2026-09-21T10:52:49Zhttps://repository.ajou.ac.kr/oai/request

oai:repository.ajou.ac.kr:201003/130742024-10-11T02:21:26Zcom_201003_14369com_201003_14368col_201003_14370

Predictive factors of stable or progressive disease during anthracycline with/without taxane-based neoadjuvant chemotherapy in breast cancer 유방암 환자의 선행항암화학요법 중 유방암의 진행 예측인자에 관한 연구 JIN, MING 한, 세환 대학원 의학과 201424693 JIN, MING neoplasms Neoadjuvant therapy Disease Progression 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. 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 Master 2016-11-30T23:41:26Z 2016-11-30T23:41:26Z 2016 2016 Thesis Theses http://repository.ajou.ac.kr/handle/201003/13074 http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000023176 000000023176 en text/plain