吴炅-初始治疗策略.pptVIP

结论 早期AI相关的血管运动症状和肌肉关节症状预测AI疗效尚无定论； ER,PR和HER2等临床和生物指标复合信息有助于预测AI疗效； HER2/3阴性表达肿瘤，初始2.75年依西美坦治疗减少更多复发风险；HER2/3阳性乳腺癌提示潜在内分泌治疗耐药； Ki-67与PEPI score有助于预测预后。 谢 谢 * 我们从大量的患者调查报告中发现，乳腺癌患者术后最担心的就是“复发”，因为复发对于她们而言就是宣布死亡的临近，生命将进入倒计时。临床数据也表明，如果术后不接受辅助治疗，有将近40%的患者将会出现各种复发。其中，乳腺癌局部复发和对侧乳腺癌新发都预示着乳腺癌出现远处复发的可能加大，对生存的影响也很大。同时，试验结果证实：无论患者处于何种预后因子，术后1-3年都是复发的高峰，因此在术后早期给予患者最佳的治疗，可以最大程度地减少复发。 * Annual hazard of recurrence for breast cancer was analyzed in patients entered into 7 completed and unblinded Eastern Cooperative Oncology Group coordinated studies of postoperative adjuvant therapy for breast cancer.1 For the entire group, there was a pattern of a peak hazard of recurrence during the first 5 years with a slowly decreasing hazard of recurrence beyond 5 years. Risk of recurrence was greatest in the interval of 1 to 2 years, largely irrespective of patient subset. A meta-analysis was conducted by the Early Breast Cancer Trialists Collaborative Group that examined adjuvant 他莫昔芬 versus no 他莫昔芬 before recurrence.2 Information was obtained and analyzed centrally on each of 37,000 women in 55 trials, comprising about 87% of the worldwide evidence. Results demonstrated an early peak of recurrence at 2-3 years post-surgery in untreated patients with node-positive and node-negative disease. Taken together, these results confirm that risk of recurrence is greatest 2-3 years post-surgery, even in patients with lower risk disease (eg, node-negative). 1. Saphner et al. J Clin Oncol. 1996;14:2738. 2. Early Breast Cancer Trialists’ Collaborative Group. Lancet. 1998;351:1451. Mansell J et al. Presented at: SABCS 2006, San Antonio, Tex. Abstract 2091. Mansell and colleagues tried to identify factors that predict early recurrence in postmenopausal women with early-stage breast cancer. Data from 5589 consecutive postmenopausal patients diagnosed with operable breast cancer were examined. 86% of the patients received adjuvant hormonal therapy. Estrogen receptor-negative patients were excluded. A