| A large number of randomized,multi-center,controlled clinical trials have demonstrated that chemotherapy combined with trastuzumab can significantly improve the pathologic complete response rate compared with chemotherapy alone in neoadjuvant therapy for patients with overexpression of human epidermal growth factor receptor-2.Moreover,it has been suggested that pathological complete response rate can be used as an independent prognostic factor for survival benefit after trastuzumab treatment.In view of the lack of objective real-world data to support the analysis of the efficacy and prognosis of trastuzumab in preoperative treatment,this study will analyze the efficacy and prognosis of trastuzumab neoadjuvant therapy.Through the retrospective analysis on January 1,2012 to January 1,2017 in the affiliated hospital of Qingdao university of mammary gland disease diagnosis and treatment center line neoadjuvant therapy 160 BC patients,5 cases were lost to follow-up,the remaining 155 patients into three groups,the three group of patients with chemotherapy regimens based on anthracycline-based and purple shirts of chemotherapy(6-8 cycles),treatment cycle for 3weeks: group I(N = 59,38.06%)in the process of neoadjuvant therapy by bead sheet resistance until total postoperative application full 1 year;In group II(N= 28,18.06%),trastuzumab was not used in the neoadjuvant therapy,and the trastuzumab was used for 1year after the surgery.Trastuzumab was not used during neoadjuvant therapy or after surgery.The dosage of trastuzumab was calculated according to body weight,with an initial dose of8mg/kg and a consolidation dose of 6mg/kg.Among the 160 patients,5 patients lost follow-up,and the remaining 155 patients were divided into three groups.Among them,59 patients(38.06%)were treated with trastuzumab during neoadjuvant therapy,and the pathological complete response rate was 52.54%,higher than the other two groups(14.29%,13.24%),and the difference was statistically significant(P=0.000).The 2-year event-free survival distribution of patients in groups I,II and III showed statistically significant differences(P=0.039),and the event-free survival of patients in group I was better than that of patients in group II,with statistically significant differences(P=0.011).Meanwhile,the event-free survival period of group I patients was better than that of group III patients,and the difference was statistically significant(P=0.000).In this study,it was concluded that the pathological complete response rate of patients did not affect the event-free survival period and the total survival period(P=0.121,P=0.305).In the subgroup analysis of the three groups of patients,patients younger than 50 years had a longer event-free survival with trastuzumab than without trastuzumab(P < 0.05).For patients with singlecenter lesions,trastuzumab in neoadjuvant therapy had a longer event free survival period than neoadjuvant chemotherapy alone,and the difference was statistically significant(P <0.05).In addition,in patients with tumor size of > 2cm,the survival time of neoadjuvant chemotherapy plus trastuzumab was longer than that of chemotherapy alone without events(P < 0.05).When patients with human epidermal growth factor receptor-2 overexpression received neoadjuvant therapy,trastuzumab combined with chemotherapy had higher pathological complete response rate and better prognosis than chemotherapy alone.In patients with single lesions and large tumors,trastuzumab combined with chemotherapy and chemotherapy alone have better prognosis in neoadjuvant therapy. |
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