CAJ | 학술논문

目的回顾性分析6周期ET方案(表阿霉素+多西他赛)新辅助化疗对乳腺癌的疗效,探讨影响病理完全缓解(pathological complete response,pCR)率的因素.方法回顾性分析2009年6月至2011年9月完成6周期ET方案新辅助化疗的52例乳腺癌患者的完整病例资料,将触诊、超声对肿瘤化疗效果的评价与术后病理结果进行比较.结果乳腺癌6周期ET方案新辅助化疗总pCR率为42.3％(22/52)；化疗1周期后超声测量肿瘤最大径缩小30％及以上者pCR率显著高于肿瘤最大径缩小30％以下者(60.9％比27.6％,P＜0.05)；肿瘤最大径≤3 cm者pCR率高于最大径＞3 cm者(P ＜0.05)；HER-2阳性型及三阴性型乳腺癌pCR率高于Luminal型者(P＜0.05)；多因素分析结果显示,肿瘤大小和其对化疗的早期反应是预测pCR的独立因素(P＜0.05).结论乳腺癌6周期ET方案新辅助化疗pCR率高,超声评价肿瘤对化疗的早期反应能够预测pCR,肿瘤大小、肿瘤分子生物学类型是影响pCR的重要因素.
목적 회고성분석6주기ET방안(표아매소+다서타새)신보조화료대유선암적료효,탐토영향병리완전완해(pathological complete response,pCR)솔적인소.방법 회고성분석2009년6월지2011년9월완성6주기ET방안신보조화료적52례유선암환자적완정병례자료,장촉진、초성대종류화료효과적평개여술후병리결과진행비교.결과 유선암6주기ET방안신보조화료총pCR솔위42.3％(22/52)；화료1주기후초성측량종류최대경축소30％급이상자pCR솔현저고우종류최대경축소30％이하자(60.9％비27.6％,P＜0.05)；종류최대경≤3 cm자pCR솔고우최대경＞3 cm자(P ＜0.05)；HER-2양성형급삼음성형유선암pCR솔고우Luminal형자(P＜0.05)；다인소분석결과현시,종류대소화기대화료적조기반응시예측pCR적독립인소(P＜0.05).결론 유선암6주기ET방안신보조화료pCR솔고,초성평개종류대화료적조기반응능구예측pCR,종류대소、종류분자생물학류형시영향pCR적중요인소.
Objective To explore the influencing factors in neoadjuvant chemotherapy on pathological complete response (pCR),by analyzing the effect of 6 cycles epirubicine combined with docetaxel(ET) regimen in breast cancer patients. Methods From June 2009 to September 2011,clinical date of 52 Ⅱ,Ⅲ stage breast cancer patients treated with ET regimen for neoadjuvant chemotherapy for 6 cycles were retrospectively analyzed.The curative effect was evaluated by palpation and ultrasonography,and finally compared with postoperative pathological results. Results In these 52 patients,the total pCR rate was 42.3％ after 6 cycles chemotherapy.After the first circle of chemotherapy,pCR rate was higher in patients with tumor size reducing ＞ 30％ than those ＜ 30％ as measured by ultrasonography(60.9％ vs.27.6％,P ＜0.05 ).Higher pCR rate was obtained in patients with tumor size ≤3 cm than those in which the initial tumor size ＞ 3 cm(52.9％ vs.22.2％,P ＜0.05) after 6 cycles ET neoadjuvant chemotherapy.PCR rate was higher in patients with positive HER-2 or triple negative breast cancer after 6 cycles than those with luminal type 1breast cancer ( 77.8％,75.0％ and 25.7％,respectively,P ＜ 0.05 ).Logistic regression analysis showed that tumor size and its early response to neoadjuvant chemotherapy evaluated by ultrasonography were the significant predictive factors. Conclusions Higher pCR rate can be achieved after 6 cycles ET regimen neoadjuvant chemotherapy in stage ]Ⅱ,Ⅲ breast cancer patients.Tumor's early response to chemotherapy as evaluated by ultrasonography could forecast the pCR.Tumor size and molecular type are important influencing factors on pCR in breast cancer patients.