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可手术乳腺癌患者每周接受紫杉醇与多西他赛治疗后的病理反应

Pathologic Response After Weekly Paclitaxel versus Docetaxel in Operable Breast Cancer.

作者信息

Bacinschi Xenia Elena, Anghel Rodica Maricela, Toma Paula Iuliana, Safta Inga, Ilie Alis, Ilie Silvia Mihaela

机构信息

Department of Oncology-Radiotherapy, Institute of Oncology Prof Dr Alexandru Trestioreanu, Bucharest, Romania.

University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.

出版信息

Cancer Manag Res. 2020 Feb 26;12:1419-1426. doi: 10.2147/CMAR.S234527. eCollection 2020.

Abstract

INTRODUCTION

Weekly paclitaxel (Ptx) and q3w docetaxel (Dtx) are equivalent in adjuvant breast cancer treatment. Weekly Ptx is better tolerated than q3w Dtx and became the first choice in daily practice, even preoperatively.

METHODS

To compare the efficacy and safety of the two regimens, a retrospective analysis was performed in breast cancer patients (pts) referred for neoadjuvant, sequential, taxane-containing chemotherapy to the Institute of Oncology and Oncofort Clinic, Bucharest, between 2008 and 2017.

RESULTS

Forty-seven cases were eligible, median age was 56 years (34-73 years), mainly stage IIIA-B (53.2%, 25 pts) and ductal invasive (70.2%, 33 pts) of which 24 pts (51%) received q3w Dtx and 23 pts (48.9%) weekly Ptx. The histological response rates were 62.5% (15 pts) and 73.7% (17 pts) (p=0.47), average dose-intensity was 87.7% and 96.7% (p=0.002) and grade III-IV toxicity rate was 12.5% and 13% (p=0.64), respectively. Pathologic response was correlated with immunophenotype, PgR expression, tumor size and backbone chemotherapy (p<0.05).

DISCUSSION

Our study showed an improved efficacy of taxane's weekly administration, probably due to a better tolerance and a lower rate of dose-impairing toxicities.

摘要

引言

每周一次的紫杉醇(Ptx)和每三周一次的多西他赛(Dtx)在辅助性乳腺癌治疗中疗效相当。每周一次的Ptx耐受性优于每三周一次的Dtx,甚至在术前就成为日常实践中的首选。

方法

为比较两种方案的疗效和安全性,对2008年至2017年间转诊至布加勒斯特肿瘤研究所和Oncofort诊所接受新辅助、序贯、含紫杉烷化疗的乳腺癌患者进行了回顾性分析。

结果

47例患者符合条件,中位年龄为56岁(34 - 73岁),主要为IIIA - B期(53.2%,25例)和导管浸润性(70.2%,33例),其中24例(51%)接受每三周一次的Dtx,23例(48.9%)接受每周一次的Ptx。组织学缓解率分别为62.5%(15例)和73.7%(17例)(p = 0.47),平均剂量强度分别为87.7%和96.7%(p = 0.002),III - IV级毒性发生率分别为12.5%和13%(p = 0.64)。病理反应与免疫表型、PgR表达、肿瘤大小和主要化疗方案相关(p < 0.05)。

讨论

我们的研究表明,紫杉烷每周给药的疗效有所提高,可能是由于耐受性更好和剂量损害毒性发生率更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f84/7051895/c4c1e6e009c5/CMAR-12-1419-g0001.jpg

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