| Objective(s): To explore the effect of chemotherapy delay on the rate of pathological complete response(p CR)in patients with breast cancer after neoadjuvant chemotherapy(NAC),so as to provide some reference for clinical optimization of NAC strategy.Methods: The data of female breast cancer patients who received NAC and underwent surgery in our hospital between 2013 and April 2022 were collected,and the patients were interviewed by telephone follow-up.Patients were divided into groups according to the cumulative time of chemotherapy delay(the group without a delay,the group with a delay of 1-7 days,the group with a delay of 8-14 days,the group with a delay of 15-21 days,and the group with a delay of > 21 days).p CR was used as the study endpoint,and Chi-square test was used to explore the influencing factors of chemotherapy delay;Chi-square test and binary Logistic regression were used to explore the influencing factors of p CR;Chi-square test was used to investigate the effect of chemotherapy delay on p CR rate.Results: A total of 1655 patients were included in this study,88.7% of whom had chemotherapy delay,the median cumulative time of chemotherapy delay was 6(1-120)days,and the average cumulative time of chemotherapy delay was 8.92 ±10.481 days.Education level,understanding of the disease,psychological status,social and family support,whether chemotherapy is rejected,whether there are serious chemotherapy toxicity and side effects,and economic status are all factors that affect chemotherapy delay(P<0.05).The molecular types and the cumulative time of chemotherapy delay were independent influencing factors for p CR(P<0.05).The overall p CR rate of patients was 30.45%,the p CR rates of patients in the groups without a delay,with a delay of 1-7 days,with a delay of 8-14 days,with a delay of15-21 days,and with a delay of > 21 days were 30.48%,33.25%,30.10%,28.67%,and 19.88%,respectively,with a significant statistical difference(P=0.019).Among them,the p CR rate of patients in the group with a delay of > 21 days were significantly lower than that in the group without a delay(P=0.023).Subgroup analysis found that:for Luminal A and Luminal B(HER-2 negative)patients,there was no significant statistical difference in the p CR rates of patients between the groups(P>0.05);for HER-2 positive patients,the p CR rate of patients in the group with a delay of > 21 days was significantly lower than that in the group without a delay(P=0.020);for triple-negative patients,the p CR rates of patients in the groups with a delay of 8-14 days(P=0.005)and with a delay of >14 days(P=0.007)were significantly lower than that in the group without a delay.For patients using the AC-TH(P)chemotherapy regimen,the p CR rate of patients in the group with a delay of > 21 days was significantly lower than that in the group without a delay(P=0.015),while for patients using the AC-T,TA(C),and TCb H(P)chemotherapy regimens,there was no significant statistical difference in the p CR rate of patients between the groups(P>0.05).Conclusion(s): 1.Patients with low educational level,insufficient understanding of disease,negative psychological status,lack of social and family support,severe chemotherapy toxicity,rejection of chemotherapy,and poor economic status are more likely to experience chemotherapy delay.2.Chemotherapy delay will reduce the p CR rate of NAC for breast cancer.3.The effect of chemotherapy delay on the p CR rate of different molecular subtypes of breast cancer was different,especially for HER-2 positive and triple-negative breast cancer.4.Chemotherapy delay will reduce the p CR rate of breast cancer patients using AC-TH(P)chemotherapy regimen.5.During the NAC process,it is necessary to improve the patient’s treatment compliance,and if the patient’s physical conditions allow,try to give chemotherapy on time to avoid unnecessary chemotherapy delays... |
PDF Full Text Request