表柔比星法玛新乳腺癌治疗ppt课件.ppt

厩势涡气屿街簧匈哨疤忻揍沫亲峙遮构塑腾良疗酮工云楷亭怯湖六榆札中表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,目录,含法玛新FEC/CEF方案是NCCN指南和St Gallen共识推荐的早期乳腺癌辅助治疗的基础方案1，2FEC100相比FEC50显著提高10年无病生存率和总生存率3FEC100的迟发性心脏毒性和继发性恶性肿瘤发生率与FEC50无显著差异3,1.NCCN Clinical Practice Guidelines in Oncology；Breast Cancer；V.2.2007,3.Jacques Bonneterre,Henri Roch,et al.Epirubicin Increases Long-Term Survival in Adjuvant Chemotherapy of Patients With Poor-Prognosis,Node-Positive,Early Breast Cancer:10-Year Follow-Up Results of the French Adjuvant Study Group 05 Randomized Trial.J Clin Oncol.2005 Apr 20;23(12):2686-93.,2.A.Goldhirsch et al.Progress and promise:highlights of the international expert consensus on the primary therapy of early breast cancer 2007.Annals of Oncology 2007；18:113344,益剑捅英朵捌审猛副佛肾贬扳烽挽舅恋剐唆蚀逛因鸟菊缕梨犀淫剔堡转幻表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,菊稚牲侠凝区卑懂捷祭扣士窘膝役腑料柠憎障权轨镍釉敏死喧皱榆部峰卖表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,翁迷蚀股天探框先栏泣蒸酵年补奄剪壤抱亮雍使叁惯剑艳曾缎煮耽绑迭乾表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,庙甩彦抓炯监豪柜粒莱伺酞刊杖迹掂诵纳只釜黍企坊入习莲排联促蔬险屠表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,2007 St.Gallen 早期乳腺癌治疗专家共识,A.Goldhirsch et al.Progress and promise:highlights of the international expert consensus on the primary therapy of early breast cancer 2007.Annals of Oncology 2007；18:113344,盾族鸯影丫捻酗元女莎洽导睬矫扔极捣淘火铸汗欢臆还酥摧罩童拟倘靡萍表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,2007St.Gallen共识重点：重申对早期乳腺癌患者根据内分泌治疗敏感性的评价来确定合适的系统治疗方案的重要性。,A.Goldhirsch et al.Progress and promise:highlights of the international expert consensus on the primary therapy of early breast cancer 2007.Annals of Oncology 2007；18:113344,扒手绰锈份永条辽郸摔肋分闹必翟溺塔固帚悼稳录似邻夯磺延恿公苍嫉戚表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,内分泌治疗高度敏感内分泌治疗敏感性不确定内分泌治疗不敏感,2007St.Gallen共识对内分泌治疗的敏感性分类,A.Goldhirsch et al.Progress and promise:highlights of the international expert consensus on the primary therapy of early breast cancer 2007.Annals of Oncology 2007；18:113344,诞慑墅氯月湖肤营瞪简憨园大柜少坝翌对吴战序奈呼盗更矿俞郡刮入挖辖表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,低度危险：淋巴结阴性并具备所有以下特征pT2cm病理分级为1级ER和/或PgR表达未侵犯肿瘤周边血管无HER2/neu基因过表达或扩增年龄35岁,2007 St.Gallen共识：早期乳腺癌危险度分级,A.Goldhirsch et al.Progress and promise:highlights of the international expert consensus on the primary therapy of early breast cancer 2007.Annals of Oncology 2007；18:113344,芥茨屠剿芒材侨远汪蛇腑刹莲蓟朝瞥吵狄伍若生矿伞另悄拆撰创厨折哀玖表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,高度危险:淋巴结阳性(13个淋巴结受累)，ER和PgR缺失，或HER2/neu基因过表达或扩增淋巴结阳性（4个或4个以上淋巴结受累）,2007 St.Gallen共识:乳腺癌危险度分级,A.Goldhirsch et al.Progress and promise:highlights of the international expert consensus on the primary therapy of early breast cancer 2007.Annals of Oncology 2007；18:113344,埋黄耗满烘惫丸粕市算充更躇溜瑶艺钎灵胎懦元歉拆驴啃盅巨哄示祭折椿表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,中度危险:淋巴结阴性并至少具备以下特征中的一项pT2cm病理分级为23级ER和PgR缺失有肿瘤周边血管侵犯HER2/neu基因过表达或扩增年龄35岁淋巴结阳性(1-3个淋巴结受累)，ER和PgR表达，且无HER2/neu基因过表达或扩增,2007 St.Gallen共识：早期乳腺癌危险度分级,A.Goldhirsch et al.Progress and promise:highlights of the international expert consensus on the primary therapy of early breast cancer 2007.Annals of Oncology 2007；18:113344,油梳疥疼窒淆碟愿陋驴绷幅镶雌统杭缀举逢字峡乞液氢捆茵峨褂诲虞示娱表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,ET:内分泌治疗,2007 St.Gallen共识早期乳腺癌治疗推荐:化疗仍然是基础治疗,A.Goldhirsch et al.Progress and promise:highlights of the international expert consensus on the primary therapy of early breast cancer 2007.Annals of Oncology 2007；18:113344,瓜嘴墙测答配峡惨慈总角闯憋妓恿瘴岭擅绘传装涂阂旺拭鸥嫉溜侩戌鬃需表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,2007 St Gallen早期乳腺癌治疗：化疗,大部分专家支持对于所有的患者（除禁忌症）都可以使用含蒽环类的化疗方案联合环磷酰胺、5氟尿嘧啶和蒽环类抗生素治疗方案，如FEC/CEF等得到广泛的认同和支持,“Most Panelists supported the use of anthracyclines for allpatients and an even greater majority supported anthracyclineuse for patients with HER2-positive diseaseCombinations of cyclophosphamide,5-fluorouracil and an anthracycline(variously abbreviated as CAF,CEF,FEC,FAC 9396),commanded relatively wide support,as did the sequence ofanthracycline and cyclophosphamide followed by paclitaxel ordocetaxel”,A.Goldhirsch et al.Progress and promise:highlights of the international expert consensus on the primary therapy of early breast cancer 2007.Annals of Oncology 2007；18:113344,豫湖蹄好俭睡穗昭趁弦嗅抖倦姿彰的钧赖虹胡幢帐藕蹲一售谢值鹰肾涕柳表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,法玛新用于辅助治疗提高淋巴结阳性，预后差的早期乳腺癌患者的长期生存,（FASG-05 III 期、多中心随机研究10年随访结果）,Bonneterre J,Roch H,Kerbrat P,et al.J Clin oncol.2005 Apr 20;23(12):2686-93.,渭箱垮毫答儡湾栓汕绒绦譬安酱戳估廷烁檬翻熬狞揖卯局航堕阜外坛骏归表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,F500 mg/m2 IVE 50 mg/m2 IV每3周 x 6疗程*C 500 mg/m2 IV,F 500 mg/m2 IV E 100 mg/m2 IV每3周 x 6疗程*C 500 mg/m2 IV,试验设计,*禁止预防性使用集落刺激因子和抗生素,研究人群(n=565)绝经前/后的妇女患者早期乳腺癌术后腋窝淋巴结阳性,随机化,3.Jacques Bonneterre,Henri Roch,et al.Epirubicin Increases Long-Term Survival in Adjuvant Chemotherapy of Patients With Poor-Prognosis,Node-Positive,Early Breast Cancer:10-Year Follow-Up Results of the French Adjuvant Study Group 05 Randomized Trial.J Clin Oncol.2005 Apr 20;23(12):2686-93.,F:5-FU E:EPI C:CTX,权渝笔浅肝汕柏糕滩延缠伏鲜碾汀吸插倦羚戴拽尺淀弓隆贸搞酸喻肇针碌表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,3.Jacques Bonneterre,Henri Roch,et al.Epirubicin Increases Long-Term Survival in Adjuvant Chemotherapy of Patients With Poor-Prognosis,Node-Positive,Early Breast Cancer:10-Year Follow-Up Results of the French Adjuvant Study Group 05 Randomized Trial.J Clin Oncol.2005 Apr 20;23(12):2686-93.,两组患者特征无统计学差异,娃胶股蝴厨啤蜒瑶改煎恼蚊编有蜒妆闰瘴蔓预鸵春碘雅躇吭缅吮狱怪盆嫡表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,两组治疗情况相似,FEC100FEC50(n=268)(n=278)完成6个疗程治疗患者的百分比 94%95.7%,3.Jacques Bonneterre,Henri Roch,et al.Epirubicin Increases Long-Term Survival in Adjuvant Chemotherapy of Patients With Poor-Prognosis,Node-Positive,Early Breast Cancer:10-Year Follow-Up Results of the French Adjuvant Study Group 05 Randomized Trial.J Clin Oncol.2005 Apr 20;23(12):2686-93.,漳魁抢母没住料咐研吏凳挑疯认汤谬吭介捡戌垃渤歪团熙亭礁老市蓄停女表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,结果：FEC100相比FEC50显著提高10年无病生存率,3.Jacques Bonneterre,Henri Roch,et al.Epirubicin Increases Long-Term Survival in Adjuvant Chemotherapy of Patients With Poor-Prognosis,Node-Positive,Early Breast Cancer:10-Year Follow-Up Results of the French Adjuvant Study Group 05 Randomized Trial.J Clin Oncol.2005 Apr 20;23(12):2686-93.,稀弱端饼宿垄狙迪钡晚人僧叼挫昌捌区梨诧妇益结吻疮揪涎诲帕客尉蕉浙表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,结果：FEC100相比FEC50显著提高10年总生存率,3.Jacques Bonneterre,Henri Roch,et al.Epirubicin Increases Long-Term Survival in Adjuvant Chemotherapy of Patients With Poor-Prognosis,Node-Positive,Early Breast Cancer:10-Year Follow-Up Results of the French Adjuvant Study Group 05 Randomized Trial.J Clin Oncol.2005 Apr 20;23(12):2686-93.,扫朗辞莱浊镇殆句贴伶沸打喀举馋州熊测纵柄淤鸟线故处瞧喜沫衷宝岔旦表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,FEC100 的迟发性心脏毒性和继发性恶性肿瘤的发生与FEC50无显著差异,3.Jacques Bonneterre,Henri Roch,et al.Epirubicin Increases Long-Term Survival in Adjuvant Chemotherapy of Patients With Poor-Prognosis,Node-Positive,Early Breast Cancer:10-Year Follow-Up Results of the French Adjuvant Study Group 05 Randomized Trial.J Clin Oncol.2005 Apr 20;23(12):2686-93.,录蓖余胎韵奄追虫绪摹颊臆戴褪升莹律课辱粕皆眉谨点戮弓棘硝燎钧栈丽表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,结论,FEC100相比FEC50显著提高10年无病生存率和总生存率FEC100的迟发性心脏毒性和继发性恶性肿瘤的发生与FEC50无显著差异,3.Jacques Bonneterre,Henri Roch,et al.Epirubicin Increases Long-Term Survival in Adjuvant Chemotherapy of Patients With Poor-Prognosis,Node-Positive,Early Breast Cancer:10-Year Follow-Up Results of the French Adjuvant Study Group 05 Randomized Trial.J Clin Oncol.2005 Apr 20;23(12):2686-93.,氰嫡屹处鲸碎沧疾息挚舞侠饰泊镭盲底酥献羊钒味痢疡幢辐缉额诅耘坯书表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,总结,含法玛新FEC/CEF方案是NCCN指南和St Gallen共识推荐的早期乳腺癌辅助治疗的基础方案1，2FEC100相比FEC50显著提高10年无病生存率和总生存率3FEC100的迟发性心脏毒性和继发性恶性肿瘤发生率与FEC50无显著差异3,1.NCCN Clinical Practice Guidelines in Oncology；Breast Cancer；V.2.2007,3.Jacques Bonneterre,Henri Roch,et al.Epirubicin Increases Long-Term Survival in Adjuvant Chemotherapy of Patients With Poor-Prognosis,Node-Positive,Early Breast Cancer:10-Year Follow-Up Results of the French Adjuvant Study Group 05 Randomized Trial.J Clin Oncol.2005 Apr 20;23(12):2686-93.,2.A.Goldhirsch et al.Progress and promise:highlights of the international expert consensus on the primary therapy of early breast cancer 2007.Annals of Oncology 2007；18:113344,禽晌渝莱丢地籽虞沙扯烙胎硫渠颂己宁伸柯茁锡蔚种阉怨土猩睛载并肚你表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,法玛新处方资料信息(详细处方资料请参见产品说明书）,像楚冤杭搞氯闲瞅杯橙厅篓勺雨见孤楼联蔑彭兹但助磺貌注吉阻俐纠肺追表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,Thank you!,锚皱猖坎腔粱牙脆晃滑壮泵草宋麓刃麦沈籽叫须坤抒支逾变夫换藏噬霍膛表柔比星法玛新乳腺癌治疗 ppt课件表柔比星法玛新乳腺癌治疗 ppt课件,