在T1c,节点阴性,三阴性乳腺癌患者中,新辅助和辅助治疗的比较生存结果:基于人口的分析
Yi-Zi Zheng1, Jia-Qi Ying1, Ting-Ting Wu1
1Department of Breast Surgery, Zhejiang Key Laboratory of Intelligent Cancer Biomarker Discovery and Translation, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Breast (Edinburgh, Scotland)
|January 22, 2025
概括
新辅助疗法 (NAT) 和辅助疗法 (AT) 对早期三阴性乳腺癌 (TNBC) 的生存结果相似. 然而,NAT识别了预后较差的患者,有助于治疗选择.
科学领域:
- 在瘤学瘤学.
- 乳腺癌研究研究 乳腺癌研究
- 临床试验分析
背景情况:
- 对T1c,节点阴性,三阴性乳腺癌 (TNBC) 的新辅助疗法 (NAT) 与辅助疗法 (AT) 的讨论缺乏明确的指导方针.
- 早期TNBC最佳治疗顺序仍然是积极临床研究的领域.
研究的目的:
- 为了比较新辅助疗法 (NAT) 与辅助疗法 (AT) 在T1c,节点阴性,三阴性乳腺癌 (TNBC) 患者的疗效.
- 在接受NAT的患者中,确定生存的预后因素和病理完整反应 (pCR) 的预测因素.
主要方法:
- 从监测,流行病学和最终结果 (SEER) 数据库 (2010-2020) 中对1033个TNBC患者对进行了回顾性分析.
- 倾向性得分匹配 (PSM) 以平衡接收NAT和AT的队列.
- 卡普兰-梅尔分析,可克斯比例危险模型用于生存,以及用于pCR预测的后勤回归.
主要成果:
- 在PSM后,NAT和AT都显示了可比的整体存活率 (OS) 和乳腺癌特异性存活率 (BCSS).
- 在NAT后未能达到病态完整反应 (非pCR) 与更糟糕的OS和BCSS (HR>2.0) 有显著的相关性.
- 年龄较小 (<50岁) 和高瘤等级 (III) 是通过NAT实现pCR的独立预测因素.
结论:
- 新辅助疗法 (NAT) 和辅助疗法 (AT) 对T1c,节点阴性TNBC产生相当的生存结果.
- NAT 作为一种有价值的工具,用于识别具有较高不良结果风险的患者,从而实现个性化治疗策略.
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