REMOTE RESULTS OF COMPLEX STAGE POLYMODAL TREATMENT OF PATIENTS WITH LOCATORY BREAST CANCER
DOI:
https://doi.org/10.32471/oncology.2663-7928.t-22-1-2020-g.8820Keywords:
complex treatment, locally advanced breast cancer, overall survival, recurrence-free survival, selective intra-arterial chemotherapyAbstract
Breast cancer (BC) is one of the five most common cancers in the world and the leading cause of death for women of working age. The use of regional methods of polychemotherapy (PCT): intra-arterial, endolymphatic — is one of the modern ways to address the issue of a selective approach to the treatment of patients with malignant neoplasms.Aim: analysis of life expectancy of patients with locally advanced breast cancer (LABC) as a result of complex staged polymodal treatment with the use of neoadjuvant PCT in systemic, endolymphatic, intra-arterial in combination with intravenous regimens, radiation therapy (RT), surgical and adjuvant drug treatment. Object and methods: this study is based on data from 526 patients undergoing specialized antitumor treatment for LABC. The program of complex treatment of patients of group 1 included systemic intravenous polychemotherapy. In group 2 for endolymphatic chemotherapy was performed. In patients of group 3 — selective intra-arterial chemotherapy (IAC). Tumor response was analyzed according to RECIST criteria, overall (OS) and recurrence-free (RFS) survival rates of patients, the frequency of metastasis in the long term. Results: selective IAC in combination with PT at the neoadjuvant stage of treatment of patients with LABC allowed to achieve a resectable tumor state in 72% of cases (after neoadjuvant systemic PCT — 56%, after endolymphatic — 64%). Long-term results in patients operated after selective IAC were: 3-year OS — 80.5%, 5-year OS — 73.9%, median use 4.8 years, which is significantly (p <0.05) higher than patients from the comparison groups. RFS in patients of this group: 3-year — 62.8, 5-year — 43.3% with a median survival — 3.6 years against 48.0 and 32.0%, respectively, with a median BRV — 3, 1 year in group 1 and 52.0 and 37.5%, respectively, with a median of 3.2 years in group 2. Conclusion: the proposed and used treatment regimen for patients with LABC on the basis of selective IAC, RT, surgery and adjuvant therapy has significantly increased the effectiveness of treatment — to improve the overall and recurrence-free survival of patients.
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