Paclitaxel improves the prognosis in estrogen receptor negative inflammatory breast cancer: the M. D. Anderson Cancer Center experience.
Paclitaxel improves the prognosis in estrogen receptor negative inflammatory breast cancer: the M. D. Anderson Cancer Center experience.
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DOI：
10.3816/cbc.2004.n.004
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发表时间：
2004-02-01
影响因子：
3.1
通讯作者：
Hortobagyi, Gabriel N
中科院分区：
文献类型：
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作者：
Cristofanilli, Massimo;Gonzalez-Angulo, Ana Maria;Hortobagyi, Gabriel N
炎性乳腺癌的治疗包括术前蒽环类药物化疗、手术和放射治疗。在过去的几年中，紫杉烷类，主要是紫杉醇，已被频繁用于术前化疗，通常与蒽环类药物顺序。这项回顾性分析的目的是确定在蒽环类药物治疗方案中加入紫杉醇对预后的影响。在1973年至2000年的6项连续试验中，共有240例患者接受了治疗。第1组（N = 178）包括前4项试验（1973-1993）中接受FAC（5-氟尿嘧啶/多柔比星/环磷酰胺）方案治疗的患者。第2组（N = 62）包括在最后2项试验（1994-2000）中接受FAC治疗的患者，随后每3周一次给予紫杉醇或每周一次给予高剂量紫杉醇。两组的中位随访持续时间不同，第1组为148个月（范围：85-283个月），第2组为45个月（范围：21-99个月）。雌激素受体（ER）状态在第1组中58例（33%）和第2组中40例（65%）为阴性。两组之间的中位年龄没有差异。客观缓解率（完全和部分）相似（第1组，74%;第2组，82%）。紫杉醇治疗组患者的中位总生存期（OS）和无进展生存期（PFS）较好，ER阴性患者的中位OS和PFS差异具有统计学意义（中位OS：第1组，32个月;第2组，54个月; P = 0.03;中位PFS：第1组，18个月;第2组，27个月; P = 0.04）。可以得出结论，紫杉醇加蒽环类药物治疗导致ER阴性炎性乳腺癌患者的结局在统计学上显著改善。
The treatment of inflammatory breast cancer includes preoperative anthracycline-based chemotherapy, surgery, and radiation therapy. In the past few years, taxanes, mainly paclitaxel, have been frequently used for preoperative chemotherapy, usually in sequence with anthracyclines. The purpose of this retrospective analysis was to determine how adding paclitaxel to anthracycline-based regimens affects prognosis. A total of 240 patients treated in 6 consecutive trials between 1973 and 2000 were included in the analysis. Group 1 (N = 178) consisted of patients treated in the first 4 trials (1973-1993) with FAC (5-fluorouracil/doxorubicin/cyclophosphamide) based regimens. Group 2 (N = 62) consisted of patients treated in the last 2 trials (1994-2000) with FAC followed by paclitaxel given every 3 weeks or given in a high-dose weekly schedule. The 2 groups differed with respect to median follow-up durations, which were 148 months (range, 85-283 months) in group 1 and 45 months (range, 21-99 months) in group 2. Estrogen receptor (ER) status was negative in 58 cases (33%) in group 1 and 40 cases (65%) in group 2. There was no difference in median age between the groups. The objective response rates (complete and partial) were similar (group 1, 74%; group 2, 82%). The median overall survival (OS) and progression-free survival (PFS) were better in the patients treated with paclitaxel, and these differences reached statistical significance in the patients with ER-negative disease (median OS: group 1, 32 months; group 2, 54 months; P = 0.03; median PFS: group 1, 18 months; group 2, 27 months; P = 0.04). It may be concluded that the addition of paclitaxel to anthracycline-based therapy resulted in a statistically significant improvement in outcome in patients with ER-negative inflammatory breast cancer.