中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2009年
7期
511-515
,共5页
黄欧%陈灿铭%吴佳毅%胡震%侯意枫%张家新%柳光宇%狄根红%陆劲松%吴炅%邵志敏%沈镇宙%沈坤炜
黃歐%陳燦銘%吳佳毅%鬍震%侯意楓%張傢新%柳光宇%狄根紅%陸勁鬆%吳炅%邵誌敏%瀋鎮宙%瀋坤煒
황구%진찬명%오가의%호진%후의풍%장가신%류광우%적근홍%륙경송%오경%소지민%침진주%침곤위
乳腺肿瘤%化学疗法,辅助%预后%长春瑞滨%表柔比星
乳腺腫瘤%化學療法,輔助%預後%長春瑞濱%錶柔比星
유선종류%화학요법,보조%예후%장춘서빈%표유비성
Breast neoplasms%Chemotherapy,adjuvant%Prognosis%Vinorelbine%Epirubicin
目的 探讨术前接受长春瑞滨联合表柔比星(VE)方案治疗的局部晚期乳腺癌的预后影响因素.方法 回顾分析2001年9月至2006年5月术前接受3个周期VE方案化疗的119例局部晚期乳腺癌患者的临床病理资料.所有患者均经术前空心针活检证实为浸润性乳腺癌,新辅助化疗后接受手术治疗.术后根据新辅助化疗的临床疗效,再继续接受3个周期VE或标准的环磷酰胺+表柔比星+氟尿嘧啶(CEF)方案辅助化疗及局部区域放射治疗和相应的内分泌治疗.分析新辅助化疗前及术后临床病理资料与预后的关系.结果 新辅助化疗后临床完全缓解27例(22.7%),部分缓解78例(65.5%);肿瘤原发灶病理完全缓解(pCR)22例(18.5%).本组115例(96.6%)获得随访,随访时间9～76个月,中位时间63.4个月.无局部复发转移患者共72例(60.5%).5年无病生存率为58.7%,5年总生存率为71.3%.多因素分析显示,新辅助化疗前Ki-67(pre-Ki-67)高表达(P=0.012)、化疗后Ki-67(post-Ki-67)高表达(P=0.045)、化疗后病理未完全缓解(P=0.034)与无病生存时间的降低有关;pre-Ki-67高表达(P=0.017)、post-Ki-67高表达(P=0.001)、pre-ER阴性(P=0.002)、化疗后病理未完全缓解(P=0.034)与总生存时间的降低有关.结论 pre-Ki-67、post-Ki-67及pre-ER的表达水平和新辅助化疗后肿瘤原发灶病理状况是接受术前3个周期VE新辅助化疗局部晚期乳腺癌的独立预后因素.
目的 探討術前接受長春瑞濱聯閤錶柔比星(VE)方案治療的跼部晚期乳腺癌的預後影響因素.方法 迴顧分析2001年9月至2006年5月術前接受3箇週期VE方案化療的119例跼部晚期乳腺癌患者的臨床病理資料.所有患者均經術前空心針活檢證實為浸潤性乳腺癌,新輔助化療後接受手術治療.術後根據新輔助化療的臨床療效,再繼續接受3箇週期VE或標準的環燐酰胺+錶柔比星+氟尿嘧啶(CEF)方案輔助化療及跼部區域放射治療和相應的內分泌治療.分析新輔助化療前及術後臨床病理資料與預後的關繫.結果 新輔助化療後臨床完全緩解27例(22.7%),部分緩解78例(65.5%);腫瘤原髮竈病理完全緩解(pCR)22例(18.5%).本組115例(96.6%)穫得隨訪,隨訪時間9～76箇月,中位時間63.4箇月.無跼部複髮轉移患者共72例(60.5%).5年無病生存率為58.7%,5年總生存率為71.3%.多因素分析顯示,新輔助化療前Ki-67(pre-Ki-67)高錶達(P=0.012)、化療後Ki-67(post-Ki-67)高錶達(P=0.045)、化療後病理未完全緩解(P=0.034)與無病生存時間的降低有關;pre-Ki-67高錶達(P=0.017)、post-Ki-67高錶達(P=0.001)、pre-ER陰性(P=0.002)、化療後病理未完全緩解(P=0.034)與總生存時間的降低有關.結論 pre-Ki-67、post-Ki-67及pre-ER的錶達水平和新輔助化療後腫瘤原髮竈病理狀況是接受術前3箇週期VE新輔助化療跼部晚期乳腺癌的獨立預後因素.
목적 탐토술전접수장춘서빈연합표유비성(VE)방안치료적국부만기유선암적예후영향인소.방법 회고분석2001년9월지2006년5월술전접수3개주기VE방안화료적119례국부만기유선암환자적림상병리자료.소유환자균경술전공심침활검증실위침윤성유선암,신보조화료후접수수술치료.술후근거신보조화료적림상료효,재계속접수3개주기VE혹표준적배린선알+표유비성+불뇨밀정(CEF)방안보조화료급국부구역방사치료화상응적내분비치료.분석신보조화료전급술후림상병리자료여예후적관계.결과 신보조화료후림상완전완해27례(22.7%),부분완해78례(65.5%);종류원발조병리완전완해(pCR)22례(18.5%).본조115례(96.6%)획득수방,수방시간9～76개월,중위시간63.4개월.무국부복발전이환자공72례(60.5%).5년무병생존솔위58.7%,5년총생존솔위71.3%.다인소분석현시,신보조화료전Ki-67(pre-Ki-67)고표체(P=0.012)、화료후Ki-67(post-Ki-67)고표체(P=0.045)、화료후병리미완전완해(P=0.034)여무병생존시간적강저유관;pre-Ki-67고표체(P=0.017)、post-Ki-67고표체(P=0.001)、pre-ER음성(P=0.002)、화료후병리미완전완해(P=0.034)여총생존시간적강저유관.결론 pre-Ki-67、post-Ki-67급pre-ER적표체수평화신보조화료후종류원발조병리상황시접수술전3개주기VE신보조화료국부만기유선암적독립예후인소.
Objective To identify predictive markers of the long-term outcome for neo-adjuvant chemotherapy (NC) in locally advanced breast cancer (LABC) treated with intravenous vinorelbine (V) and epirubicin (E) combination regimen. Methods One hundred and nineteen patients with LABC were treated from September 2001 to May 2006. All patients were diagnosed as invasive breast cancer by 14G core needle biopsy and treated with three cycles of VE regimen before the operation. The patients were subjected to surgery and subsequently were given other three cycles of VE or cyclophosphamide + epirubicin + fluorouracil (CEF) regimen according to the clinical responses. Local-regional radiotherapy was applied to all patients after the chemotherapy and followed by hormone-therapy according to hormone receptor status. The impact of clinical, pathological, and immunohistochemical features on disease free survival (DFS) and overall survival (OS) was evaluated. Results All patients were evaluable for responses: clinical complete response was documented in 27 patients (22.7%), 78 patients (65.5% ) obtained partial clinical response. The pathological complete response was found in 22 cases (18.5%). Of the patients, 115 cases (96.6%) were followed-up for a median time of 63.4 months (range, 9-76 months), the 5-year DFS rate and OS rate was 58.7% and 71.3% , respectively. On multivariate analysis, high pre-Ki-67 (P=0.012) and post-Ki-67 expression (P=0.045) , no pathological complete response after NC (P=0.034) were associated with the higher risk of disease relapse; high pre-Ki-67(P=0.017) and post-Ki-67 expression (P=0.001), negative pre-ER (P=0.002) and no pathological complete response after NC (P=0.034) were associated with a shorter survival. Conclusion Pathological response in primary tumor, pre-Ki-67 and post-Ki-67 expression, pre-ER expression are important predictors of long-term outcome for LABC patients with three cycles of VE regimen before operation.
