JAMA Surg:三阴性乳腺癌、新辅助全身治疗与保乳治疗

2020-01-14 MedSci MedSci原创

研究认为,新辅助全身治疗可使得约一半基线不符合保乳治疗的三阴性乳腺癌患者转变为符合要求,且可获得与基线符合要求患者相同的预后效果。

新辅助全身治疗(NST)常作为II至III期乳腺癌患者的保乳治疗(BCT)手段。近日研究人员评估了NST在三阴性乳腺癌(TNBC)患者中的应用,并评估NST反应、生殖系BRCA(gBRCA)状态和治疗区域与手术选择的关系。

研究在北美、欧洲和亚洲15个国家的145个中心招募了634名参与者,随机接受12周的Paclitaxel单独治疗或联合卡铂和/或Velipari,然后进行4轮盐酸阿霉素和环磷酰胺治疗。研究的主要终点为在NST前后临床和放射学标准评估BCT适用性。

患者平均年龄51,604名患者可进行NST疗效评估。在141名被认为基线不符合BCT的患者中,75名(53.2%)患者经NST后符合BCT要求。总体而言,502名患者中有342名(68.1%)在NST后符合BCT条件。与北美患者相比,欧洲和亚洲患者更容易满足BCT(优势比为2.66)要求。在接受乳房切除术的无gBRCA突变的患者中,北美患者更容易接受对侧预防性乳房切除术(81例中57例(70.4%)vs 30例中的6例(20.0%))。在基线检查时被认为符合BCT要求的患者和那些先前不符合但在NST后符合BCT标准的患者之间,病理完全缓解率相似(55.3[235/425] vs 49.3%[37/75])。

研究认为,新辅助全身治疗可使得约一半基线不符合保乳治疗的三阴性乳腺癌患者转变为符合要求,且可获得与基线符合要求患者相同的预后效果。

原始出处:


本文系梅斯医学(MedSci)原创编译整理,转载需授权!

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 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1678620, encodeId=9b5d16e862060, content=<a href='/topic/show?id=110c5869153' target=_blank style='color:#2F92EE;'>#新辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58691, encryptionId=110c5869153, topicName=新辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=941f27706894, createdName=charl1234576, createdTime=Sun Jul 26 22:03:00 CST 2020, time=2020-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048033, encodeId=fd712048033e3, content=<a href='/topic/show?id=12e49e53102' target=_blank style='color:#2F92EE;'>#阴性乳腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97531, encryptionId=12e49e53102, topicName=阴性乳腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f65b226, createdName=circumcision, createdTime=Sat Jul 04 17:03:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1797735, encodeId=b82c1e97735ae, content=<a href='/topic/show?id=0f8b23e26a8' target=_blank style='color:#2F92EE;'>#乳腺癌、#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23726, encryptionId=0f8b23e26a8, topicName=乳腺癌、)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8143398, createdName=lily1616, createdTime=Wed Jul 01 06:03:00 CST 2020, time=2020-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1458754, encodeId=d9cf1458e5445, content=<a href='/topic/show?id=3ef91982030' target=_blank style='color:#2F92EE;'>#三阴性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19820, encryptionId=3ef91982030, topicName=三阴性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5666112721, createdName=xlysu, createdTime=Thu Jan 16 11:03:00 CST 2020, time=2020-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035869, encodeId=4ad61035869a3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Jan 14 23:03:00 CST 2020, time=2020-01-14, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1678620, encodeId=9b5d16e862060, content=<a href='/topic/show?id=110c5869153' target=_blank style='color:#2F92EE;'>#新辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58691, encryptionId=110c5869153, topicName=新辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=941f27706894, createdName=charl1234576, createdTime=Sun Jul 26 22:03:00 CST 2020, time=2020-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048033, encodeId=fd712048033e3, content=<a href='/topic/show?id=12e49e53102' target=_blank style='color:#2F92EE;'>#阴性乳腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97531, encryptionId=12e49e53102, topicName=阴性乳腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f65b226, createdName=circumcision, createdTime=Sat Jul 04 17:03:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1797735, encodeId=b82c1e97735ae, content=<a href='/topic/show?id=0f8b23e26a8' target=_blank style='color:#2F92EE;'>#乳腺癌、#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23726, encryptionId=0f8b23e26a8, topicName=乳腺癌、)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8143398, createdName=lily1616, createdTime=Wed Jul 01 06:03:00 CST 2020, time=2020-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1458754, encodeId=d9cf1458e5445, content=<a href='/topic/show?id=3ef91982030' target=_blank style='color:#2F92EE;'>#三阴性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19820, encryptionId=3ef91982030, topicName=三阴性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5666112721, createdName=xlysu, createdTime=Thu Jan 16 11:03:00 CST 2020, time=2020-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035869, encodeId=4ad61035869a3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Jan 14 23:03:00 CST 2020, time=2020-01-14, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1678620, encodeId=9b5d16e862060, content=<a href='/topic/show?id=110c5869153' target=_blank style='color:#2F92EE;'>#新辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58691, encryptionId=110c5869153, topicName=新辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=941f27706894, createdName=charl1234576, createdTime=Sun Jul 26 22:03:00 CST 2020, time=2020-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048033, encodeId=fd712048033e3, content=<a href='/topic/show?id=12e49e53102' target=_blank style='color:#2F92EE;'>#阴性乳腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97531, encryptionId=12e49e53102, topicName=阴性乳腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f65b226, createdName=circumcision, createdTime=Sat Jul 04 17:03:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1797735, encodeId=b82c1e97735ae, content=<a href='/topic/show?id=0f8b23e26a8' target=_blank style='color:#2F92EE;'>#乳腺癌、#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23726, encryptionId=0f8b23e26a8, topicName=乳腺癌、)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8143398, createdName=lily1616, createdTime=Wed Jul 01 06:03:00 CST 2020, time=2020-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1458754, encodeId=d9cf1458e5445, content=<a href='/topic/show?id=3ef91982030' target=_blank style='color:#2F92EE;'>#三阴性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19820, encryptionId=3ef91982030, topicName=三阴性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5666112721, createdName=xlysu, createdTime=Thu Jan 16 11:03:00 CST 2020, time=2020-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035869, encodeId=4ad61035869a3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Jan 14 23:03:00 CST 2020, time=2020-01-14, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1678620, encodeId=9b5d16e862060, content=<a href='/topic/show?id=110c5869153' target=_blank style='color:#2F92EE;'>#新辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58691, encryptionId=110c5869153, topicName=新辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=941f27706894, createdName=charl1234576, createdTime=Sun Jul 26 22:03:00 CST 2020, time=2020-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048033, encodeId=fd712048033e3, content=<a href='/topic/show?id=12e49e53102' target=_blank style='color:#2F92EE;'>#阴性乳腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97531, encryptionId=12e49e53102, topicName=阴性乳腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f65b226, createdName=circumcision, createdTime=Sat Jul 04 17:03:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1797735, encodeId=b82c1e97735ae, content=<a href='/topic/show?id=0f8b23e26a8' target=_blank style='color:#2F92EE;'>#乳腺癌、#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23726, encryptionId=0f8b23e26a8, topicName=乳腺癌、)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8143398, createdName=lily1616, createdTime=Wed Jul 01 06:03:00 CST 2020, time=2020-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1458754, encodeId=d9cf1458e5445, content=<a href='/topic/show?id=3ef91982030' target=_blank style='color:#2F92EE;'>#三阴性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19820, encryptionId=3ef91982030, topicName=三阴性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5666112721, createdName=xlysu, createdTime=Thu Jan 16 11:03:00 CST 2020, time=2020-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035869, encodeId=4ad61035869a3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Jan 14 23:03:00 CST 2020, time=2020-01-14, status=1, ipAttribution=)]
    2020-01-16 xlysu
  5. [GetPortalCommentsPageByObjectIdResponse(id=1678620, encodeId=9b5d16e862060, content=<a href='/topic/show?id=110c5869153' target=_blank style='color:#2F92EE;'>#新辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58691, encryptionId=110c5869153, topicName=新辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=941f27706894, createdName=charl1234576, createdTime=Sun Jul 26 22:03:00 CST 2020, time=2020-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048033, encodeId=fd712048033e3, content=<a href='/topic/show?id=12e49e53102' target=_blank style='color:#2F92EE;'>#阴性乳腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97531, encryptionId=12e49e53102, topicName=阴性乳腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f65b226, createdName=circumcision, createdTime=Sat Jul 04 17:03:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1797735, encodeId=b82c1e97735ae, content=<a href='/topic/show?id=0f8b23e26a8' target=_blank style='color:#2F92EE;'>#乳腺癌、#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23726, encryptionId=0f8b23e26a8, topicName=乳腺癌、)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8143398, createdName=lily1616, createdTime=Wed Jul 01 06:03:00 CST 2020, time=2020-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1458754, encodeId=d9cf1458e5445, content=<a href='/topic/show?id=3ef91982030' target=_blank style='color:#2F92EE;'>#三阴性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19820, encryptionId=3ef91982030, topicName=三阴性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5666112721, createdName=xlysu, createdTime=Thu Jan 16 11:03:00 CST 2020, time=2020-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035869, encodeId=4ad61035869a3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Jan 14 23:03:00 CST 2020, time=2020-01-14, status=1, ipAttribution=)]
    2020-01-14 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0