Kharchenko V P, Khmelevskiĭ E V, Panyshin G A
Research Institute of Diagnosis and Surgery, Health Ministry of the RF, Moscow.
Vopr Onkol. 1998;44(4):443-6.
Different combinations of radical mastectomy, radiotherapy and cycle polychemotherapy were compared in 330 patients with T2N2 and T3-4N0-2M0 breast cancers: preoperative radiotherapy followed by surgery and adjuvant chemo-hormonal therapy (CT/HT)-118: neoadjuvant polychemotherapy (neCT) combined with preoperative radiation, surgery and adjuvant CT/HT-105; surgery, postoperative radiotherapy (PoRT) and adjuvant CT/HT-51, and neoCT followed by surgery, PoLT and adjuvant CT/HT-56. Advantage offered by postoperative radiotherapy proved significant only in the T2N2 and T3N1M0 groups and only in cases of combined PoLT and neoadjuvant polychemotherapy. Neoadjuvant polychemotherapy proved advantageous only in combination with postoperative surgery, and, on the whole, its application was as effective as adjuvant administration of cytostatic drugs. However, considering significant increase in recurrence-free survival in neoCT-sensitive patients within the first years of follow-up, one can expect to obtain higher stable effect in application of methods leading to more frequent complete regression.
对330例T2N2和T3 - 4N0 - 2M0期乳腺癌患者比较了根治性乳房切除术、放疗和周期多药化疗的不同组合:术前放疗后手术及辅助放化疗(CT/HT)- 118例;新辅助多药化疗(新辅助CT)联合术前放疗、手术及辅助CT/HT - 105例;手术、术后放疗(PoRT)及辅助CT/HT - 51例,新辅助CT后手术、PoLT及辅助CT/HT - 56例。术后放疗的优势仅在T2N2和T3N1M0组以及仅在联合PoLT和新辅助多药化疗的情况下被证明具有显著性。新辅助多药化疗仅在与术后手术联合时被证明具有优势,总体而言,其应用效果与辅助使用细胞毒性药物相当。然而,考虑到新辅助CT敏感患者在随访的头几年无复发生存率显著提高,可以预期在应用导致更频繁完全缓解的方法时能获得更高的稳定效果。