RESUMEN
BACKGROUND: This post-hoc analysis aimed to compare an intense dose-dense sequential chemotherapy (DD-CT) and a conventionally-dosed chemotherapy (CD-CT) in the neoadjuvant AGO-1 study, focusing on the subgroup with inflammatory breast cancer (IBC). PATIENTS AND METHODS: Out of 668 randomised patients, 101 patients presented with IBC. Patients received epirubicin followed by paclitaxel every 2 weeks (DD-CT) or simultaneously every 3 weeks (CD-CT). RESULTS: No differences in pathological complete response rates were observed [odds ratio (OR)=1.27, p=0.33]. Most patients were scheduled for mastectomy before starting therapy; however, in 21.7% breast-conserving surgery was performed. Disease-free survival rates [Hazard Ratio (HR)=0.65; p=0.597] and overall survival rates (HR=1.40; p=0.327) were similar for both treatment arms. Patients with breast-conserving surgery had a significantly better outcome than patients treated with mastectomy (disease-free survival: HR=0.41; p=0.034 and overall survival: HR=0.09; p=0.003). CONCLUSION: Patients with IBC benefited not from DD-CT but from breast-conserving surgery after neoadjuvant chemotherapy.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Inflamatorias de la Mama/tratamiento farmacológico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Quimioterapia Adyuvante , Relación Dosis-Respuesta a Droga , Epirrubicina/administración & dosificación , Femenino , Humanos , Persona de Mediana Edad , Paclitaxel/administración & dosificación , Resultado del TratamientoAsunto(s)
Neoplasias Encefálicas/secundario , Neoplasias Encefálicas/cirugía , Neoplasias de la Mama/cirugía , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/cirugía , Neoplasias Pulmonares/secundario , Neoplasias Pulmonares/cirugía , Escisión del Ganglio Linfático , Metástasis Linfática , Neoplasias de la Mama/mortalidad , Estudios de Seguimiento , Humanos , Complicaciones Intraoperatorias , Metástasis Linfática/diagnóstico por imagen , Mastectomía , Mastectomía Segmentaria , Análisis Multivariante , Guías de Práctica Clínica como Asunto , Calidad de Vida , Radiografía Torácica , Factores de Riesgo , Factores de Tiempo , Tomografía Computarizada por Rayos XRESUMEN
In proximal tubal occlusions (PTO) the microsurgical anastomosis or in case of extensive tubal damage the in vitro-fertilisation (IVF) are the treatment modalities of choice. Aim of our study was to evaluate the effectivity of GnRH-analogues in the treatment of PTO. In 23 patients with repeatedly proven proximal tubal occlusion the GnRH-analogon Leuprorelin was applied for a 3 month period. 20 out of 23 patients completed the entire study including a further tubal patency test. 10 patients showed open tubes on both sides and in 2 cases one oviduct was patent. In 8 patients no effect of the hormonal treatment was found. Following the therapy 4 pregnancies occurred, 2 were located ectopically. Regarding tubal patency we could demonstrate a significant effect of hormonal treatment in proximal tubal occlusions (PTO). However, in respect to the pregnancy rate the results were not satisfactory. Therefore, the hormonal treatment of PTO by GnRH-analogues is limited to certain cases and doesn't represent a standard therapy.
