从循证医学角度谈乳癌化疗价值.pptVIP

 （中国肿瘤医学论坛)   大量肿瘤学资料免费下载 * * This figure shows an age-adjusted model of the estimated mortality trends associated with various combinations of treatment and screening. Early detection through mammography screening, along with adjuvant therapy, has prompted a decrease in breast cancer mortality rates. In the absence of screening and adjuvant therapy, from 1975 to 2000, the estimated mortality rate would have increased by approximately 30%. 1. Berry DA, Cronin KA, Plevritis SK, et al, for the Cancer Intervention and Surveillance Modeling Network (CISNET) Collaborators. Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med. 2005;353:1784-1792 (C). * Receptor status is an extremely important parameter influencing the treatment of breast cancer positive ER/PgR receptor status means that a patient is more likely to respond to hormone therapy, even in the event of a recurrence negative ER/PgR receptor status means that a patient will not respond to hormone therapy, and chemotherapy must be considered if a patient is HER2 positive, they are suitable for treatment with trastuzumab. Local disease can be best treated with lumpectomy, mastectomy or radiation. For metastatic disease, systemic chemotherapy is the most appropriate treatment there are a number of treatment options, the choice of which is influenced by disease characteristics, including location and number of metastatic sites. * 辅助化疗方案. CMF; 含蒽环; 含紫杉醇类; 联合曲妥珠单抗. Oxford的Meta分析. 辅助化疗减少死亡危险. 50岁以下38％; 50-69岁20％; 70岁以上受益不明确 The forest plot shown on this slide is from the Oxford Overview and represents pooled data from trials of CMF vs no chemotherapy. There is an approximate 25% reduction in the annual odds of recurrent breast cancer. For more information, go online to: /Oncology/Journal%20Options/Articles/EBCT-Lancet-2005-05/Capsule.aspx * * * * Through 3 years of follow-up, findings from 2,194 patients indicate no significant differen