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유방암 환자의 선행항암화학요법 중 유방암의 진행 예측인자에 관한 연구
- Alternative Title
- Predictive factors of stable or progressive disease during anthracycline with/without taxane-based neoadjuvant chemotherapy in breast cancer
- Author(s)
- Jin, Ming
- Alternative Author(s)
- JIN MING
- Advisor
- 한세환
- Department
- 일반대학원 의학과
- Publisher
- The Graduate School, Ajou University
- Publication Year
- 2016-08
- Language
- eng
- Keyword
- neoplasms; Neoadjuvant therapy; Disease Progression
- Alternative Abstract
- - ABSTRACT - Predictive factors of stable or progressive disease during anthracycline with/without taxane-based neoadjuvant chemotherapy in breast cancer Purpose: Neoadjuvant chemotherapy (NAC) has been shown to effectively downstage locally advanced breast cancer; however, clinically, no response or a progression of the tumor can occur in some cases. Predictive factors of no response or progression are unknown compared to predictive factors of a response. We investigated predictive factors of stable (SD) or progressive disease (PD) during anthracycline with/without taxane based NAC. Methods: From January 2012 to December 2015, data were collected retrospectively by reviewing medical records of patients who received NAC. Statistical analysis was performed to compare patients with a partial response and complete remission to patients with SD or PD after anthracycline- or taxane-based chemotherapy. Results: In total, 242 patients received NAC with an anthracycline and cyclophosphamide (AC) regimen and 159 patients received anthracycline followed by taxane. Forty-one (17%) patients had SD or PD after anthracycline treatment, and 50 (31%) patients had SD or PD after taxane treatment. Factors related to SD/PD after an AC regimen included a large pretreatment tumor size (p = 0.001), clinical T3 status (p = 0.01) and high histologic grade (p < 0.001). In cases of a T regimen, clinical T3 status (p = 0.04), estrogen receptor(ER)/progesterone receptor (PR) positivity (p = 0.04, 0.02, respectively), and human epidermal growth factor 2(HER2) negativity (p < 0.001) were predictors of no response.SD or PD after taxane was a negative predictor of disease-free survival. Moreover, SD or PD after anthracycline or taxane was a negative predictor of overall survival. Conclusions: Clinical stage, ER/PR positivity and HER2 negativity were predictors of no response to NAC. We need a combination of predictive factors including clinical data, novel molecular markers, and genetic factors to identify patients who will show no response to the standard NAC regimen.
- Fulltext
- Appears in Collections:
- Graduate School of Ajou University > Department of Medicine > 3. Theses(Master)
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