在新辅助内分泌疗法 (NET) 后的轴心管理
Laura Leonard1, Min Yi1, Emma Wingate1
1Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Annals of surgical oncology
|December 27, 2025
概括
新辅助性内分泌疗法 (NET) 对激素受体阳性乳腺癌是安全的,其5年局部区域复发率较低. 轴心管理策略可以优化后NET,即使有积极的淋巴结.
科学领域:
- 在瘤学瘤学.
- 乳腺癌研究研究 乳腺癌研究
- 内分泌治疗疗法 内分泌治疗疗法
背景情况:
- 在荷尔蒙受体阳性 (HR+),HER2阴性乳腺癌的新辅助内分泌疗法 (NET) 后最佳的腹管理策略缺乏足够的数据.
- 激素受体阳性乳腺癌的治疗需要量身定制的方法,特别是在新辅助疗法后.
研究的目的:
- 评估用NET治疗的HR+,HER2阴性乳腺癌患者的腹管理策略和瘤结果.
- 评估NET在该患者群体中治疗股疾病的安全性和有效性.
主要方法:
- 对230名临床阶段I-III,HR+乳腺癌患者的回顾性评估,这些患者接受了90天以上的NET治疗.
- 对关手术的分析,包括哨兵淋巴结解剖 (SLND) 和关淋巴结解剖 (ALND).
- 评估局部区域复发率 (LRR),远程复发率和整体存活率.
主要成果:
- 总共有230名患者被分析;120名临床结节阴性 (cN0) 和110名临床结节阳性 (cN+).
- 整个队列的5年LRR率为2.2%,cN0和cN+组之间没有显著差异 (2.0%对2.2%,p>0.05).
- 在cN+患者中,远程复发率较高 (15.0%对6.9%,p=0.03),而5年后的生存率为79.5% (cN0:88.4%对cN+:69.7%,p=0.004).
结论:
- 新辅助内分泌疗法 (NET) 证明了HR+乳腺癌的瘤安全性,包括大型瘤和阳性淋巴结的病例.
- 极低的5年LRR率支持NET作为一种可行的策略,即使在节点阳性患者中也是如此.
- 为了优化结果,需要对后NET定制的状管管理进行进一步研究.
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