Previous
Next
ARCHIVE
№1' 2019
ONCOLOGYInternational Medical Journal, Vol. 25., Iss. 1, 2019, P. 65−69.
INDIVIDUALIZATION OF NEOADJUVANT THERAPY IN PATIENTS WITH LOCALLY-DISTRIBUTED BREAST CANCER
Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
Neoadjuvant chemotherapy after breast cancer is performed to reduce the size of the primary tumor in order to create favorable conditions when performing organ−saving surgery; it provides the achievement of a complete morphological regression of the tumor process and metastatic lymph nodes. To reveal the relationship between the manifestation of tumor regression at different neoadjuvant chemotherapy protocols and distant results of treatment of the patients of this category, as well as some prognostic markers of treatment effectiveness, a study was performed, which comprised 139 patients with diagnosed breast cancer (T1−2 N2−3M0, T3N1−3M0, T4N0−3M0) aged from 29 to 64 years. Clinical response after neoadjuvant therapy was evaluated by physical and instrumental methods every two cycles. To determine the biological subtype of tumor, the indices of the level of estrogen and progesterone receptors, HER2 / neu expression and the extent of histological malignancy (H), determined by immunohistochemistry, were used. It was established that treatment with the TAS regimen provided the best results as compared with the TS regimen. The study found that the combination of detection of high expression of topoisomerase II−alpha with low expression of beta−tubulin class III was a reliable predictive sign of achieving a complete morphological regression in response to taxane−containing chemotherapy.
Key words: breast cancer, neoadjuvant chemotherapy, prognostic criteria, immediate efficiency.