Abstract:【Objective】 To investigate the effect of neoadjuvant chemotherapy cycle on the chemotherapy effect of triple negative breast cancer.【Methods】The clinical data of 110 patients with triple negative breast cancer who received preoperative neoadjuvant chemotherapy in our hospital from June 2015 to June 2019 were retrospectively analyzed. All patients received epirubicin combined with docetaxel and cyclophosphamide neoadjuvant chemotherapy. They were divided into short cycle group (preoperative neoadjuvant chemotherapy 3-4 cycles, n=35) and long cycle group (preoperative neoadjuvant chemotherapy 6-8 cycles(n=75).The clinical and pathological efficacy, adverse reactions and disease-free survival (DFS) were compared between the two groups.【Results】There was no significant difference in the clinical total effective rate between the two groups (P>0.05); there was no significant difference in the Mille Payne pathological grade between the two groups (P>0.05). The PCR rate was 24.5%. The PCR rate of the long cycle group was 24.0% (18/75), which was not significantly different from that of the short cycle group (25.7%) (χ2=0.06,P=0.80). There was no significant difference in the incidence of arrhythmia, hematochezia, vomiting, diarrhea, thrombocytopenia, peripheral neuritis, menstrual disappearance and drowsiness between the two groups (P>0.05), but the incidence of abnormal liver enzymes and leukopenia in the long cycle group was higher than that in the short cycle group (P<0.05). The follow-up time was 12-36 months, with a median of 20.9 months. There were 24 cases of DFS, including 2 cases in the short-term group and 22 cases in the long-term group. Kaplan Meier method and Log rank test showed that there was no significant difference in DFS between the short cycle group and the long cycle group (log rank χ2=0.185,P=0.667).【Conclusion】Compared with 3-4 cycles of neoadjuvant chemotherapy, prolonging the neoadjuvant chemotherapy cycle (up to 6-8 cycles) may have little effect on the therapeutic effect and prognosis of triple negative breast cancer patients.
[1] Anastasiadi Z, Lianos GD, Ignatiadou E, et al. Breast cancer in young women: an overview[J].Updates Surg,2017,69(3):313-317.
[2] Denkert C, Liedtke C, Tutt A, et al. Molecular alterations in triple-negative breast cancer-the road to new treatment strategies[J].Lancet,2017,389(10087):2430-2442.
[3] Jitariu AA. Triple negative breast cancer: the kiss of death[J].Oncotarget,2017,8(28):46652-46662.
[4] 仉玮,赖米林,杨时鸿,等.Luminal B型乳腺癌新辅助化疗效果与影响因素分析[J].广东医学,2017,38(22):3426-3429.
[5] Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)[J].Eur J Cancer,2009,45(2):228-247.
[6] 汤红平,荣磊,梁冠男, 等.乳腺癌新辅助化疗前后病理组织学及分子指标变化[J].临床与实验病理学杂志,2018,34(1):12-15.
[7] Merino BJ, Torres TM, Ros ML. Breast cancer in the 21st century: from early detection to new therapies[J].Radiologia,2017,59(5):368-379.
[8] Chen Y, Shi XE, Tian JH, et al. Survival benefit of neoadjuvant chemotherapy for resectable breast cancer: A meta-analysis[J].Medicine (Baltimore),2018,97(20):e10634.
[9] Iwata H, Sato N, Masuda N, et al. Docetaxel followed by fluorouracil/epirubicin/cyclophosphamide as neoadjuvant chemotherapy for patients with primary breast cancer[J].Jpn J Clin Oncol,2011,41(7):867-875.
[10] 李曼曼,徐斌,邵营波, 等.不同雌激素受体状态下化疗周期数对乳腺癌新辅助化疗病理完全缓解率的影响[J].肿瘤防治研究,2017,44(1):38-41.
[11] Ali AM, Ansari J, El-Aziz N, et al. Triple Negative Breast Cancer: A Tale of Two Decades[J].Anticancer Agents Med Chem,2017,17(4):491-499.
[12] Cerulla N, Arcusa A, Navarro JB, et al. Role of taxanes in chemotherapy-related cognitive impairment: A prospective longitudinal study[J].Breast Cancer Res Treat,2017,164(1):179-187.