Weekly paclitaxel improves pathologic complete remission in operable breast cancer when compared with paclitaxel once every 3 weeks
Weekly paclitaxel improves pathologic complete remission in operable breast cancer when compared with paclitaxel once every 3 weeks
复制标题
DOI：
10.1200/jco.2005.06.232
复制
发表时间：
2005-09-01
影响因子：
45.3
通讯作者：
Hortobagyi, GN
中科院分区：
文献类型：
--
作者：
Green, MC;Buzdar, AU;Hortobagyi, GN
目的确定紫杉醇给药方案从每3周一次改为频繁给药对浸润性乳腺癌患者的乳腺和淋巴结病理学完全缓解率（pCR）的影响，浸润性乳腺癌患者接受初次全身化疗（PST）。IIIA乳腺癌患者随机接受紫杉醇剂量的PST，每周给药一次，（共12剂紫杉醇）或每3周一次（四个周期），随后是每3周以标准剂量的氟尿嘧啶/多柔比星/环磷酰胺（FAC）的四个周期。根据超声和细针穿刺确定的淋巴结状态，使用两种不同剂量的紫杉醇。结果258例患者随机分为紫杉醇组（每周1次）和紫杉醇组（每3周1次），随后进行FAC治疗。在这258名患者中，110名患者有组织学淋巴结受累，148名患者有临床NO疾病。127例患者接受每周一次紫杉醇治疗，随后接受FAC治疗，131例患者接受每3周一次紫杉醇治疗，随后接受FAC治疗。两组间对治疗的临床反应相似（P = 0.25）。每周接受紫杉醇治疗的患者的pCR率（28.2%）高于每3周一次紫杉醇治疗的患者（15.7%; P = 0.02），乳腺保护率提高（P = 0.05）。结论紫杉醇治疗方案从每3周一次改为更频繁的给药显著提高了根除乳腺和淋巴结浸润性癌的能力。
Purpose To determine the impact a change in schedule of paclitaxel administration from once every 3 weeks to frequent administration would have do the pathologic complete response (pCR) rate in the breast and lymph nodes for patients with invasive breast cancer treated with primary systemic chemotherapy (PST).Patients and Methods Patients with clinical stage I-IIIA breast cancer were randomly assigned to receive PST of paclitaxel doses administered either weekly (for a total of 12 doses of paclitaxel) or once every 3 weeks (four cycles), followed by four cycles of fluorouracil/doxorubicin/cyclophosphamide (FAC) in standard doses every 3 weeks. Two different doses of paclitaxel were used based on lymph node status defined by ultrasound and fine needle aspiration. Clinical response and extent of residual disease in the breast and lymph nodes was assessed after completion of all chemotherapyResults A total of 258 patients were randomly assigned to receive doses of paclitaxel administered either weekly or once every 3 weeks, followed by FAC. Of these 258 patients, 110 patients had histologic lymph node involvement and 148 patients had clinical NO disease. Weekly paclitaxel followed by FAC was administered to 127 patients and once-every-3-weeks paclitaxel followed by FAC was administered to 131 patients. Clinical response to treatment was similar between groups (P =.25). Patients receiving weekly paclitaxel had a higher pCR rate (28.2%) than patients treated with once-every-3-weeks paclitaxel (15.7%; P =.02), with improved breast conservation rates (P =.05)Conclusion The change in schedule of paclitaxel from once every 3 weeks to a more frequent administration significantly improved the ability to eradicate invasive cancer in the breast and lymph nodes.