Treatment outcomes of neoadjuvant chemotherapy with dose-dense AC-T regimen for patients with stage II, III breast cancer

  • Nguyen Thi Minh Phuong 108 Military Central Hospital
  • Pham Dinh Phuc 108 Military Central Hospital
  • Nguyen Ngoc Minh Tien 108 Military Central Hospital
  • Phan Minh Tam 108 Military Central Hospital

Main Article Content

Tóm tắt

Objective: To evaluate the treatment outcomes of neoadjuvant chemotherapy with dose-dense AC-T (dd AC-T) regimen on stage II, III breast cancer (BC) patients, and to assess several clinical and subclinical factors associated with treatment response in these patients. Subject and method: This was a cross-sectional, prospective study with longitudinal follow-up, no control group. The study was conducted on 44 stage II, III BC patients receiving NAC with dd AC-T regimen at Department of General Oncology, Institute of Oncology, 108 Military Central Hospital from June 2018 to August 2022. Result: After receiving NAC, CEA, CA15-3 mean concentrations and tumor size decreased statistically (p<0.05). Regarding clinical response according to RECIST ver 1.1 criteria, the overall response rate (ORR) was 97.7%, in which the complete response (CR) rate accounted for 36.4%. All patients underwent surgery after receiving NAC. The rate of pathological complete response (pCR) was 31.8%. Several factors associated with treatment response include: Tumor size, skin involvement status, TNM stage, histopathology grade (p<0.05). Patients achieving clinical CR had a higher rate of pCR than the other group (p<0.001). Conclusion: NAC with ddAC-T regimen in treatment for stage II, III BC patients resulted in high clinical and pathological response. As a result, this is a good NAC option for these patients. Several factors associated with response include: Tumor size, skin involvement status, TNM stage, histology grade. Patients achieving clinical CR had a higher rate of pCR than the other group.

Article Details

Các tài liệu tham khảo

1. Sung H, Ferlay J et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3): 209-249.
2. Killelea BK, Yang VQ et al (2015) Neoadjuvant chemotherapy for breast cancer increases the rate of breast conservation: Results from the National Cancer Database. J Am Coll Surg 220(6): 1063-1069.
3. Cortazar P, Zhang L et al (2019) Pathological complete response and long-term clinical benefit in breast cancer: The CTNeoBC pooled analysis. Lancet Onco J 393(10175): 986.
4. Hà Thành Kiên (2018) Đánh giá kết quả hoá trị bổ trợ trước phẫu thuật phác đồ 4AC-4T liều dày trên bệnh nhân ung thư vú tại Bệnh viện K. Luận văn Thạc sĩ y học, Trường Đại học Y Hà Nội.
5. Lena M, Zucali R et al (1978) Combined chemotherapy-radiotherapy approach in locally advanced (T3b-T4) breast cancer. Cancer Chemother Pharmacol 1(1): 53-59.
6. Lê Thanh Đức (2013) Nghiên cứu hiệu quả hoá trị bổ trợ trước phẫu thuật phác đồ AP trong ung thư vú giai đoạn III. Luận án bảo vệ Tiến sĩ, Trường Đại học Y Hà Nội.
7. Nguyễn Thị Thuỷ (2016) Đánh giá kết quả hoá trị bổ trợ trước phác đồ 4AC-4T trên bệnh nhân ung thư vú giai đoạn III. Luận văn tốt nghiệp bác sĩ nội trú, Trường Đại học Y Hà Nội.
8. Hong WS, Jeon JY et al (2013) Comparison of neoadjuvant adriamycin and docetaxel versus adriamycin, cyclophosphamide followed by paclitaxel in patients with operable breast cancer. J Korean Surg Soc 85(1): 7-14.
9. Đỗ Thị Kim Anh (2016) Đánh giá hiệu quả hoá trị bổ trợ trước kết hợp phẫu thuật bảo tồn trên bệnh nhân ung thư vú giai đoạn II. Luận văn bác sĩ chuyên khoa cấp II, Trường Đại học Y Hà Nội.
10. Nguyễn Việt Cường, Phùng Thị Huyền (2020) Đánh giá đáp ứng hoá trị bổ trợ trước kết hợp trastuzumab trên bệnh nhân ung thư vú giai đoạn II, III. Tạp chí Y học thực hành, 1141(5), tr. 36-39.
11. Hayes DF, Kufe DW et al (1986) Comparison of circulating CA15-3 and carcinoembryonic antigen levels in patients with breast cancer. J Clin Oncol 4(10): 1542-1550.
12. Gajdos C, Tartter PI, Estabrook A, Gistrak MA, Jaffer S, Bleiweiss IJ (2002) Relationship of clinical and pathologic response to neoadjuvant chemotherapy and outcome of locally advanced breast cancer. J Surg Oncol 80(1): 4-11.