HR+晚期乳腺癌内分泌治疗优先再添力证!Young-PEARL为绝经前HR+晚期乳腺癌患者带来新希望

2019-06-09 佚名 肿瘤资讯

绝经前晚期乳腺癌的发病率渐增,但是绝经前HR+晚期乳腺癌的治疗在很多临床研究中却常常被忽视。对于这部分患者的治疗策略主要是基于绝经后患者的研究数据,使用含卵巢功能抑制(OFS)的内分泌治疗方案。近年来,绝经后HR+/HER2-晚期乳腺癌的治疗模式有了较大改变,靶向治疗药物尤其是CDK4/6抑制剂联合内分泌治疗已被证实可以显着改善疗效,延缓内分泌耐药的发生。而对于绝经前HR+的晚期乳腺癌患者,也亟需

绝经前晚期乳腺癌的发病率渐增,但是绝经前HR+晚期乳腺癌的治疗在很多临床研究中却常常被忽视。对于这部分患者的治疗策略主要是基于绝经后患者的研究数据,使用含卵巢功能抑制(OFS)的内分泌治疗方案。近年来,绝经后HR+/HER2-晚期乳腺癌的治疗模式有了较大改变,靶向治疗药物尤其是CDK4/6抑制剂联合内分泌治疗已被证实可以显着改善疗效,延缓内分泌耐药的发生。而对于绝经前HR+的晚期乳腺癌患者,也亟需专门的研究来探讨这些年轻患者的治疗模式。在今年的ASCO大会上,针对于绝经前HR+的晚期乳腺癌患者,我们很高兴看到两项重磅研究数据的公布,MONALEESA-7的OS数据和来自韩国的KCSG-BR 15-10研究,为此类患者的治疗提供了新的思路。尤其是KCSG-BR 15-10研究为HR+晚期乳腺癌内分泌治疗优先再添力证!也为绝经前HR+晚期乳腺癌患者带来新希望!

Young-PEARL(KCSG-BR 15-10):palbociclib联合GnRHa及依西美坦对比卡培他滨在绝经前激素受体阳性转移性乳腺癌患者的随机Ⅱ期研究

背景

HR+/HER2-的转移性乳腺癌(MBC)绝经前和绝经后妇女的临床指南首选内分泌治疗。然而在现实的临床实践中,由于内分泌耐药和/或医生担心恶性肿瘤进展迅速和年龄较轻与预后较差有关,大量患者在早期接受了化疗。就化疗方案而言,卡培他滨似乎是最受欢迎的选择之一。

目的

评估palbociclib联合GnRHa及依西美坦与卡培他滨治疗绝经前HR阳性MBC患者的安全性和临床抗肿瘤疗效。

方法

本研究为韩国癌症研究组的前瞻性、双臂、随机、多中心、开放标签Ⅱ期研究。患者允许既往行1线MBC化疗。新发转移患者应在入组前用他莫昔芬治疗。患者被随机分为化疗(卡培他滨1250mg/m2 1天2次,d1~14,每3周)或联合内分泌治疗(依西美坦25mg,28天;palbociclib 125mg,21天;GnRHa每4周)。主要终点为研究者评估的无进展生存(PFS)。

结果

2016—2018年14个中心纳入189例患者,184例患者随机分为化疗组(92例) 和内分泌组(92例) 。中位年龄为44岁(28~58岁) 。新发MBC在两组均有发现 (30%) 。中位随访14个月,中位PFS: 内分泌加palbociclib优于卡培他滨 [20.1个月 vs 14.4个月,P=0.0469; HR=0.659(0.437~0.994), P=0.0469] 。Ⅲ级以上血液学毒性反应在palbociclib组较卡培他滨组更为常见(60.9% vs 19.2%,P<0.0001) 。腹泻(11% vs 38%) 和手足综合征(1% vs 76%) 在卡培他滨组更为常见。

结论

palbociclib联合GnRHa及依西美坦治疗绝经前ER阳性MBC患者,PFS较卡培他滨有明显改善。

耿翠芝主任医师、教授、博士生导师、医学博士,河北医科大学第四医院暨河北省肿瘤医院副院长,中国抗癌协会乳腺癌专业委员会常务委员,中国抗癌协会河北省乳腺癌专业委员会主任委员,中华医学会肿瘤分会乳腺癌学组委员,中国医师协会乳腺疾病培训专家委员会常务委员,中华医学会河北省外科分会常务委员,《中华乳腺病杂志》《中华外科杂志》《中国肿瘤临床》编委,《中华全科医师杂志》通讯编委,从事普通外科、肿瘤外科和乳腺外科的工作,2005—2006年在美国德克萨斯大学 M.D  Anderson Cancer Center 学习,现为全国重点专科——河北医科大学第四医院外科的学术带头人

晚期乳腺癌我们的治疗目标是延长生存时间和保证生活质量。对于HR+/HER2-的晚期乳腺癌患者,ABC4指南强烈推荐内分泌治疗应该是首选,即便存在内脏转移,除非有内脏危象或内分泌耐药的可能[4]。2016年荷兰马斯特里赫特大学医学中心一项真实世界的数据也证明,HR+/HER2-的晚期乳腺癌患者,起始内分泌治疗优于起始化疗,mPFS分别为13.3个月vs 5.3个月(P<0.0001),mOS分别为36.9个月 月vs 16.1个月(P<0.0001)[5]。对于接受起始内分泌治疗的患者,ABC4指南强烈推荐含OFS的治疗方案,无论是药物去势还是手术去势[4]。然而在临床实践中,由于内分泌耐药、对恶性肿瘤快速进展的担忧,以及担心年龄轻与预后较差有关,大量患者在早期接受了化疗。卡培他滨作为一个口服化疗药物,由于其有效性和较低的毒性也成为既往蒽环和紫衫类治疗失败后的I级推荐。

随着CDK4/6抑制剂在绝经后HR+/HER2-晚期乳腺癌患者中被证明可以显着改善PFS,其在绝经前HR+/HER2-晚期乳腺癌患者的应用也受到越来越多临床专家的关注。在PALOMA-3的绝经前亚组人群中,palbociclib联合氟维司群和戈舍瑞林可以显着改善既往内分泌治疗进展患者的PFS(9.5个月 vs 5.6个月,HR=0.50, 95%CI 0.29~0.87)[6]。 在MONALEESA-7研究中,ribociclib联合GnRHa和AI可以显着延长PFS(23.8个月vs 13个月,HR=0.55, 95%CI 0.44~0.69; P<0.0001)[7]。今年ASCO大会上公布的MONALEESA-7 OS的结果则显示ribociclib+戈舍瑞林+AI/TAM相较于戈舍瑞林+AI/TAM在绝经前HR+/HER2-晚期乳腺癌患者中同样显着延长OS(未达到 vs 40.9个月,HR=0.712,P=0.00973)。而随着氟维司群在晚期内分泌治疗基石地位的建立,CDK4/6抑制剂+氟维司群+GnRHa相较于CDK4/6抑制剂+GnRHa+AI是否可以取得进一步疗效的改善也值得思考。

KCSG-BR 15-10研究是第一个对比化疗和CDK4/6抑制剂联合GnRHa和AI治疗的研究,主要研究终点是研究者评估的PFS,次要研究终点包括疾病控制率(disease control rate, DCR),总生存、毒性反应、QoL和biomarkers。结果显示研究者评估的PFS palbociclib+GnRHa+AI组对比卡培他滨组分别为20.1个月 vs 14.4个月,在PFS的亚组分析中,各亚组显示出CDK4/6抑制剂+内分泌治疗更优的趋势,而在年龄>35岁、既往没有接受过化疗以及没有内脏转移的患者中CDK4/6抑制剂+内分泌治疗具有更加显着的获益。在毒性反应方面,CDK4/6抑制剂+内分泌治疗的血液学毒性和非血液学毒性的发生率高于卡培他滨。KCSG-BR 15-10研究阳性结果可以为绝经前HR+/HER2-晚期乳腺癌患者的治疗提供指导,但需要更大规模、前瞻性、Ⅲ期随机临床试验的验证。同时我们需要考虑原发性耐药和继发性耐药、内脏危象,肿瘤负荷等患者特征,针对绝经前HR+/HER2-晚期乳腺癌患者选择个体化的治疗方案。

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (7)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1636018, encodeId=1ef31636018bd, content=<a href='/topic/show?id=b87ce888080' target=_blank style='color:#2F92EE;'>#绝经前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78880, encryptionId=b87ce888080, topicName=绝经前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e8e22571454, createdName=ms5768352621950538, createdTime=Mon Feb 10 19:04:00 CST 2020, time=2020-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1969992, encodeId=854b19699928c, content=<a href='/topic/show?id=ec345834075' target=_blank style='color:#2F92EE;'>#新希望#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58340, encryptionId=ec345834075, topicName=新希望)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Mon Jul 22 05:04:00 CST 2019, time=2019-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1682531, encodeId=99c7168253101, content=<a href='/topic/show?id=d4d031e8074' target=_blank style='color:#2F92EE;'>#分泌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31780, encryptionId=d4d031e8074, topicName=分泌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da227938338, createdName=gwc392, createdTime=Sun Apr 26 15:04:00 CST 2020, time=2020-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1699666, encodeId=bd69169966617, content=<a href='/topic/show?id=a70a189e4c7' target=_blank style='color:#2F92EE;'>#Young#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18974, encryptionId=a70a189e4c7, topicName=Young)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42dc29964565, createdName=mjldent, createdTime=Tue Jul 09 06:04:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728006, encodeId=62231e280063b, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Fri Jan 03 16:04:00 CST 2020, time=2020-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257210, encodeId=8e49125e210d7, content=<a href='/topic/show?id=cdfce8879b1' target=_blank style='color:#2F92EE;'>#绝经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78879, encryptionId=cdfce8879b1, topicName=绝经)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571161, encodeId=fa7615e11618f, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1636018, encodeId=1ef31636018bd, content=<a href='/topic/show?id=b87ce888080' target=_blank style='color:#2F92EE;'>#绝经前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78880, encryptionId=b87ce888080, topicName=绝经前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e8e22571454, createdName=ms5768352621950538, createdTime=Mon Feb 10 19:04:00 CST 2020, time=2020-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1969992, encodeId=854b19699928c, content=<a href='/topic/show?id=ec345834075' target=_blank style='color:#2F92EE;'>#新希望#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58340, encryptionId=ec345834075, topicName=新希望)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Mon Jul 22 05:04:00 CST 2019, time=2019-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1682531, encodeId=99c7168253101, content=<a href='/topic/show?id=d4d031e8074' target=_blank style='color:#2F92EE;'>#分泌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31780, encryptionId=d4d031e8074, topicName=分泌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da227938338, createdName=gwc392, createdTime=Sun Apr 26 15:04:00 CST 2020, time=2020-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1699666, encodeId=bd69169966617, content=<a href='/topic/show?id=a70a189e4c7' target=_blank style='color:#2F92EE;'>#Young#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18974, encryptionId=a70a189e4c7, topicName=Young)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42dc29964565, createdName=mjldent, createdTime=Tue Jul 09 06:04:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728006, encodeId=62231e280063b, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Fri Jan 03 16:04:00 CST 2020, time=2020-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257210, encodeId=8e49125e210d7, content=<a href='/topic/show?id=cdfce8879b1' target=_blank style='color:#2F92EE;'>#绝经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78879, encryptionId=cdfce8879b1, topicName=绝经)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571161, encodeId=fa7615e11618f, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=)]
    2019-07-22 珙桐
  3. [GetPortalCommentsPageByObjectIdResponse(id=1636018, encodeId=1ef31636018bd, content=<a href='/topic/show?id=b87ce888080' target=_blank style='color:#2F92EE;'>#绝经前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78880, encryptionId=b87ce888080, topicName=绝经前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e8e22571454, createdName=ms5768352621950538, createdTime=Mon Feb 10 19:04:00 CST 2020, time=2020-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1969992, encodeId=854b19699928c, content=<a href='/topic/show?id=ec345834075' target=_blank style='color:#2F92EE;'>#新希望#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58340, encryptionId=ec345834075, topicName=新希望)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Mon Jul 22 05:04:00 CST 2019, time=2019-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1682531, encodeId=99c7168253101, content=<a href='/topic/show?id=d4d031e8074' target=_blank style='color:#2F92EE;'>#分泌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31780, encryptionId=d4d031e8074, topicName=分泌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da227938338, createdName=gwc392, createdTime=Sun Apr 26 15:04:00 CST 2020, time=2020-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1699666, encodeId=bd69169966617, content=<a href='/topic/show?id=a70a189e4c7' target=_blank style='color:#2F92EE;'>#Young#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18974, encryptionId=a70a189e4c7, topicName=Young)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42dc29964565, createdName=mjldent, createdTime=Tue Jul 09 06:04:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728006, encodeId=62231e280063b, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Fri Jan 03 16:04:00 CST 2020, time=2020-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257210, encodeId=8e49125e210d7, content=<a href='/topic/show?id=cdfce8879b1' target=_blank style='color:#2F92EE;'>#绝经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78879, encryptionId=cdfce8879b1, topicName=绝经)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571161, encodeId=fa7615e11618f, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=)]
    2020-04-26 gwc392
  4. [GetPortalCommentsPageByObjectIdResponse(id=1636018, encodeId=1ef31636018bd, content=<a href='/topic/show?id=b87ce888080' target=_blank style='color:#2F92EE;'>#绝经前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78880, encryptionId=b87ce888080, topicName=绝经前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e8e22571454, createdName=ms5768352621950538, createdTime=Mon Feb 10 19:04:00 CST 2020, time=2020-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1969992, encodeId=854b19699928c, content=<a href='/topic/show?id=ec345834075' target=_blank style='color:#2F92EE;'>#新希望#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58340, encryptionId=ec345834075, topicName=新希望)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Mon Jul 22 05:04:00 CST 2019, time=2019-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1682531, encodeId=99c7168253101, content=<a href='/topic/show?id=d4d031e8074' target=_blank style='color:#2F92EE;'>#分泌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31780, encryptionId=d4d031e8074, topicName=分泌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da227938338, createdName=gwc392, createdTime=Sun Apr 26 15:04:00 CST 2020, time=2020-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1699666, encodeId=bd69169966617, content=<a href='/topic/show?id=a70a189e4c7' target=_blank style='color:#2F92EE;'>#Young#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18974, encryptionId=a70a189e4c7, topicName=Young)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42dc29964565, createdName=mjldent, createdTime=Tue Jul 09 06:04:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728006, encodeId=62231e280063b, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Fri Jan 03 16:04:00 CST 2020, time=2020-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257210, encodeId=8e49125e210d7, content=<a href='/topic/show?id=cdfce8879b1' target=_blank style='color:#2F92EE;'>#绝经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78879, encryptionId=cdfce8879b1, topicName=绝经)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571161, encodeId=fa7615e11618f, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=)]
    2019-07-09 mjldent
  5. [GetPortalCommentsPageByObjectIdResponse(id=1636018, encodeId=1ef31636018bd, content=<a href='/topic/show?id=b87ce888080' target=_blank style='color:#2F92EE;'>#绝经前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78880, encryptionId=b87ce888080, topicName=绝经前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e8e22571454, createdName=ms5768352621950538, createdTime=Mon Feb 10 19:04:00 CST 2020, time=2020-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1969992, encodeId=854b19699928c, content=<a href='/topic/show?id=ec345834075' target=_blank style='color:#2F92EE;'>#新希望#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58340, encryptionId=ec345834075, topicName=新希望)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Mon Jul 22 05:04:00 CST 2019, time=2019-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1682531, encodeId=99c7168253101, content=<a href='/topic/show?id=d4d031e8074' target=_blank style='color:#2F92EE;'>#分泌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31780, encryptionId=d4d031e8074, topicName=分泌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da227938338, createdName=gwc392, createdTime=Sun Apr 26 15:04:00 CST 2020, time=2020-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1699666, encodeId=bd69169966617, content=<a href='/topic/show?id=a70a189e4c7' target=_blank style='color:#2F92EE;'>#Young#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18974, encryptionId=a70a189e4c7, topicName=Young)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42dc29964565, createdName=mjldent, createdTime=Tue Jul 09 06:04:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728006, encodeId=62231e280063b, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Fri Jan 03 16:04:00 CST 2020, time=2020-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257210, encodeId=8e49125e210d7, content=<a href='/topic/show?id=cdfce8879b1' target=_blank style='color:#2F92EE;'>#绝经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78879, encryptionId=cdfce8879b1, topicName=绝经)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571161, encodeId=fa7615e11618f, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=)]
    2020-01-03 feather89
  6. [GetPortalCommentsPageByObjectIdResponse(id=1636018, encodeId=1ef31636018bd, content=<a href='/topic/show?id=b87ce888080' target=_blank style='color:#2F92EE;'>#绝经前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78880, encryptionId=b87ce888080, topicName=绝经前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e8e22571454, createdName=ms5768352621950538, createdTime=Mon Feb 10 19:04:00 CST 2020, time=2020-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1969992, encodeId=854b19699928c, content=<a href='/topic/show?id=ec345834075' target=_blank style='color:#2F92EE;'>#新希望#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58340, encryptionId=ec345834075, topicName=新希望)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Mon Jul 22 05:04:00 CST 2019, time=2019-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1682531, encodeId=99c7168253101, content=<a href='/topic/show?id=d4d031e8074' target=_blank style='color:#2F92EE;'>#分泌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31780, encryptionId=d4d031e8074, topicName=分泌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da227938338, createdName=gwc392, createdTime=Sun Apr 26 15:04:00 CST 2020, time=2020-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1699666, encodeId=bd69169966617, content=<a href='/topic/show?id=a70a189e4c7' target=_blank style='color:#2F92EE;'>#Young#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18974, encryptionId=a70a189e4c7, topicName=Young)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42dc29964565, createdName=mjldent, createdTime=Tue Jul 09 06:04:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728006, encodeId=62231e280063b, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Fri Jan 03 16:04:00 CST 2020, time=2020-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257210, encodeId=8e49125e210d7, content=<a href='/topic/show?id=cdfce8879b1' target=_blank style='color:#2F92EE;'>#绝经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78879, encryptionId=cdfce8879b1, topicName=绝经)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571161, encodeId=fa7615e11618f, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1636018, encodeId=1ef31636018bd, content=<a href='/topic/show?id=b87ce888080' target=_blank style='color:#2F92EE;'>#绝经前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78880, encryptionId=b87ce888080, topicName=绝经前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e8e22571454, createdName=ms5768352621950538, createdTime=Mon Feb 10 19:04:00 CST 2020, time=2020-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1969992, encodeId=854b19699928c, content=<a href='/topic/show?id=ec345834075' target=_blank style='color:#2F92EE;'>#新希望#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58340, encryptionId=ec345834075, topicName=新希望)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Mon Jul 22 05:04:00 CST 2019, time=2019-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1682531, encodeId=99c7168253101, content=<a href='/topic/show?id=d4d031e8074' target=_blank style='color:#2F92EE;'>#分泌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31780, encryptionId=d4d031e8074, topicName=分泌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da227938338, createdName=gwc392, createdTime=Sun Apr 26 15:04:00 CST 2020, time=2020-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1699666, encodeId=bd69169966617, content=<a href='/topic/show?id=a70a189e4c7' target=_blank style='color:#2F92EE;'>#Young#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18974, encryptionId=a70a189e4c7, topicName=Young)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=42dc29964565, createdName=mjldent, createdTime=Tue Jul 09 06:04:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728006, encodeId=62231e280063b, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Fri Jan 03 16:04:00 CST 2020, time=2020-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257210, encodeId=8e49125e210d7, content=<a href='/topic/show?id=cdfce8879b1' target=_blank style='color:#2F92EE;'>#绝经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78879, encryptionId=cdfce8879b1, topicName=绝经)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571161, encodeId=fa7615e11618f, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Tue Jun 11 08:04:00 CST 2019, time=2019-06-11, status=1, ipAttribution=)]

相关资讯

妊娠晚期合并肠套叠1例

患者,女,26岁,孕2产1,2015年足月平产一活婴。主诉:停经34+6周,上腹部疼痛不适10h余,于2018年4月26日16:09收入院,疼痛发作时伴有恶心呕吐,呕吐物为胃内容物,有黄色胆汁,味苦。入院查体:体温37.2℃,脉搏86次,急性病容,右上腹压痛(+),反跳痛(+),肌卫(-),未及明显包块,移动性浊音阴性,肠鸣音无亢,结肠充气试验(-);闭孔内肌试验(-);腰大肌试验(-),双肾区叩

1例癌症晚期重度疼痛患者的药学监护

疼痛已成为癌症患者最常见的伴随症状。有报道,初诊癌症患者的疼痛发生率为25%;晚期癌症患者的疼痛发生率约为60%~80%,其中1/3患者为重度疼痛。目前止痛治疗已成为癌症晚期姑息治疗很重要的一部分。在由医生、药师和护士组成的疼痛治疗团队中,临床药师发挥了非常重要的作用。本文通过临床药师参与1例肺癌晚期患者的止痛治疗,说明临床药师在药学监护及药物不良反应监测方面发挥的作用。

Ann Surg:全程新辅助治疗(TNT)可提高晚期胰腺癌生存率

胰腺导管腺癌(PDAC)是一种高致死率的恶性肿瘤,其发病率不断上升。一项新的回顾性研究显示,若对全程新辅助治疗(TNT)产生最佳的生化和病理反应,那么无论是边缘性还是局部晚期胰腺癌患者的术后生存率都会显着延长。研究结果发表于近期的Annals of Surgery杂志。

手术治疗局部晚期原发性胸腺腺癌一例

患者, 38 岁,女,就诊前 3 个月,自 觉晨起眼睑浮肿,日间正常,未在意; 随后眼睑水肿 持续时间变长,同时出现脸部水肿,颈部血管充盈扩 张;情绪激动时加重,夜间平卧逐渐受限。入院前 1 周,脸浮肿加重,出现胸部紧缩感,胸背部疼痛等症 状;无眼睑下垂、咀嚼无力、吞咽困难、乏力等重症肌 无力症状;体格检查无特殊异常,既往体健。胸部增 强 CT 发现前纵隔有一约52 mm ×49 mm 大小软组

无法手术的晚期肺癌患者生存结果大不同——局部晚期&转移性晚期肺癌

虽然随着医学的进步,目前的筛查手段越来越先进,但仍然有大量的患者在就诊之初就错过了手术的机会,这个阶段的肺癌往往被称为“晚期肺癌”。但同样是晚期肺癌,医生给出的治疗选择和生存预期却大相径庭,难道晚期肺癌之间有很大差别吗?!

乳腺癌晚期治疗思路1例

患者王XX,发病年龄:58岁。40岁绝经,家族中无乳腺癌患者。