乳腺放射相关血管肉瘤（RAAS）的新辅助化疗：单中心回顾性研究。

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Pub Date : 2024-10-21 DOI:10.1016/j.breast.2024.103825

Stijn J.C. van der Burg , Sophie J.M. Reijers , Anke Kuijpers , Lotte Heimans , Astrid N. Scholten , Rick L.M. Haas , Hester van Boven , Willemijn M. Kolff , Marie-Jeanne T.F.D. Vrancken Peeters , Martijn Kerst , Beatrijs A. Seinstra , Neeltje Steeghs , Winette T.A. van der Graaf , Yvonne M. Schrage , Winan J. van Houdt

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引用次数: 0

摘要

背景：乳腺放射相关血管肉瘤（RAAS）是一种罕见的恶性肿瘤，存活率很低。由于缺乏数据，最佳治疗策略仍不确定，包括单纯手术和手术与（新）辅助化疗（NACT）和/或再放疗相结合。本研究旨在评估以紫杉类药物为基础的新辅助化疗（NACT）的潜在益处：在这项回顾性单中心研究中，纳入了 1994 年至 2024 年间接受治疗的所有乳腺 RAAS 患者。自2018年起，我院将NACT视为该患者群体的治疗选择。研究比较了接受和未接受NACT治疗患者的肿瘤预后差异：结果：共纳入 35 名女性患者。13名患者（37%）接受了NACT治疗，其中5名患者（39%）还接受了新辅助热疗再放疗。11名患者（85%）接受了紫杉醇治疗，另外2名患者（15%）接受了多柔比星/多西他赛治疗。病理完全反应率为 69%（9 例）。NACT 组患者的中位随访时间为 41 个月（24-56 个月），非 NACT 组患者的中位随访时间为 44 个月（20-108 个月）。在 NACT 组中，只有一名患者在 6.5 年后复发。在3年无局部复发生存率（100% vs. 63.9%，p = 0.14）、无远处转移生存率（100% vs. 47.5%，p = 0.005）和总生存率（100% vs. 56.1%，p = 0.016）方面，接受NACT治疗的患者比未接受NACT治疗的患者的肿瘤治疗效果更好：结论：在这项研究中，新辅助他汀类药物治疗乳腺 RAAS 可改善 NACT 治疗患者的无远处转移生存率和总生存率。

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Neoadjuvant chemotherapy for radiation associated angiosarcoma (RAAS) of the breast: A retrospective single center study

Background

Radiation associated angiosarcoma (RAAS) of the breast is a rare malignancy with poor survival. Optimal treatment strategies remain uncertain due to a lack of data, and vary between surgery alone and a combination of surgery with (neo)adjuvant chemotherapy (NACT) and/or re-irradiation. The aim of this study was to evaluate the potential benefit of taxane based NACT.

Methods

In this retrospective single center study, all patients with RAAS of the breast treated between 1994 and 2024 are included. Since 2018, NACT is considered a treatment option for this patient population in our institute. The difference in oncological outcomes of patients with and without NACT were compared.

Results

Thirty-five women were included. Thirteen (37 %) received NACT of which five (39 %) also had neoadjuvant re-irradiation with hyperthermia. Eleven patients (85 %) received paclitaxel, the other two (15 %) had doxorubicine/docetaxel. Complete pathological response was found in 69 % (n = 9). Median follow up was 41 months (range 24–56) for patients with NACT and 44 (range 20–108) for patients without NACT. In the NACT group, only one patient developed a recurrence after 6.5 years. Patients with NACT had improved oncological outcomes compared to patients without NACT in terms of 3-year local recurrence free survival (100% vs. 63.9 %, p = 0.14), distant metastasis free survival (100 % vs. 47.5 %, p = 0.005), and overall survival (100% vs. 56.1 %, p = 0.016).

Conclusion

In this study, neoadjuvant taxanes for RAAS of the breast leads to improved distant metastasis free survival and overal survival in patients treated with NACT compared to no NACT

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来源期刊

Breast 医学-妇产科学

CiteScore

8.70

自引率

2.60%

发文量

165

审稿时长

59 days

期刊介绍： The Breast is an international, multidisciplinary journal for researchers and clinicians, which focuses on translational and clinical research for the advancement of breast cancer prevention, diagnosis and treatment of all stages.