Chemotherapy(CT) And Hormonotherapy (HT) As Neoadjuvant Treatment In Breast Cancer:a Meta-Analysis

Background:Nowadays breast cancer is a big threaten to women’s health. And the neoadjuvant therapy before surgery is a novel therapy in the treatment of breast cancer. However few studies have directly compared primary neoadjuvant endocrine therapy with neoadjuvant chemotherapy in breast cancer patients. Our investigation is aimed to evaluate the efficacy of chemotherapy(NCT) and hormonetherapy (NHT) in breast cancer patients in the neoadjuvant setting.Methods:A search of PubMed, EMBASE, the Web of Science, the Cochrane Central Register of Controlled Trials, CNKI, VIP and WANFANG was performedto identify studies that investigated clinicalresponse rate, cCR, pCR and BCS in patients with breast cancer that were treatedwith neoadjuvant chemotherapy or neoadjuvant endocrine therapy. Meta-analysis was carried out with Rev Man5.3.Results:Ten studies were included (four randomized controlled trials, six retrospective trials), for a total of489patients for neoadjuvant endocrine therapy and689for neoadjuvant chemotherapy. Patients in NHT share the same clinical response rate with patients in NCT, OR=0.85(95%,CI0.65-1.22). NHT was associated with a lower pCR (OR=0.42,95%CI0.20-0.88). The overall BCS seemed to elevate in the NHT compared with NCT (OR=1.53,95%CI0.98-2.40, p=0.06). Contusions:Preoperative neoadjuvant endocrine therapy was well tolerated and resulted in rates similar to chemotherapy in overall clinical response and breast-conserving surgery in postmenopausal women with the positive status of ER or PR. But the strongly positive ER in patients doesn’t demonstrate more benefits from the NHT.