COMPLEX TREATMENT OF PATIENTS WITH INFLAMMATORY BREAST CANCER USING SELECTIVE NEOADJUVANT POLYCHEMOTHERAPY
Keywords:
inflammatory breast cancer, intraarterial polychemotherapy, surgical treatment, complex treatment.Abstract
Summary. To date, the treatment of inflammatory breast
cancer (IBC) is a serious problem, and its results are
not satisfactory. Recently, many methods of intensifying
the treatment of patients with IBC have been proposed,
however, no significant changes have been made in terms
of both the response of the tumor to treatment and the
overall and relapse-free survival (OS, RFS). Objective:
to develop a method of non-adjuvant treatment of patients with IBC that would allow increase the frequency
of regression of the tumor, to increase the RFS and OS
rate of the patients. Object and methods: the method of
complex treatment of patients with IBC with the use of
strictly selective intraarterial polychemotherapy (SIPC)
was developed and tested. The results of complex treatment of 212 patients with IBC stage IIBI were analyzed.
The 1st (main) group included 71 patients, in the treatment of which were used SIPC; 2th — 70 patients who
have undergone intraarterial polychemotherapy (IPC)
through the internal thoracic artery; 3rd (control) —
70 patients, who used system neoadjuvant polychemotherapy. For the first time, infusions of taxane preparations have been performed via SIPC. The number of
courses of chemotherapy varied from 4 to 8 at intervals
of 21 days. In each group, the immediate results of neoadjuvant treatment, OS and RFS were evaluated. In the
absence of a direct effect, patients received neoadjuvant
radiotherapy (2.5 Gy, totaling 65 Gy). Three weeks after the last course, in the absence of signs of disease progression, a radical mastectomy was performed, in which
it was essential to achieve the purity of the edges of the
resection in the main groups of patients. Results: the
use of nonselective IPC increases the frequency of partial regressions by 11.9% (0.05 < p < 0.1), full regression by 1.4% compared with the control group; the use
of SIPC — by 19.8% (p < 0.05), and 4.2%, respectively.
In the group SIPC the frequency of stabilization of the
process was significantly higher (p < 0.05) in comparison with the control. The median 5-year mortality rate
for patients with IPC was 33 months, for patients with
SIPC — 48 months. Conducting IPC did not increase
the toxicity of treatment, did not increase postoperative
complications and had no side effects that would affect
the outcome of treatment. Conclusion: the results give
moderate optimism and may become the basis for further
improvement of treatment methods for patients with IBC
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