乳腺癌医学知识.pptVIP

* * 演讲重点： 1。对淋巴结阴性的患者而言，HER2状态决定了复发风险的高低 2。2004年《癌症》发表的文献报道显示HER2阳性，淋巴结阴性的患者复发风险明显高于HER2阴性，淋巴结阴性的患者，P值＝0.0001 * * * * At the present time, the main factors driving treatment choice in breast cancer include: Patient characteristics older, frail patients may be less able to tolerate intensive chemotherapies than a fit, young patient with good performance status comorbidities may mean a patient is less suited to intensive chemotherapy patient preference for oral chemotherapy. Tumor biology: accurate tumor evaluation according to clinical and pathological criteria ensures that patients can be offered suitable treatments at the appropriate stage of their disease surgery radiotherapy hormone treatment chemotherapy, with and without Herceptin. Prior treatment early relapse after adjuvant chemotherapy (e.g. less than 2 years) has a poor prognosis and may be indicative of resistant or refractory disease [1] in addition, the cumulative dose of certain treatments, such as anthracyclines, may preclude further treatment with agents of the same class. 1. Sledge GW et al. J Clin Oncol 2003;21:588–92. * * The choice of single-agent or polychemotherapy will depend on several factors, including: indolent or aggressive and rapidly progressing disease extent of visceral involvement symptomatic or asymptomatic disease frail and elderly or fit and healthy patient. It may be that a patient meets the other criteria for polychemotherapy but is too frail to undergo that form of treatment. In these circumstances, single-agent chemotherapy would be a more appropriate option. * * The heterogeneity of breast cancer argues for flexibility in approach, and it is clear that both combination and sequential strategies have a role in the metastatic setting: a combination regimen such as Xeloda/Taxotere (XT) offers highly effective disease control and an established survival benefit compared with Taxotere alone and is particularly suited to patients with rapidly progressing disease and/or visceral