The Study Of Effect And Prognosis Of Neoadjuvant Chemotherapy For Breast Cancer

ObjectiveTo investigate the efficacy of neoadjuvant chemotherapy and the related factors and analyze the prognosis factors.MethodsWe retrospectively analyzed228patients between January2007to December2008in our hospital, according to different chemotherapy regimens, the patients were divided into three groups, one used anthracycline, another used anthracycline and paclitaxel. According to the RECIST1.1solid tumor curative effect evaluation standard to evaluate curative effect of chemotherapy, the treatments were repeated every21days.They accepted about2-6cycles of neoadjuvant chemotherapy before they had surgical treatment. All of the patients were received surgical treatments and all of them finished the chemothrapies. We judge clinical curative effect with the application of clinical evaluation (clinical touch, color dopplar ultrasound, breast X-ray radiography, breast MRI) and postoperative pathologic diagnosis. We use immunohistochemistry to detect the expression of ER, PR, HER-2, Ki67, P53, PCNA and VEGF after neoadjuvant chemotherapy.ResultsThe clinical efficacy:,131cases of PR (57.5%),19cases of CR (8.3%),5cases of pCR (2.0%),1cases of PD (0.4%). The difference of chemotherapy regimens beween the group of chemotherapy efficacy was statistically significant CP=0.008).There was a significant difference between chemotherapy cycles and the efficacy of neoadjuvant chemotherapy (P=0.026), in which the efficacy of neoadjuvant chemotherapy was the best in4-6cycles. No statistically significant correlation between the efficacy of neoadjuvant chemotherapy and ER, PR, HER-2and other factors, a significant correlation with the p53status (P=0.002). Multivariate analysis showed that chemotherapy efficacy (P=0.007), primary clinical staging (P-0.003) and ER status (P=0.006) are independent prognostic factors for the disease-free survival of patients. Chemotherapy efficacy(P=0.035), primary clinical staging (P=1.54X10-4), ER status (P=0.006), Her-2status (P=0.032) are independent prognostic factors for the overall survival of patients.ConclusionsThe efficacy of neoadjuvant chemotherapy has correlation with chemotherapy regimens, chemotherapy cycles and p53status. Chemotherapy efficacy, primary clinical staging and ER status are independent prognostic factors for the disease-free survival of patients.Chemotherapy efficacy, primary clinical staging, ER status, Her-2status are independent prognostic factors for the overall survival of patients.