tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2017-2-14-18tumors-335Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL REPORTSОтдаленные результаты комбинированного и комплексного лечения больных местно-распространенным HER2-позитивным раком молочной железыLong-term results of combined and complex treatment of patients with locally advanced HER2-positive breast cancerБелохвостоваА. С.BelokhvostovaA. S.

научный сотрудник отделения лучевого и хирургического лечения заболеваний торакальной области

Researcher, Department of Radiation and Surgical Treatment of Thoracic Diseases

anna.belokchvostova@gmail.comРагулинЮ. А.RagulinY. A.

к.м.н., заведующий отделением лучевого и хирургического лечения заболеваний торакальной области

PhD, Head of the Department of Radiation and Surgical Treatment of Thoracic Diseases

yuri.ragulin@mail.ru«Медицинский радиологический научный центр» им. А.Ф. Цыба – филиал ФГБУ «Национальный медицинский исследовательский радиологический центр», ОбнинскРоссияA.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center, ObninskRussian Federation201720072017021418Copyright © Белохвостова А.С., Рагулин Ю.А., 20172017Белохвостова А.С., Рагулин Ю.А.Belokhvostova A.S., Ragulin Y.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/335

В исследование включены 73 женщины с III стадией HER2-позитивного местно-распространенного рака молочной железы (РМЖ), получившие одновременную химиолучевую терапию в комбинации с таргетной терапией. Проведена стратификация на две группы: в первой пациентки в неоадъювантном периоде получили одномоментную химиолучевую терапию в комбинации с трастузумабом, во второй таргетная терапия не назначалась. При оценке общей выживаемости наиболее эффективной оказалась терапия с трастузумабом. 3-летняя выживаемость в первой группе составила 85,5%, во второй – 73,3%, 5-летняя – 73,9% и 40,3% соответственно (р<0,05). При этом безрецидивная выживаемость оказалась выше в группе с трастузумабом, но разница не достигла статистической значимости. 3-летняя безрецидивная выживаемость в первой группе составила 71,4%, во второй – 47,6%, 5-летняя – 40,9% и 26,0% соответственно (р=0,06). Помимо этого, в исследовании проведен анализ влияния операции радикальной мастэктомии на отдаленные результаты лечения, а также изучена эффективность различных режимов фракционирования. Полученные данные позволили сделать заключение, что одномоментное химиолучевое лечение в комбинации с таргетной терапией является эффективным методом лечения больных HER2-позитивным местно-распространенным РМЖ. Оно не уступает комплексному лечению с включением хирургического вмешательства и может использоваться как самостоятельный метод терапии, позволяющий избежать операции и связанных с ней осложнений.

The study included 73 women with stage III HER2-positive locally advanced breast cancer (BC) which received simultaneous chemoradiotherapy in combination with targeted therapy. Patients were stratified into two groups: in the first group patients in the neoadjuvant received concomitant chemoradiotherapy in combination with trastuzumab, in the second group patients were prescribed no targeted therapy. The therapy with trastuzumab appeared to be the most effective. 3-year survival rate in the first group was 85.5%, 73.3% – in the second group, 5-year survival rate was 73.9% and 40.3% respectively (p<0.05). Herewith, disease-free survival was higher in the trastuzumab group, but the difference did not reach statistical significance. 3-year disease-free survival rate in the first group was 71.4%, 47.6% – in the second group, 5-year disease-free survival was 40.9% and 26.0% respectively (p=0.06). In addition, the study analyzed the influence of radical mastectomy surgery on long-term outcomes, and explored the efficacy of different fractionation regimes. The findings led to the conclusion that the combined chemoradiotherapy in combination with targeted therapy is an effective treatment for patients with the HER2-positive locally advanced BC. Provided that this therapy is not inferior to the comprehensive treatment which includes surgery and can be used as an independent method of treatment without surgery and associated complications.

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The authors declare that there are no conflicts of interest present.