Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany.
West German Breast Center (WBC), Düsseldorf, Germany.
Int J Cancer. 2020 Dec 1;147(11):3049-3058. doi: 10.1002/ijc.33122. Epub 2020 Jun 13.
Neoadjuvant chemotherapy (NACT) in early breast cancer (EBC) enables in vivo sensitivity testing and less radical surgery as compared to primary surgery and adjuvant chemotherapy (ACT). The aim of our study is to illustrate trends of systemic treatment of EBC. The study analyzed chemotherapy usage and time trends for patients with EBC treated at 104 German breast units between January 2008 and December 2017. The data were obtained through a quality-controlled benchmarking process. Altogether, 124 084 patients were included, of whom 46 279 (37.3%) received chemotherapy. For 44 765 of these cases, detailed information on systemic treatment and surgery were available. Overall use of chemotherapy declined from 42.0% in 2008 to 32.0% in 2017. During that same time, the proportion of NACT increased from 20.0% to 57.7%, irrespective of tumor subtype. The pathological complete response (pCR) rate (defined as ypT0 ypN0) at surgery after NACT increased from 15.0% to 34.2%. The results from this large cohort from the clinical routine reflect the refined indications for chemotherapy in EBC.
新辅助化疗（NACT）在早期乳腺癌（EBC）中可进行体内药敏试验，并使手术比原发性手术和辅助化疗（ACT）更具保守性。我们的研究旨在说明 EBC 系统性治疗的趋势。本研究分析了 2008 年 1 月至 2017 年 12 月 104 家德国乳腺单位治疗的 EBC 患者的化疗使用情况和时间趋势。数据是通过质量控制基准测试过程获得的。共纳入 124084 例患者，其中 46279 例（37.3%）接受化疗。对于其中 44765 例患者，有关于系统治疗和手术的详细信息。总体而言，化疗的使用率从 2008 年的 42.0%下降到 2017 年的 32.0%。同期，NACT 的比例从 20.0%增加到 57.7%，而肿瘤亚型无差异。NACT 术后手术的病理完全缓解（pCR）率（定义为 ypT0 ypN0）从 15.0%增加到 34.2%。这一大规模临床常规队列的结果反映了 EBC 中化疗适应症的精细化。
