Breast cancer is the first cancer of women in the world and in France.In very elderly patients,the treatment options are often very limited.Neoadjuvant hormone therapy has shown similar or even better results than che...Breast cancer is the first cancer of women in the world and in France.In very elderly patients,the treatment options are often very limited.Neoadjuvant hormone therapy has shown similar or even better results than chemotherapy.This is why we decided to evaluate the clinical response following exclusive hormonal therapy and the 5,then 10 years survival in these very elderly women.This was a retrospective,longitudinal cohort-type study with descriptive and analytical purposes.The study population consisted of 59 patients,with an average age of 85 years.Fifteen(15,25%)of our patients had a complete clinical response after two years of treatment,16(27%)a partial clinical response,23(39%)lesion stabilization and 5(9%)cancer progression.The presence of metastasis at diagnosis increased the risk of cancer progression by 2.84.Overall 5-year survival was 72.5%,and breast cancer mortality 5.88%.The 10-year survival was 27.5%and breast cancer mortality 15%.In the age group 85 and over increased the risk of death by 3.25 in the first 10 years of treatment.The clinical response after 2 years was marked by a low rate of cancer progression.Mortality over 5 and 10 years was mostly related to patient comorbidities.展开更多
This study aimed to identify the pathological outcomes and survival benefits of neoadjuvant hormone therapy(NHT)combined with radical prostatectomy(RP)and radiotherapy(RT)administered to patients with high-risk prosta...This study aimed to identify the pathological outcomes and survival benefits of neoadjuvant hormone therapy(NHT)combined with radical prostatectomy(RP)and radiotherapy(RT)administered to patients with high-risk prostate cancer(HRPCa).We searched PubMed,Embase,and the Cochrane Library for studies comparing NHT plus RP or RT with RP or RT alone,administered to patients with HRPCa.We used a random-effects model to compute risk estimates with 95%confidence intervals(CIs)and quantified heterogeneity using the I2 statistic.Subgroup and sensitivity analyses were performed to identify potential sources of heterogeneity.We selected 16 studies.NHT before RP significantly decreased lymph node involvement(risk ratio[RR]=0.69,95%CI:0.56–0.87)and increased the rates of pathological downstaging(RR=2.62,95%CI:1.22–5.61)and organ-confinement(RR=2.24,95%CI:1.54–3.25),but did not improve overall survival and biochemical progression-free survival(bPFS).The administration of NHT before RT to patients with HRPCa was associated with significant benefits for cancer-specific survival(hazard ratio[HR]=0.51,95%CI:0.39–0.68),disease-free survival(HR=0.51,95%CI:0.44–0.60),and bPFS(HR=0.54,95%CI:0.46–0.64).Short-term NHT combined with RT administered to patients with HRPCa conferred significant improvements.Although the advantage of local control was observed when NHT was administered before RP,there was no significant survival benefit associated with HRPCa.Therefore,short-term NHT combined with RT is recommended for implementation in standard clinical practice but not for patients who undergo RP.展开更多
文摘Breast cancer is the first cancer of women in the world and in France.In very elderly patients,the treatment options are often very limited.Neoadjuvant hormone therapy has shown similar or even better results than chemotherapy.This is why we decided to evaluate the clinical response following exclusive hormonal therapy and the 5,then 10 years survival in these very elderly women.This was a retrospective,longitudinal cohort-type study with descriptive and analytical purposes.The study population consisted of 59 patients,with an average age of 85 years.Fifteen(15,25%)of our patients had a complete clinical response after two years of treatment,16(27%)a partial clinical response,23(39%)lesion stabilization and 5(9%)cancer progression.The presence of metastasis at diagnosis increased the risk of cancer progression by 2.84.Overall 5-year survival was 72.5%,and breast cancer mortality 5.88%.The 10-year survival was 27.5%and breast cancer mortality 15%.In the age group 85 and over increased the risk of death by 3.25 in the first 10 years of treatment.The clinical response after 2 years was marked by a low rate of cancer progression.Mortality over 5 and 10 years was mostly related to patient comorbidities.
基金This study was supported by grants from the National Natural Science Foundation of China(No.81502195).
文摘This study aimed to identify the pathological outcomes and survival benefits of neoadjuvant hormone therapy(NHT)combined with radical prostatectomy(RP)and radiotherapy(RT)administered to patients with high-risk prostate cancer(HRPCa).We searched PubMed,Embase,and the Cochrane Library for studies comparing NHT plus RP or RT with RP or RT alone,administered to patients with HRPCa.We used a random-effects model to compute risk estimates with 95%confidence intervals(CIs)and quantified heterogeneity using the I2 statistic.Subgroup and sensitivity analyses were performed to identify potential sources of heterogeneity.We selected 16 studies.NHT before RP significantly decreased lymph node involvement(risk ratio[RR]=0.69,95%CI:0.56–0.87)and increased the rates of pathological downstaging(RR=2.62,95%CI:1.22–5.61)and organ-confinement(RR=2.24,95%CI:1.54–3.25),but did not improve overall survival and biochemical progression-free survival(bPFS).The administration of NHT before RT to patients with HRPCa was associated with significant benefits for cancer-specific survival(hazard ratio[HR]=0.51,95%CI:0.39–0.68),disease-free survival(HR=0.51,95%CI:0.44–0.60),and bPFS(HR=0.54,95%CI:0.46–0.64).Short-term NHT combined with RT administered to patients with HRPCa conferred significant improvements.Although the advantage of local control was observed when NHT was administered before RP,there was no significant survival benefit associated with HRPCa.Therefore,short-term NHT combined with RT is recommended for implementation in standard clinical practice but not for patients who undergo RP.
