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《2019年乳腺癌最新进展 第3部分 - 早期乳腺癌的当前发展:国际专家小组的综述与批判性评估》

Update Breast Cancer 2019 Part 3 - Current Developments in Early Breast Cancer: Review and Critical Assessment by an International Expert Panel.

作者信息

Kolberg Hans-Christian, Schneeweiss Andreas, Fehm Tanja N, Wöckel Achim, Huober Jens, Pontones Constanza, Titzmann Adriana, Belleville Erik, Lux Michael P, Janni Wolfgang, Hartkopf Andreas D, Taran Florin-Andrei, Wallwiener Markus, Overkamp Friedrich, Tesch Hans, Ettl Johannes, Lüftner Diana, Müller Volkmar, Schütz Florian, Fasching Peter A, Brucker Sara Y

机构信息

Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop, Germany.

National Center for Tumor Diseases, Division Gynecologic Oncology, University Hospital and German Cancer Research Center Heidelberg, Heidelberg, Germany.

出版信息

Geburtshilfe Frauenheilkd. 2019 May;79(5):470-482. doi: 10.1055/a-0887-0861. Epub 2019 May 21.

Abstract

The treatment of breast cancer patients in a curative situation is special in many ways. The local therapy with surgery and radiation therapy is a central aspect of the treatment. The complete elimination of tumour cells at the site of the primary disease must be ensured while simultaneously striving to keep the long-term effects as minor as possible. There is still focus on the continued reduction of the invasiveness of local therapy. With regard to systemic therapy, chemotherapies with taxanes, anthracyclines and, in some cases, platinum-based chemotherapies have become established in the past couple of decades. The context for use is being continually further defined. Likewise, there are questions in the case of antihormonal therapy which also still need to be further defined following the introduction of aromatase inhibitors, such as the length of therapy or ovarian suppression in premenopausal patients. Finally, personalisation of the treatment of early breast cancer patients is also being increasingly used. Prognostic tests could potentially support therapeutic decisions. It must also be considered how the possible use of new therapies, such as checkpoint inhibitors and CDK4/6 inhibitors could look in practice once study results in this regard are available. This overview addresses the backgrounds on the current votes taken by the international St. Gallen panel of experts in Vienna in 2019 for current questions in the treatment of breast cancer patients in a curative situation.

摘要

对处于治愈阶段的乳腺癌患者进行治疗在很多方面都很特殊。手术和放射治疗等局部治疗是治疗的核心方面。必须确保在原发疾病部位彻底清除肿瘤细胞,同时要尽量减少长期影响。目前仍着重于持续降低局部治疗的侵入性。在全身治疗方面,过去几十年里,紫杉烷类、蒽环类化疗药物以及在某些情况下的铂类化疗药物已被广泛应用。其使用背景也在不断得到进一步明确。同样,在抗激素治疗方面也存在一些问题,在引入芳香化酶抑制剂后,诸如治疗时长或绝经前患者的卵巢抑制等问题仍需进一步明确。最后,早期乳腺癌患者治疗的个性化也越来越受到重视。预后检测可能有助于支持治疗决策。一旦有这方面的研究结果,还必须考虑诸如检查点抑制剂和CDK4/6抑制剂等新疗法在实际应用中的可能情况。本综述阐述了2019年在维也纳召开的国际圣加仑专家小组针对处于治愈阶段的乳腺癌患者当前治疗问题所进行的投票的背景情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b08f/6529230/d8e7b8671e9c/10-1055-a-0887-0861-igf01.jpg

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