乳腺癌新辅助化疗前后激素受体变化对术后内分泌治疗的影响

摘要

目的:评估乳腺癌患者新辅助化疗前后激素受体变化对术后内分泌治疗及远期生存的影响.方法:收集接受新辅助化疗的乳腺癌患者215例.观察新辅助化疗前后激素受体的表达差异,其中59例手术后确认已达到病理完全缓解,剩余156例患者中63例出现新辅助化疗前后激素受体表达的不一致.63例患者分为两组,A组39例,于手术、化疗结束后接受标准内分泌治疗5年;B组24例,因无法耐受内分泌治疗药物或其他原因拒绝内分泌治疗.结果:A组、B组的一般情况差异无统计学意义(P＞0.05).63例在新辅助化疗后出现激素受体表达改变的患者,其中ER、PR表达发生改变的分别是37例(23.7％)、48例(30.8％).A组的3年无病生存率(74.4％)与B组(54.2％)比较差异无统计学意义(P＞0.05),但A组的5年生存率(74.3％)与B组(45.8％)比较差异有统计学意义(P=0.023).结论:接受新辅助化疗的患者即使在化疗前后出现激素受体变化,也应该接受标准的5年内分泌治疗.%Objective:To evaluate the impact of change in the hormone receptor (HR) status on the long-term outcomes of breast cancer patients treated with neoadjuvant chemotherapy (NAC).Methods:There were 215 patients for the HR status of their lesions before and after NAC.After surgery,59 cases were confirmed to have achieved complete remission of pathology,The expression of hormo ne receptors was not consistent in 63 patients before and after neoadjuvant chemotherapy.63 patients were divided into two groups,Group A:39 patients received standard endocrine therapy for 5 years after surgery and chemotherapy;Group B:24 patients were not treated with standard endocrine therapy after surgery and chemotherapy.Conclusions:The 3-year DFS rates were 77.4％ and 54.2％ in Group A and Group B patients,respectively,There was not statistical significancebetween the two groups.The 5-year overall survival rate for Group A patients was higher than that of Group B patients(74.3％ vs 45.8％,P=0.028),The difference was statistically significant.Conclusions:This study revealed that breast cancer patients with HR altered after NAC still benefit from standard endocrine therapy.