One-Year Neoadjuvant Endocrine Therapy in Breast Cancer
One-Year Neoadjuvant Endocrine Therapy in Breast Cancer
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DOI：
10.1007/s12253-015-9911-1
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发表时间：
2015-09-01
影响因子：
2.8
通讯作者：
Kahan, Zsuzsanna
中科院分区：
文献类型：
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作者：
Rusz, Orsolya;Voeroes, Andras;Kahan, Zsuzsanna
对内分泌治疗(NET)1年的疗效进行评价。对42例II-III期、激素受体阳性、HER2阴性的浸润性乳腺癌的临床资料进行了回顾分析。其中绝经前组33例，格列林+来曲唑组7例，格列林+三苯氧胺组2例。根据初始阶段和治疗反应进行手术治疗。对于残留在手术标本中的肿瘤，建立危险组：第1组：0期，病理完全消退(PCR)；第2组：IA-IIA期；第3组：临床进展的A/1000例IIB+病例。由于局部进展，3名患者(4个肿瘤)的Net被新辅助化疗所取代。在2例绝经后患者中，因治疗效果不佳，来曲唑被他莫昔芬取代。其中19/42例行保乳手术。在第1组中，4例无癌，仅2例DCIS残留(PCR13%)；第2组和第3组分别为25例和15例。ER表达每增加1%，对Net有良好反应的可能性增加7%(OR=1.070；95%CI：1.007~1.138，p=0.029)。无进展存活率因治疗反应而异(p=0.001)。治疗后Ki67值为千分之15%，对生存期影响不大。未发现肿瘤特征与治疗反应或生存期之间的其他关联。长效净对激素敏感型乳腺癌是有效和安全的。
The evaluation of the effects of 1-year endocrine therapy (NET) was aimed at. A retrospective analysis of 42 cases with 46 stage II-III invasive, hormone receptor-positive, HER2-negative breast cancers was performed. One-year NET was planned with letrozole (n = 33, postmenopausal group), or with goserelin plus letrozole (n = 7) or with goserelin plus tamoxifen (n = 2) (premenopausal group). Surgery was performed in accordance with the initial stage and the response to therapy. With regard to the tumor remaining in the surgical specimen, risk groups were constructed: Group 1: stage 0, pathological complete regression (pCR); Group 2: stages IA-IIA; Group 3: stages a parts per thousand yenIIB + cases with clinical progression. Due to local progression, NET was replaced by neoadjuvant chemotherapy in three patients (four tumors). In two postmenopausal patients, letrozole was replaced by tamoxifen because of the insufficient treatment effect. In 19/42 cases, breast-conserving surgery was performed. Within Group 1, there was no cancer in four cases, while only DCIS remained in 2 (pCR: 13 %); Groups 2 and 3 comprised 25 and 15 cases, respectively. The likeliness of a good response (Groups 1 and 2 vs. Group 3) to NET was increased by 7 % for every 1 % increase of the expression of ER (OR = 1.070; 95 % CI: 1.007-1.138, p = 0.029). Progression-free survival differed according to treatment response (p = 0.001). The post-therapy Ki67 value of a parts per thousand currency sign15 % had only a marginal effect on survival. No other associations were detected between the tumor characteristics and the therapeutic response or survival. Long-duration NET is effective and safe in cases of hormone-sensitive breast cancer.