含紫杉类方案辅助化疗对Her-2阳性乳腺癌患者生存率影响.docVIP

含紫杉类方案辅助化疗对Her-2阳性乳腺癌患者生存率影响【摘要】 目的 观察Her-2/neu过表达的乳腺癌患者对不同辅助化疗方案的敏感性。方法 选取2002年5月至2005年8月在我院乳腺中心接受手术且术后辅助化疗的原发性乳腺癌患者Her-2过表达者共134例,分别采用蒽环类或紫杉类方案化疗,中位随访时间38个月,分析她们的临床特征和病理学特征,不同化疗方案对无病生存期的影响。结果 Her-2过表达(++、+++)者134例,占27.7%,采用CAF方案化疗者77例,含紫杉类化疗者57例,采用CAF方案复发转移31.2%(24/77),无病生存率68.8%,含紫杉类复发率14.0%(8/57),无病生存率86%,χ?2=5.290,P10%的肿瘤细胞膜观察到淡的或较难觉察的着色,细胞的部分细胞膜着色为Her-2过表达阴性,评分为+;10%的肿瘤细胞全部的细胞膜存在弱至中等强度的着色为Her-2过表达弱阳性,评分为++;10%的肿瘤细胞全部的细胞膜存在高强度的着色为Her-2过表达强阳性,评分为+++。 2 结果 记录所有患者的临床病理特征和化疗方案,共483例,其中Her-2过表达(++、+++)134例,Her-2过表达占27.7 %,采用CAF方案化疗者77例,含紫杉类化疗者57例,采用CAF方案复发转移24例,占31.2%,含紫杉类8例,占14.0%,χ?2=5.290,P 参 考 文 献 [1] Early Breast Cancer Trialists Collaborative Group (EBTCG).Effects of Chemotherapy And Hormonal Therapy For Early Breast Cancer On Recurrence And 15-Year Survival:AnOverview Of The Randomized Trials.Lancet,2005,365(9472):1687-1717. [2] Winstanley J,Cooke T,Murray GD,et al.The Long Term Prognostic Significance ofCerbB-2 in Primary Breast Cancer.Br J Cancer,1991,63(4):447-450. [3] Levine MN,Pritchard KI,Bramwell VH,et al.A Randomized Trial Comparing Cyclophosphamide, Epirubicin, Fluorouracil With Cyclophosphamide, Methotrexate, Fluorouracil in Premenopausal Women With Node-Positive Breast Cancer: Update of National Cancer Institute of Canada Clinical Trial Group Trial MA5.J Clin Oncol,2005,23(22):5166-5170. [4] Thor AD,Berry DA,Dudman DR,et al.ErbB-2,P53,and Efficacy of Adjuvant Therapy in Lumph Node-Positive Breast Cancer.J Natl Cancer Inst,1998,90(18):1346-1360. [5] Henderson IC,Berry DA,Demetri GD,et al.Improved Outcomes From Adding Sequential Paclitaxel but not From Escalating Doxorubicin Dose in an Adjuvant Chemotherapy Regimen for Patients With Node-Positive Primary Breast Cancer.J Clin Oncol,2003,21(6):976-983. [6] Konecny GE,Thomssen C,Luck HJ,et al.Her-2/neu Gene Amplification and Respond to Paclitaxel in Patients with Metastatic Breast Cancer.J National Cancer Institute,2004,96(15):1141-1151. [7] Hayes DF,Thor AD,Dressle