jnci/dju288. Print 2014 Dec.
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Br J Surg. 2015 Feb;102(3):159-68. doi: 10.1002/bjs.9663. Epub 2014 Oct 29.
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Breast. 2013 Dec;22(6):1108-13. doi: 10.1016/j.breast.2013.09.002. Epub 2013 Oct 2.
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Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial.腋窝清扫与前哨淋巴结微转移患者不进行腋窝清扫(IBCSG 23-01):一项 3 期随机对照试验。
Lancet Oncol. 2013 Apr;14(4):297-305. doi: 10.1016/S1470-2045(13)70035-4. Epub 2013 Mar 11.
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The role for sentinel lymph node dissection after neoadjuvant chemotherapy in patients who present with node-positive breast cancer.新辅助化疗后前哨淋巴结活检在淋巴结阳性乳腺癌患者中的作用。
Ann Surg Oncol. 2012 Oct;19(10):3177-84. doi: 10.1245/s10434-012-2484-2. Epub 2012 Jul 7.

接受保乳治疗的临床淋巴结阴性乳腺癌患者,前哨淋巴结手术与随访:一项荷兰随机对照多中心试验(BOOG 2013 - 08)

Clinically node negative breast cancer patients undergoing breast conserving therapy, sentinel lymph node procedure versus follow-up: a Dutch randomized controlled multicentre trial (BOOG 2013-08).

作者信息

van Roozendaal L M, Vane M L G, van Dalen T, van der Hage J A, Strobbe L J A, Boersma L J, Linn S C, Lobbes M B I, Poortmans P M P, Tjan-Heijnen V C G, Van de Vijver K K B T, de Vries J, Westenberg A H, Kessels A G H, de Wilt J H W, Smidt M L

机构信息

Division of Surgical Oncology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.

GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands.

出版信息

BMC Cancer. 2017 Jul 1;17(1):459. doi: 10.1186/s12885-017-3443-x.

DOI:10.1186/s12885-017-3443-x
PMID:28668073
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5494134/
Abstract

BACKGROUND

Studies showed that axillary lymph node dissection can be safely omitted in presence of positive sentinel lymph node(s) in breast cancer patients treated with breast conserving therapy. Since the outcome of the sentinel lymph node biopsy has no clinical consequence, the value of the procedure itself is being questioned. The aim of the BOOG 2013-08 trial is to investigate whether the sentinel lymph node biopsy can be safely omitted in clinically node negative breast cancer patients treated with breast conserving therapy.

METHODS

The BOOG 2013-08 is a Dutch prospective non-inferiority randomized multicentre trial. Women with pathologically confirmed clinically node negative T1-2 invasive breast cancer undergoing breast conserving therapy will be randomized for sentinel lymph node biopsy versus no sentinel lymph node biopsy. Endpoints include regional recurrence after 5 (primary endpoint) and 10 years of follow-up, distant-disease free and overall survival, quality of life, morbidity and cost-effectiveness. Previous data indicate a 5-year regional recurrence free survival rate of 99% for the control arm and 96% for the study arm. In combination with a non-inferiority limit of 5% and probability of 0.8, this result in a sample size of 1.644 patients including a lost to follow-up rate of 10%. Primary and secondary endpoints will be reported after 5 and 10 years of follow-up.

DISCUSSION

If the sentinel lymph node biopsy can be safely omitted in clinically node negative breast cancer patients undergoing breast conserving therapy, this study will cost-effectively lead to a decreased axillary morbidity rate and thereby improved quality of life with non-inferior regional control, distant-disease free survival and overall survival.

TRIAL REGISTRATION

The BOOG 2013-08 study is registered in ClinicalTrials.gov since October 20, 2014, Identifier: NCT02271828. https://clinicaltrials.gov/ct2/show/NCT02271828.

摘要

背景

研究表明,对于接受保乳治疗的乳腺癌患者,若前哨淋巴结阳性,则可安全地省略腋窝淋巴结清扫术。由于前哨淋巴结活检的结果并无临床意义,该操作本身的价值受到质疑。BOOG 2013 - 08试验的目的是研究在接受保乳治疗的临床腋窝淋巴结阴性乳腺癌患者中,是否可安全地省略前哨淋巴结活检。

方法

BOOG 2013 - 08是一项荷兰前瞻性非劣效性随机多中心试验。病理确诊为临床腋窝淋巴结阴性的T1 - 2期浸润性乳腺癌且接受保乳治疗的女性将被随机分为前哨淋巴结活检组与无前哨淋巴结活检组。终点指标包括随访5年(主要终点)和10年后的区域复发、无远处疾病生存率和总生存率、生活质量、发病率及成本效益。既往数据显示,对照组5年区域无复发生存率为99%,研究组为96%。结合5%的非劣效性界限和0.8的概率,得出样本量为1644例患者,包括10%的失访率。主要和次要终点指标将在随访5年和10年后报告。

讨论

如果在接受保乳治疗的临床腋窝淋巴结阴性乳腺癌患者中可安全地省略前哨淋巴结活检,本研究将在不降低区域控制、无远处疾病生存率和总生存率的情况下,以成本效益的方式降低腋窝发病率,从而提高生活质量。

试验注册

BOOG 2013 - 08研究自2014年10月20日起在ClinicalTrials.gov注册,标识符:NCT02271828。https://clinicaltrials.gov/ct2/show/NCT02271828