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【medical-news】老年乳腺癌患者系统化疗二期临床
PURPOSE: To investigate the activity of letrozole plus/minus oral metronomic cyclophophamide as primary systemic treatment (PST) in elderly breast cancer patients.
METHODS: One hundred fourteen consecutive elderly women with T2-4 N0-1 and estrogen receptor–positive breast cancer were randomly assigned to primary letrozole therapy (2.5 mg daily for 6 months) or a combination of letrozole plus oral cyclophosphamide (50 mg/daily for 6 months) in an open-labeled, randomized phase II trial. Tumor response was assessed clinically, and tumor Ki67 index and vascular endothelial growth factor (VEGF) -A levels were measured before and after treatment.
RESULTS: Overall response rate was 71.9% (95% CI, 60.0 to 83.8) in the 57 patients randomly assigned to receive primary letrozole and 87.7% (95% CI, 78.6 to 96.2) in the 57 patients randomly assigned to receive letrozole plus cyclophosphamide. The difference in activity between treatment arms was predominantly confined to patients with ductal histology. There was a significantly greater suppression of Ki67 and VEGF-A expression in the letrozole/cyclophosphamide-treated group than in the letrozole-treated group, leading to lower Ki67 and VEGF expression at post-treatment residual histology (P = .03 and P = .002, respectively).
CONCLUSION: Both letrozole and letrozole plus cyclophosphamide treatments appeared active as PST in elderly breast cancer patients. Metronomic scheduling of cyclophosphamide may have an antiangiogenetic effect and the combination of letrozole plus cyclophosphamide warrants testing in a randomized phase III trial. 认领。。。 来曲唑和来曲唑加低剂量不间断口服环磷酰胺作为老年乳腺癌患者主要系统化疗的二期临床试验
目的：研究来曲唑和来曲唑加/减口服环磷酰胺作为老年乳腺癌患者主要系统化疗的活性。
方法：在一个开放的随机II期临床实验中，114个T2-4 N0-1和雌激素受体阳性的乳腺癌老年妇女随机安排至来曲唑治疗组(2.5mg/d，为期6个月)或来曲唑＋口服环磷酰胺联合治疗组(50mg/d，为期6个月)。通过临床诊断、在治疗前后肿瘤 Ki67 指数和血管内皮生长因子(VEGF)-A浓度的测量来评估肿瘤的响应。
结果： 57个随机接受来曲唑治疗组的患者总响应率为71.9% (95% CI, 60.0至83.8)，57个随机接受来曲唑＋口服环磷酰胺组的患者总响应率为87.7% (95% CI, 78.6至96.2)。两组治疗的活性差异主要被患者的原位组织限制。来曲唑/环磷酰胺治疗组比来曲唑治疗组抑制Ki67和VEGF-A表达更显著，主要降低了治疗后残存的组织中Ki67和VEGF-A表达。
结果：来曲唑和来曲唑＋环磷酰胺在老年乳腺癌患者主要系统化疗中均有活性。环磷酰胺不间断的给药可能有抗血管形成效果，来曲唑＋口服环磷酰胺的联用保证III期临床的开展。
ic Treatment in Elderly Breast Cancer Patients.pdf (261.81k) 认领一下，会不会太晚啊？先练练手，呵呵 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-02-20 05:14
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