结节阳性 HR+、HER2- 乳腺癌新辅助内分泌治疗与新辅助化疗的比较(结节 pCR 和 ALND 率):系统回顾与元分析

IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Breast Journal Pub Date : 2024-08-01 DOI:10.1155/2024/8866756
Mahtab Vasigh, Mohammadreza Karoobi, Austin D. Williams, Fasika Molla Abreha, Richard J. Bleicher, Seyed Mostafa Meshkati Yazd, Tahereh Shamsi, Ramesh Omranipour, Ahmad Elahi, David Farhat, Mehran Habibi
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引用次数: 0

摘要

导言。在所有亚型中,激素受体阳性(HR+)、HER2-阴性(HER2-)乳腺癌患者对新辅助治疗的反应最低。本荟萃分析评估了新辅助内分泌治疗(NET)在临床结节阳性(cN+)、HR+、HER2-患者中的作用。研究方法本研究在2010年1月至2022年8月期间进行。我们评估了新辅助内分泌治疗(NET)后的结节病理完全反应率(pCR)和腋窝淋巴结清扫率(ALND)。结果如下11项研究中的18037名HR+、HER2-、cN+的II期和III期乳腺癌患者接受了新辅助治疗。3707名(20.6%)患者接受了NET治疗,14330名(79.4%)患者接受了NAC治疗。NET患者的平均年龄高于新辅助化疗(NAC)患者(64.1岁对47.6岁,P< 0.001)。45.0%的NET组和26.9%的NAC组患者接受了肿块切除术。NET组和NAC组结节pCR的汇总估计值分别为8.9%和14.9%,ALND的汇总比例分别为39.1%和58.5%。结论与NAC组相比,接受NET治疗的cN+患者的结节pCR率较低。cN+ NET患者的ALND率低于NAC组,这表明在NET组中有更多有残余结节病的患者没有获得ALND。需要进一步开展前瞻性研究,以比较生存结果作为更可靠的替代指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Neoadjuvant Endocrine Therapy Compared to Neoadjuvant Chemotherapy in Node-Positive HR+, HER2− Breast Cancer (Nodal pCR and the Rate of ALND): A Systematic Review and Meta-Analysis

Introduction. Patients with hormone receptor-positive (HR+), HER2-negative (HER2−) breast cancers have the lowest response to neoadjuvant therapy of all subtypes. The role of neoadjuvant endocrine therapy (NET) in clinically node-positive (cN+), HR+, HER2− patients is evaluated in this meta-analysis. Methods. This study was performed between January 2010 and August 2022. We evaluated the node pathologic complete response (pCR) and axillary lymph node dissection (ALND) rates after neoadjuvant endocrine therapy (NET). Results. 18,037 HR+, HER2−, cN+ stage II and stage III breast cancer patients within eleven studies received neoadjuvant treatments. 3,707 (20.6%) patients received NET and 14,330 (79.4%) received NAC. The average age of the NET patients was higher than that of the neoadjuvant chemotherapy (NAC) patients (64.1 versus 47.6 years old, p < 0.001). 45.0% and 26.9% of the NET and the NAC groups underwent a lumpectomy. The pooled estimates of node pCR in NET and NAC groups were 8.9% and 14.9%, and the pooled proportion of ALND was 39.1% and 58.5%, respectively. Conclusion. The rate of node pCR was lower among cN+ patients who received NET compared to the NAC group. The rate of ALND among cN+ NET patients was lower than the NAC group, revealing more patients with residual nodal disease do not get ALND in the NET group. Further prospective studies are required to compare survival outcomes as a more reliable surrogate.

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来源期刊
Breast Journal
Breast Journal 医学-妇产科学
CiteScore
4.00
自引率
0.00%
发文量
47
审稿时长
4-8 weeks
期刊介绍: The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include: Risk Factors Prevention Early Detection Diagnosis and Therapy Psychological Issues Quality of Life Biology of Breast Cancer.
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