Analysis Of Response And Predictive Factor In Breast Cancer Treated With Neoadjuvant Chemotherapy

Purpose:The aim of this study was to determine whether there exists different therapeutic effectiveness between different neoadjuvant chemotherapy(XEC,FEC,TEC,EC,EC followed by T),and evalueate the predictive value of different factor for the response of patients who treated by neoadjuvant chemotherapy.Patients and Methods:A total of 162 breast cancer patients who received primary anthracycline-based chemotherapy in The Affiliated Tumor Hospital of Guangxi Medical University from January 2012 to December 2014 were retrospectively studied.We determined whether there existed difference about their ORR,pCR between different chemotherapy regimens,and try to study their relationship with different clinical characteristics by chi-square test and logistic multivariate analysis.Results:1.The overall curative:The general ORR rate was 73.5%,group XEC was 88.6%,group FEC was 62.8%,group TEC 70.0%,group EC-T was 71.4%,group EC was 80.0%,respectively,and they had significant difference(P=0.046);The general pCR rate was 16.7%,group XEC was 27.3%,group FEC was 13.7%,group TEC was 10%,group EC-T was 14.3%,group EC was 20.0%,there had no statisticaldifference between them(P=0.208);In the study,we also found breast cancer with clinical stage II B stage(87.0%vs.60.0%),N1 stage(89.3%vs.68.3%),ER positive(88.5%vs.61.7%),PR positive(94.7%vs.61.3%),Her-2 positive(95.0%vs.67.4%),Ki-67>14%(89.5%vs.68.0%),and type LuminalB2(100.0%vs.54.2%)treated with capecitabine-contained chemotherapy have better ORR rate than those not contained,ER positive(26.9%vs.7.4%,P=0.021)achieved better pCR rate too.Those with N1 stage(83.6%vs.55.6%),Her-2 positive(84.0%vs.46.2%),Ki-67? 14%(71.2%vs.61.9%),type LuminalB2(78.3%vs.33.3%)treated with not contained fluorouraci chemotherapy have better ORR rate than thoseluorouraci-contained;2.Predictors of efficacy:The ORR was significant difference by varied clinical stage.,node stage,ER status and chemotherapy cycles,multivariate analysis showed that ER statusand clinical stage were independent predictor of ORR.The pCR rate was significant difference by varied ER status and PR status,multivariate analysis showed that PR statusis an independent predictor of pCR.Conclusion:1.There exists statistical-difference therapeutic effectiveness between different neoadjuvant chemotherapy.Group XEC had better ORR rate than group FEC.Breast with Clinical stage IIB,N1,ER positive and PR positive,positive HER-2 positive,Ki-67>14%,LuminalB2 treated with capecitabine-contained regimen had better ORR rate.Breast withER positive treated with capecitabine-contained regimen had better pCR rate.Breast with N1,positive HER-2 positive,Ki-67?14%,LuminalB2 treated with not contained fluorouraci chemotherapy had better ORR rate.2.Clinical stage,node stage,ER status and chemotherapy cycles can predict the clinlcal response of neoadjuvant chemotherapy;ER status and clinical stage were independent predictor of ORR.ER status and PR status can predict the pathologic response of neoadjuvant chemotherapy;PR status was independent predictor of pCR.