早期乳腺癌助化疗进展 中国医学科学院肿瘤医院 徐兵河.ppt

早期乳腺癌辅助化疗进展 中国医学科学院肿瘤医院 徐兵河 中国乳腺癌发病概况 每年约有19万新发乳腺癌病例 2002年全国乳腺癌年龄标化发病率:18.7/100,000；死亡率: 5.5/100,000 发病率：城市＞农村 高发年龄段：45－50岁 近15年来乳腺癌发病率上升死亡率下降 死亡率下降的原因 The benefits of chemotherapy data from clinical trails Early Breast Cancer Trialists Collaborative Group (EBCTCG). 194 randomised trials of adjuvant chemotherapy (CMF,CAF,CEF) or hormonal therapy (TAM) that began by 1995. 15-year probabilities of recurrence in women aged 50 years, with / without polychemotherapy 15-year probabilities of breast cancer mortality in women aged 50 years, with / without polychemotherapy 15-year probabilities of recurrence in women aged 50-69 years, with / without polychemotherapy 15-year probabilities of breast cancer mortality in women aged 50-69 years, with / without polychemotherapy 15-year probabilities of recurrence in women with ER+ (or ER-unknown) disease, with / without ~5 years tamoxifen 15-year probabilities of breast cancer mortality in women with ER+ (or ER-unknown) disease, with / without ~5 years tamoxifen 5-year recurrence in women with ER+ (or ER-unknown) disease with no chemotherapy, with / without ~5 years tamoxifen 5-year recurrence in women with ER+ (or ER-unknown) disease with chemotherapy, with / without ~5 years tamoxifen Chemotherapy versus endocrine therapy in the treatment of breast cancer In premenopausal women, polychemotherapy improves 15-year recurrence by 12.4% and survival by 10.0% In postmenopausal women, 15-year gains in recurrence and survival are smaller (4.2% and 3.0%, respectively) anthracycline-based polychemotherapy reduces the annual death rate by 38% for women ＜50 years and by 20% for those of age 50-69 years Chemotherapy versus endocrine therapy in the treatment of breast cancer In patients with ER+ disease, tamoxifen improves 15-year recurrence by 11.8% and survival by 9.2% Gains made with tamoxifen treatment appear to be irrespective of adjuvant chemotherapy 乳腺癌辅助化疗进展 Five Year follow-up of INT C9741: Dose-dense chemotherap