EFFECTS OF PRIMARY CHEMOTHERAPY IN CONSERVATIVE TREATMENT OF BREAST-CANCER PATIENTS WITH OPERABLE TUMORS LARGER THAN 3 CM - RESULTS OF A RANDOMIZED TRIAL IN A SINGLE CENTER

被引:241
作者
MAURIAC, L
DURAND, M
AVRIL, A
DILHUYDY, JM
机构
[1] Fondation Bergonié, Comprehensive Cancer Center of South West France, Bordeaux
关键词
CONSERVATIVE TREATMENT; INDUCTION CHEMOTHERAPY; OPERABLE BREAST CARCINOMA;
D O I
10.1093/oxfordjournals.annonc.a057953
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
272 women with operable breast adenocarcinomas larger than 3 cm were included in a randomized trial. The patients in group A (n = 138) with histological nodal involvement (N+) or a lack of estrogen and progesterone receptors (EPR-) were treated by initial mastectomy and axillary node dissection + adjuvant chemotherapy. Those in group B (n = 134) were treated by initial chemotherapy (the same as in group A) followed by locoregional treatment, adjusted according to their response to chemotherapy. Prognostic factors were identical in the two groups. In group A, 32 patients received no adjuvant treatment (N- and EPR+), while 104 were given adjuvant chemotherapy (N+ and/or EPR-). Two patients were lost to follow-up. In group B, all patients received initial chemotherapy; 44 were in complete clinical remission and were treated with radiotherapy only; 40 with residual tumor (< 20 mm) were treated with tumorectomy + axillary node dissection + radiotherapy; 49 with residual tumors (> 20 mm) had mastectomies. Conservative treatment was administered to 84 patients in group B (62.6%). EPR-tumors responded better to chemotherapy than did EPR+ ones (p = .003). After a median follow-up of 34 months, isolated local recurrences were more frequent in the group with initial chemotherapy, which, however, experienced a better overall survival (p = 0,04).
引用
收藏
页码:347 / 354
页数:8
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