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Background

The impact of pathological complete response after neoadjuvant chemoradiotherapy on survival of patients with squamous cell carcinoma of esophagus is still controversial. We retrospectively investigated the survival outcome in this group of patients.

Methods

Ninety-eight patients with locally advanced squamous cell carcinoma of esophagus, who received neoadjuvant chemoradiotherapy were included in this retrospective analysis. Treatment protocols were radiotherapy with standard dose 50.4 Gy/28 fr, and chemotherapy with cisplatin 20 mg/m2 and 5-FU 800 mg/m2 for 4 days given on week 1 and 5. After neoadjuvant chemoradiotherapy is completed, patients who were eligible for surgery received surgery within 4–6 weeks. Patients who were not suitable for surgery were shifted to definite chemoradiotherapy. The primary end points were overall survival and progression-free survival.

Results

Sixty-eight patients out of the ninety-eight patients received surgery after neoadjuvant chemoradiotherapy. There were 32 patients who achieved pathological complete response with a pCR rate of 47%. Thirty patients were shifted to definite concurrent chemoradiotherapy. The 2-year overall survival rate was 81.3% in the patients whose tumors showed a pCR and 58.3% in the patients with tumors that had a pathological partial response (p = 0.025). The 2-year overall survival in patients who received neoadjuvant chemoradiotherapy followed by surgery and definite chemoradiotherapy were 69.1% and 40.0%, respectively. There are 13 patients experienced grade 3–4 adverse event.

Conclusion

Pathological complete response after neoadjuvant chemoradiotherapy is associated with a significant survival benefit in patients with locally advanced squamous cell carcinoma of esophagus. The toxicities related to neoadjuvant chemoradiotherapy were tolerable.  相似文献
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目的:探讨相关因素在新疆地区维吾尔族女性乳腺癌新辅助化疗(NAC)疗效中的意义。方法收集新疆医科大学第二附属医院及肿瘤医院2010年1月至2014年6月87例行NAC的维吾尔族女性乳腺癌患者的全部病历资料。NAC前均行肿块空心针穿刺活检病理确诊,并用免疫组化(IHC)方法明确患者雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(Her-2)状态和肿瘤增殖指数(Ki-67)。分析患者年龄、绝经状态、体质指数(BMI)、肿块大小、腋窝淋巴结状况、临床分期、NAC周期数、分子分型对NAC有效率(CR+PR)和病理完全缓解(pCR)的预测作用。结果在87例患者中NAC总有效率为85.06%(74/87),疾病稳定(SD)率为11.49%(10/87),疾病进展(PD)率为3.45%(3/87);pCR率为14.94%(13/87)。激素受体阴性、Ki-67指数>20%、体重指数(BMI)<25 kg/m2、非LuminaA型患者NAC疗效更好。NAC周期数>4个周期为预测pCR的独立变量(P=0.004,OR=0.081;95%CI:0.015~0.441)。结论 ER阴性、PR阴性、NAC周期>4个周期者pCR率更高。ER阴性、PR阴性、Ki-67指数>20%、非LuminaA型、BMI<25 kg/m2者NAC后临床有效率更高。NAC周期>4周期为预测pCR的独立因素。  相似文献
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目的:探讨低位直肠癌新辅助放化疗后完全缓解病例的治疗策略。方法:对我院接受新辅助放化疗的147例Ⅱ、Ⅲ期低位直肠癌患者的临床、病理资料进行回顾性分析。结果:新辅助放化疗后125例(85.03%)获得症状缓解,14例(9.52%)术后病理完全缓解(病理分期为pT0N0M0),其中5例行术后辅助化疗,未出现术后复发转移;其余9例未行术后治疗,有3例(33.3%)出现术后转移。结论:新辅助放疗可使低位直肠癌肿瘤缩小,临床症状大部分缓解,病理降期,部分患者可达到病理完全缓解,但对完全缓解病例,术后仍需行辅助化疗。  相似文献
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目的探讨中晚期食管鳞癌新辅助放化疗加胸腔镜联合手术治疗后的病理特征、分级方法,寻找食管鳞癌预后不良的危险因素。方法2011年6月~2013年6月间浙江省台州医院共完成术前放化疗加胸腹镜联合手术治疗中晚期(ⅡB~ⅢA期)食管鳞癌22例。对食管肿瘤及送检淋巴结全部取材,进行病理分析。结果7例(31.8%)达到完全病理缓解(pCR),15例(61.2%)未达到完全病理缓解(非pCR)。在15例非pCR患者中,13例食管有肿瘤残留,6例有淋巴结转移,4例既有食管肿瘤残留又有淋巴结转移。2例患者术后短时间内发生远处转移并死亡,食管均有肿瘤残留且有淋巴结转移。结论TNM分期或G分期均适合于食管鳞癌新辅助放化疗加手术治疗后的病理分析,非pCR是食管鳞癌发生远处转移及预后不良的重要危险因素。根治性放化疗因可能遗漏较小的肿瘤或不能清除已经转移的淋巴结,可能对患者的预后造成不良影响。  相似文献
5.
Anthracycline-Taxane chemotherapy is widely used in neoadjuvant treatment for breast cancers. However, there is limited data reported in patients with triple negative breast cancer (TNBC). Here, we evaluated the pathologic responses and survival of neoadjuvant epirubicin and taxanes chemotherapy in patients with locally advanced TNBC to provide some useful information for clinical practice. A total of 43 patients with locally advanced TNBC were enrolled in this study. Patients were administered with epirubicin 75 mg/m 2 plus paclitaxel 175 mg/m 2 or docetaxel 75 mg/m 2 every 3 weeks for at least 2 cycles. The primary endpoint was pathologic complete response (pCR), which was defined as no residual invasive cancer, or only carcinoma in situ in both the excised breast and axillary lymph node, while relapse-free survival (RFS) and overall survival (OS) were secondary endpoints. Thirty-nine (90.7%) patients were at clinical stages ⅡB-ⅢC. Thirty-seven (86%) completed 4-6 cycles of preoperative chemotherapy, and objective response rate (ORR) was 81.4% (35/43). Forty-two patients underwent radical surgery subsequently. The pCR rate was 14.3% (6/42). The most common adverse events in neoadjuvant chemotherapy were nausea/vomiting (88.4%, 38/43) and neutropenia (88.4%). After a median follow-up period of 34.0 months, 3-year RFS and OS rate was 53.6% and 80.1%, respectively. All events of recurrence and death occurred in non-pCR patients, in whom the 3-year RFS and OS rates were 44.3% and 76.6%, respectively. This study suggest that neoadjuvant chemotherapy with epirubicin plus taxanes has a relatively low pCR rate and high early recurrence risk in locally advanced TNBC, which indicates the necessity for more efficacious treatment. Further study is needed to validate these results.  相似文献
6.
 近年,乳腺癌新辅助化疗的研究不再局限于局部晚期乳腺癌、炎性乳腺癌或肿块较大不可保乳的乳腺癌患者,研究的范围进一步扩大到可手术的早期乳腺癌,这得益于进一步认识到新辅助化疗的优势。新辅助化疗不仅提高了保乳率,更便于了解患者对化疗方案的敏感性,甚至预测患者的预后,从而指导临床化疗方案的调整。本文将对新辅助化疗药物的选择、疗程及用法等方面进行总结,同时对病理完全缓解的定义、预后意义与分子分型的关系等内容进行探讨。  相似文献
7.
Hui R  Zhang J  Fan Y 《中华医学杂志》2008,88(14):961-964
目的 探讨乳腺癌新辅助化疗后肿瘤和腋淋巴结及结外软组织病理缓解的影响因素及与预后的关系.方法 选择2000年10月至2001年8月在天津肿瘤医院乳腺科接受新辅助化疗、化疗后手术的196例ⅡB~ⅢB期乳腺癌患者.观察肿瘤、腋淋巴结及结外软组织病理缓解的程度,分析影响病理缓解的因素,及病理缓解与预后的关系.随访率100%,中位随访期61个月(4~70个月).结果 新辅助化疗后肿瘤的病理完全缓解pCR20例(10.2%),病理部分缓解pPR108例(55.1%),病理无变化pSD68例(34.7%),27.0%的转移淋巴结降期.病理缓解率与患者年龄、临床分期无关(P>0.05),与肿瘤大小、激素受体状况、病理类型相关(P<0.01).5年总生存率62.8%(P<0.01),中位生存期为61个月(P<0.01).结论 病理缓解率与肿瘤大小、激素受体状况、病理类型相关.新辅助化疗后原发瘤和转移淋巴结的降期是重要的预后因素.  相似文献
8.
近年来,尽管可切除非小细胞肺癌(non-small-cell lung cancer, NSCLC)的治疗方式不断取得进展,但在以总生存期(overall survival, OS)和无病生存期(disease-free survival, DFS)为主要终点的相关临床试验中,漫长的试验周期一定程度上限制了NSCLC的治疗进展。为加快抗癌药物研发进程,让更多患者及早获益,临床研究中急需一个能够快速评估NSCLC治疗效果的评价指标。而NSCLC经新辅助治疗后,其原发病灶可通过手术切除进行病理学评估的独特性,使得将病理缓解作为OS的替代终点成为可能。本文总结病理缓解作为可切除NSCLC新辅助化学治疗、放射治疗、靶向治疗及免疫治疗中的疗效评价指标的应用概况,探讨其作为OS替代终点的可行性。  相似文献
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