PROGNOSTIC FACTORS IN INFLAMMATORY BREAST-CANCER AND THERAPEUTIC IMPLICATIONS
PROGNOSTIC FACTORS IN INFLAMMATORY BREAST-CANCER AND THERAPEUTIC IMPLICATIONS
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DOI：
10.1016/0959-8049(94)90115-5
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发表时间：
1994-01-01
影响因子：
8.4
通讯作者：
POUILLART, P
中科院分区：
文献类型：
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作者：
PALANGIE, T;MOSSERI, V;POUILLART, P
1977年至1987年间，居里研究所诊断出223名炎性乳腺癌患者。根据三项连续随机试验，患者接受化疗和放疗。5年和10年生存率分别为41%和32%。5年和10年的无疾病间隔率分别为25.5%和19%。多变量分析中与预后不良显著相关的参数为：弥漫性红斑、淋巴结受累、胸壁粘连和年龄50岁以上。当治疗反应参数被纳入多变量分析时，五个最重要的预后因素按显著性顺序为完成诱导治疗后肿瘤完全消退（8个月时），新辅助化疗3个月后炎症症状完全消退，出现有限的红斑，炎症症状在8个月时完全消退，肿瘤在3个月时消退。总之，实现快速和完全缓解的患者比对化疗反应不完全的患者具有更好的预后。高剂量化疗和逆转或预防耐药性将在未来的试验中进行评估。关于这种疾病的生物学的详细信息应该允许设计旨在改善患者管理的新策略。
223 inflammatory breast cancer patients were diagnosed at the Institut Curie between 1977 and 1987. Patients received chemotherapy and radiation treatment according to three consecutive randomised trials. Five- and 10-year survival rates were 41 and 32%, respectively. Disease-free interval rates were 25.5% at 5 years and 19% at 10 years. Parameters significantly linked with a pejorative prognosis in a multivariate analysis were: diffuse erythema, lymph node involvement, chest wall adherence, and age above 50 years. When therapeutic response parameters were included in the multivariate analysis, the five most important prognostic factors in order of significance were complete tumour regression after completion of induction treatment (at 8 months), complete regression of inflammatory symptoms after 3 months of neoadjuvant chemotherapy, limited erythema at presentation and, less significantly, complete regression of inflammatory symptoms at 8 months and tumour regression at 3 months, in conclusion, patients who achieved a rapid and complete remission had a better prognosis than patients who had an incomplete response to chemotherapy. High-dose chemotherapy and reversal or prevention of drug resistance will be evaluated in future trials. Detailed information on the biology of this disease should allow the design of new strategies aiming to improve patient management.