循证医学证据抗乳癌化疗演变.pptVIP

1、等剂量表柔比星与阿霉素，疗效一致 2、表柔比星与阿霉素相比毒性更低（例如：血液毒性-表柔比星120mg=阿霉素100mg，非血液毒性-表柔比星150mg=阿霉素100mg，心脏安全性-表柔比星180mg=阿霉素100mg） 3、表阿的最高累积剂量可以达到900-1000mg/m2，且FASG08、ACTION研究显示对于老年患者有很好的安全性 * * FEC超越CMF * FEC超越CMF * FASG01:证实6个疗程是标准 FASG05:表柔比星100mg是标准剂量 FASG08:表柔比星使老年患者显著获益 * 明确6周期由于3周期等剂量及高剂量 * 明确6周期由于3周期等剂量及高剂量 * 明确6周期由于3周期等剂量及高剂量 * PACS04:希望强调FEC的优势非劣于ED * * * * * * * * ADEBAR:请胡教授酌情帮忙强调一下。 * 78] Superiority of sequential docetaxel over standard FE100C in patients with intermediate risk breast cancer: survival results of the randomized intergroup phase III trial EC-Doc.Nitz U, Huober J, Lisboa B, Harbeck N, Fischer H, Moebus V, Hoffmann G, Augustin D, Weiss E, Gluz O, Kuhn W West German Study Group, Moenchengladbach, Germany; Kantonspital, St. Gallen, Switzerland; Unikl. HH-Eppendorf, Hamburg, Germany; KH Rechts d. Isar, Muenchen, Germany; EKO, Oberhausen, Germany; STK Frankfurt Hoechst, Frankfurt, Germany; St. Josefs H., Wiebaden, Germany; Kl. Deggendorf, Deggendorf, Germany; KKH Boeblingen, Boeblingen, Germany; Unik. Bonn, Bonn, GermanyBackground: Taxane based adjuvant chemotherapy (CHT) is standard of care in node-positive breast cancer. Several pre-planned subgroup analyses detected the maximum benefit from taxanes in patients with 1-3 positive lymph nodes (LN).According to the St. Gallen consensus CHT in endocrine responsive tumors is optional in these patients. Recently the ABCSG reported excellent survival data after endocrine therapy +/- bisphosphonates without CHT in low to intermediate risk breast cancer (Gnant et al., ASCO 2008). The EC-Doc trial compares a modern sequential taxane-based regimen with standard FE100C in patients with 1-3 positive LN.Methods: Patients from 18 to 65 years with primary breast cancer and 1 to 3 positive LN were eligible if they had operable breast cancer with histologically confirmed free margins. M0 status was assessed by conventional staging. 2011 patients were randomized to a phase III trial comparing 4 cycles E90C600 q3w fol