有没有T1c-2N0-1M0三阴性乳腺癌从新辅助化疗中获益?
Ruiliang Chen1, Yushuai Yu2, Weiwei Chen3
1Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian Province, China.
European journal of medical research
|December 19, 2024
概括
新辅助化疗 (NCT) 对早期三阴性乳腺癌 (TNBC) 的辅助化疗 (ACT) 没有显示生存益处. NCT甚至可能对T1cN0M0TNBC有害,因此在扩大其使用时需要谨慎.
科学领域:
- 在瘤学瘤学.
- 乳腺癌研究研究 乳腺癌研究
- 化疗疗的有效性 化疗的有效性
背景情况:
- 新辅助化疗 (NCT) 是可操作的三阴性乳腺癌 (TNBC) 的标准.
- 将NCT扩展到早期阶段 (T1cN0M0) TNBC的适当性需要调查,因为存在潜在风险.
- 将NCT和辅助化疗 (ACT) 之间的长期存活率进行比较对于优化治疗策略至关重要.
研究的目的:
- 为了比较小瘤TNBC患者的长期生存结果,使用NCT治疗与ACT治疗.
- 评估NCT在TNBC早期阶段的疗效,特别是T1cN0M0和T1-2N0-1M0群体.
- 根据瘤和节点分期,确定NCT是否在可操作的TNBC中提供了比ACT更好的生存优势.
主要方法:
- 使用来自监测,流行病学和最终结果 (SEER) 数据库 (2016-2017) 的数据进行倾向得分匹配分析.
- 包括1183个NCT病例和2550个ACT病例与AJCC临床T1c-T2 N0-N1侵入性三阴性乳腺癌.
- 危险比率 (HRs) 和95%置信区间 (CI) 通过考克斯比例危险回归计算,以评估生存差异.
主要成果:
- 与ACT患者相比,NCT患者更年轻,更常见的是T2阶段,N1阶段,并且接受乳腺切除术的频率更高.
- 多变量分析显示,在T1c-2N0-1M0 TNBC患者中,NCT与ACT相比没有显著的生存益处.
- 只有在N1阶段的患者中,NCT显示了生存优势;它没有改善T1cN0M0 TNBC的乳腺癌特定存活率 (BCSS) 或整体存活率 (OS),但在T2N1M0 TNBC中改善了OS.
结论:
- 与辅助化疗 (ACT) 相比,新辅助化疗 (NCT) 在I阶段和IIa阶段的TNBC队列中没有显示出生存益处.
- 在用NCT治疗的T1cN0M0TNBC队列中观察到不利的结局,表明潜在的危害.
- 建议对NCT指示扩展到T1cN0M0TNBC群体进行谨慎.
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