Neoadjuvant Chemotherapy in Triple Negative Breast Cancer: An Observational Study.
Neoadjuvant Chemotherapy in Triple Negative Breast Cancer: An Observational Study.
复制标题
DOI：
10.3727/096504016x14562725373879
复制
发表时间：
2016
影响因子：
3.1
通讯作者：
Rea D
中科院分区：
文献类型：
--
作者：
Shao Z;Chaudhri S;Guo M;Zhang L;Rea D
三阴性乳腺癌（TNBC）是一种具有侵袭性临床行为的乳腺癌表型。由于缺乏最佳治疗，这种疾病的预后很差。本研究的主要目的是检测TNBC队列中对新辅助化疗（NACT）的反应，并比较有和无病理完全缓解（pCR）患者的长期生存率。从2005年到2013年，共有53名在伯明翰大学医院接受NACT的TNBC患者入选本研究。比较pCR组和非pCR组的总生存期（OS）和无进展生存期（PFS）。人口统计学信息和临床或病理参数也进行了分析，以探索潜在的预测和预后因素。14例患者（26.4%）达到pCR至NACT。在单变量分析中，与无pCR的患者相比，pCR患者的PFS时间（p = 0.013）和OS时间（p = 0.054）更长。多因素分析显示，淋巴血管浸润（LVI）的存在显著降低了OS（HR = 17.404，95%CI = 2.923-103.644）和PFS（HR = 7.776，95%CI = 1.645-36.753）。实现pCR至NACT可显著推迟TNBC患者疾病进展的发生率。没有足够的证据表明它对最终生存的影响。在TNBC队列中，LVI可能是比pCR更有效的预后因素。
Triple negative breast cancer (TNBC) is a phenotype of breast cancer with aggressive clinical behavior. Because of the absence of optimal treatment, the prognosis of this disease is poor. The main purpose of this study was to detect the response to neoadjuvant chemotherapy (NACT) in a TNBC cohort and compare the long-term survival between patients with and without pathological complete response (pCR). A total of 53 patients diagnosed with TNBC from 2005 to 2013 who received NACT at the University Hospital Birmingham were enrolled in this study. Overall survival (OS) and progression-free survival (PFS) were compared between the pCR group and non-pCR group. Demographic information and clinical or pathologic parameters were also analyzed to explore potential predictive and prognostic factors. Fourteen patients (26.4%) achieved pCR to NACT. In univariate analysis, patients with pCR had longer PFS time (p = 0.013) and OS time (p = 0.054) compared with their counterparts without pCR. In multivariate analysis, the existence of lymphovascular invasion (LVI) significantly reduced OS (HR = 17.404, 95% CI = 2.923–103.644) and PFS (HR = 7.776, 95% CI = 1.645–36.753). The achievement of pCR to NACT can significantly postpone the incidence of disease progression in patients with TNBC. There is not enough evidence showing its influence on ultimate survival. LVI may be a more potent prognostic factor than pCR in the TNBC cohort.