4简要乳腺癌新辅助化疗.ppt

乳腺癌新辅助化疗初步共识 含紫杉类/蒽环类的化疗方案优于不含二者的方案， Her-2过度表达的曲妥珠单抗联合紫杉类有效， 足量化疗（达到总剂量的85%以上）优于低剂量化疗， 紫杉类与蒽环类的序贯化疗优于二者联合化疗， 紫杉类与蒽环类周疗法优于3周疗法， 紫杉类与蒽环类剂量密集化疗优于常规化疗， 疗程以4-6个疗程为宜， 方案的选择上，应以获得更高的pCR为目标， 疗效的判定上，以生存率作为疗效判定的金标准。 新辅助化疗展望 寻找标准的新辅助化疗方案 寻找新辅助化疗效果的预测方法 谢 谢！ 人有了知识，就会具备各种分析能力， 明辨是非的能力。 所以我们要勤恳读书，广泛阅读， 古人说“书中自有黄金屋。 ”通过阅读科技书籍，我们能丰富知识， 培养逻辑思维能力； 通过阅读文学作品，我们能提高文学鉴赏水平， 培养文学情趣； 通过阅读报刊，我们能增长见识，扩大自己的知识面。 有许多书籍还能培养我们的道德情操， 给我们巨大的精神力量， 鼓舞我们前进。 * * 17 * [26] A randomized trial comparing preoperative (preop) doxorubicin/cyclophosphamide (AC) to preop AC followed by preop docetaxel (T) and to preop AC followed by postoperative (postop) T in patients (pts) with operable carcinoma of the breast: results of NSABP B-27.Bear HD, Anderson S, Smith RE, Robidoux A, Kahlenberg MS, Margolese RG, Dakhil SR, Pajon ER, Hoehn JL, Mamounas EP, Geyer CE, Julian TB, Wolmark N.. National Surgical Adjuvant Breast and Bowel Project (NSABP), Pittsburgh, PAPurpose: NSABP Protocol B-27 was designed to determine the effect of adding docetaxel (Taxotere [T]) after 4 cycles of preop doxorubicin (Adriamycin) and cyclophosphamide (AC) on clinical and pathological response rates and on overall and disease-free survival of women with operable breast cancer.Patients and Methods: Women (N=2,411) with operable primary breast cancer were randomized to receive either 4 cycles of preop AC followed by surgery (Group I) or 4 cycles of preop AC followed by 4 cycles of preop T, followed by surgery (Group II), or 4 cycles of preop AC followed by surgery and then 4 cycles of postop T (Group III). Results: Mean tumor size (4.5 cm) and other key characteristics were evenly balanced among the three treatment arms. It was reported previously that the addition of preop T increased clinical complete responses (CR) by more than 50%, and pathologic CR were nearly doubled. Enough events have now occurred to trigger analysis of disease-free and overall survival for this trial. The resulting effects on OS and DFS from adding T to