RESUMO
Objective: To evaluate the efficacy and safety of neoadjuvant dose-dense or standard schedule chemotherapy with anthracyclines and taxanes for Luminal B (HER2-)Breast Cancer. Methods: From January 2010 to December 2014, 168 Luminal B (HER2-) breast cancer patients with stageâ ¡A-â ¢C confirmed by pathology were randomly assigned to receive one of the following regimens: (group A) concurrent TEC× 4 every 3 weeks, ( group B ) sequential EC× 4-T × 4 every 3 weeks, (group C ) dose-dense TEC× 4 every 2 weeks with G-CSF, (group D) sequential EC× 4(dose-dense)-T × 4 with dose-dense every 2 weeks . Results: A total of 168 patients completed the neoadjuvant chemotherapy as planned. The pathologic complete response (pCR) was 16.8% in the 4 groups.The pCR were 30.9% and 26.1% in the group C and group D respectively, significantly higher than patients with group A and group B(9.5%and 7.1%) ( P<0.05). Median follow-up was 43 months (IQR 3-63). The 3-year disease free survival (DFS) rate was 64.7%, 55.5%, 87.8% and 92.1% and the 3-year overall survival(OS)rate was 79.4%, 77.7%, 95.1%, 97.3% in the 4 groups respectively. Patients in the dose-dense group had better 3-year DFS and 3-year OS than those with the regular group.The side-effects could be evaluated in 154 patients.The incidence of neutropenia was 29.2% and 21.9% in the group C and group D versus 65.7%and 51.3% in the regular group(P<0.05), the incidence of nervous toxicity was 54.2%, 18.9%, 60.0%, 26.8% in the 4 groups respectively. The incidence of nervous toxicity in the dose-dense group was lower than that in the regular regimen group(P<0.05). Conclusion: Neoadjuvant dose-dense chemotherapy with anthracyclines and taxanes for Luminal B (HER2-)Breast Cancer was effective and can improve the pCR, DFS and OS.Comparing the two dose dense regimens, sequentially with anthracyclines and taxanes, the incidence of nervous toxicity were lower.
Assuntos
Antraciclinas/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Terapia Neoadjuvante , Taxoides/uso terapêutico , Quimioterapia Adjuvante , Intervalo Livre de Doença , Feminino , Humanos , PrognósticoAssuntos
Hipertensão/fisiopatologia , Insulina/metabolismo , Adulto , Idoso , Glicemia/metabolismo , Captopril/uso terapêutico , Feminino , Teste de Tolerância a Glucose , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/genética , Indapamida/uso terapêutico , Secreção de Insulina , Masculino , Pessoa de Meia-IdadeAssuntos
Hipertensão/fisiopatologia , Indapamida/farmacologia , Saponinas , Função Ventricular Esquerda/efeitos dos fármacos , Adulto , Idoso , Proteínas Sanguíneas/metabolismo , Cardenolídeos , Digoxina/administração & dosagem , Digoxina/farmacologia , Quimioterapia Combinada , Feminino , Humanos , Hipertensão/sangue , Hipertensão/tratamento farmacológico , Indapamida/uso terapêutico , Masculino , Pessoa de Meia-IdadeRESUMO
We studied the effect of captopril on exercise performance in 30 patients with congestive heart failure using a randomized, double-blind and placebo-controlled method. 4-week captopril treatment can significantly increase the exercise tolerance time and work load, heart function, blood flow in exercising lower limbs as well as oxygen metabolic capacity. However, 3-day captopril treatment had no effect on exercise performance. A significant correlation was found between improvement in exercise performance and the pretreatment level of plasma angiotensin II. The increased levels of plasma prostaglandins E 2 and I 2 after captopril treatment were also correlated with improvement of exercise performance. The results indicated that long-term captopril treatment can increase exercise performance in congestive heart failure by improving both central and peripheral hemodynamics and metabolism. Certain vasomotor or endocrine factor may play a mediate role in the above changes.