유방암 환자의 선행항암화학요법 중 유방암의 진행 예측인자에 관한 연구
Predictive factors of stable or progressive disease during anthracycline with/without taxane-based neoadjuvant chemotherapy in breast cancer
- 주제(키워드) neoplasms , Neoadjuvant therapy , Disease Progression
- 발행기관 아주대학교
- 지도교수 한세환
- 발행년도 2016
- 학위수여년월 2016. 8
- 학위명 석사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000023176
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
- 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.
more목차
Ⅰ. INTRODUCTION 1
Ⅱ. METHODS 2
A. Study population 2
B. Staging and Treatment 2
C. Assessment of tumor response 3
D. Statistical analysis 3
Ⅲ. RESULTS 4
A. Response to anthracycline-based regimen 4
B. Response to taxane-based regimen 5
C. Pathologic response after neoadjuvant chemotherapy 8
D. Predictive factors of no response to neoadjuvant chemotherapy 8
E. Clinical outcomes 10
Ⅳ. DISCUSSION 12
Ⅴ. CONCLUSION 16
REFERENCES 17
