新辅助化疗后ER、PR由阴性转为阳性乳腺癌患者的序贯内分泌治疗
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管小青 E-mail:guan_dr@163.com

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R 737.9

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江苏省科技厅社会发展资助项目(BS2006045)。


Sequential endocrine therapy for breast cancer patients with ER and PR negitive expression conversion to positive expression after neoadjuvant cnemotherapy
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    摘要:

    目的:探讨术前ER、PR阴性表达经新辅助化疗(NACT)后呈阳性表达的乳腺癌患者行序贯内分泌治疗的效果。
    方法:将上述患者随机分为两组,即序贯内分泌治疗组和对照组。序贯内分泌组在术后辅助化疗后口服他莫昔芬(TAM)10 mg/次,2次/d,共5年,对照组口服安慰剂。对比两组临床疗效。
    结果:序贯内分泌治疗组3,5年总生存率(OS)为80.0%(41/51)和74.5%(38/51),3,5年无病生存率(DFS)分别为74.5%(38/51)和60.7%(31/51),对照组的3,5年的OS分别为 60.9%(28/46)、50.0%(23/46),3,5年DFS 分别为52.2%(24/46)和39.1%(18/46)。上述各生存率治疗组均明显高于对照组(均P<0.05)。
    结论:对于NACT后ER、PR由阴性转为阳性表达的患者,采用序贯内分泌治疗可明显提高此类患者的DFS和OS。

    Abstract:

    Objective:To explore the effect of sequential endocrine therapy in breast cancer patients whose expression of ER and PR was negative preoperatively and was converted to positive by neoadjuvant chemotherapy (NAC).
    Methods:The clinical study was carried out in 97 cases of breast cancer whose ER and PR statue were converted from negative to positive after NAC. after NAC the 97 cases were divided into sequential endocrine therapy group and control group. The sequential endocrine group was treated with TAM 10mg Bid for 5 years, the control group was treated with placebo. 
    Results: In sequential endocrine treatment group, the 3-and 5-year disease-free survival was 74.5%(38/51) and 60.7%(31/51)  respectively, and the 3-and 5-year overall survival was 80%(41/51) and 74.5%(38/51)  respectively. In control group, the 3-and 5-year disease-free survival was respectively 52.2%(24/46) and 39.1%(18/46), and the 3-and 5-year overall survival was respectively 60.9%(28/46) and 50.0%(23/46). The corresponding values were significantly higher in sequential endocrine therapy group than in control group.
    Conclusions: The disease-free and overall survival are significantly increased by applying sequential endocrine therapy in breast cancer patients whose expression of ER and PR has been converted from negative to positive by neoadjuvant chemotherapy.

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管小青| 吴骥| 陈焰| 顾书成| 吴建强| 吴际生| 袁牧| 江小玲| 侍孝红| 葛立峰.新辅助化疗后ER、PR由阴性转为阳性乳腺癌患者的序贯内分泌治疗[J].中国普通外科杂志,2010,19(11):1196-1199.

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  • 收稿日期:2010-04-07
  • 最后修改日期:2010-08-19
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  • 在线发布日期: 2010-11-15
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