Neoadjuvant Chemotherapy: What Are the Benefits for the Patient and for the Investigator?
Neoadjuvant Chemotherapy: What Are the Benefits for the Patient and for the Investigator?
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DOI：
10.1093/jncimonographs/lgv004
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发表时间：
2015-05-01
期刊：
影响因子：
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通讯作者：
Schott, Anne F.
中科院分区：
文献类型：
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作者：
Hayes, Daniel F.;Schott, Anne F.
与传统的辅助化疗相比，新辅助化疗具有一些吸引人的潜在益处。其中，唯一被证实的益处是促进手术方法，通过将不能手术的癌症转化为可手术的癌症，或者通过将被认为是乳房切除术候选者的患者转化为可能通过保乳治疗成功治疗的患者。比较新辅助化疗与术后化疗的随机试验未能证明总生存期的延长。新辅助化疗期间监测明显缓解的益处尚未得到证实。在新辅助治疗环境中进行II期药物开发试验可能比在转移性环境中进行此类试验更有利。然而，这种审判引起了一些并非不可避免但需要解决的关切。
Neoadjuvant chemotherapy has several appealing potential benefits compared with classic adjuvant chemotherapy. Of these, the only proven benefit is to facilitate the surgical approach, either by converting an inoperable cancer to one that is operable, or by converting a patient who is felt to be a candidate for mastectomy to one who might be treated successfully with breast conserving therapy. Randomized trials comparing neoadjuvant chemotherapy with postoperative chemotherapy have failed to demonstrate prolongation of overall survival. The benefits of monitoring apparent response during neoadjuvant chemotherapy have not been proven. Conduct of phase II drug development trials in the neoadjuvant setting may be advantageous compared with performing such trials in the metastatic setting. However, such trials raise concerns that are not unavoidable but need to be addressed.