文献类型：期刊文献

英文题名：Survival benefit of neoadjuvant chemotherapy for resectable breast cancer: A meta-analysis

作者：Chen, Yan[1,2,3];Shi, Xiu-E[4,5];Tian, Jin-Hui[2,3];Yang, Xu-Juan[6];Wang, Yong-Feng[7];Yang, Ke-Hu[1,2,3]

第一作者：Chen, Yan

通信作者：Yang, KH[1];Wang, YF[2]

机构：[1]Lanzhou Univ, Hosp 1, Lanzhou, Gansu, Peoples R China;[2]Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, Lanzhou, Gansu, Peoples R China;[3]Lanzhou Univ, Key Lab Evidence Based Med & Knowledge Translat G, Lanzhou, Gansu, Peoples R China;[4]Lanzhou Univ, Dept Internal Med, Gansu Rehabil Ctr Hosp, Lanzhou, Gansu, Peoples R China;[5]Lanzhou Univ, Ctr Evidence Based Rehabil Med, Lanzhou, Gansu, Peoples R China;[6]Lanzhou Univ, Sch Basic Med Sci, Lanzhou, Gansu, Peoples R China;[7]Gansu Univ Tradit Chinese Med, Sch Basic Med Sci, Lanzhou, Gansu, Peoples R China

第一机构：Lanzhou Univ, Hosp 1, Lanzhou, Gansu, Peoples R China

通信机构：[1]corresponding author), Lanzhou Univ, Hosp 1, Lanzhou, Gansu, Peoples R China;[2]corresponding author), Gansu Univ Tradit Chinese Med, Sch Basic Med Sci, Lanzhou, Gansu, Peoples R China.|[107351d2d02a88e1f325f]甘肃中医药大学基础医学院（敦煌医学研究所）;[10735]甘肃中医药大学;

年份：2018

卷号：97

期号：20

外文期刊名：MEDICINE

收录：;WOS:【SCI-EXPANDED(收录号:WOS:000434305900007)】；

基金：This study was supported by the Natural Science Foundation of Gansu Province (No. 1606RJYA265).

语种：英文

外文关键词：breast cancer; meta-analysis; neoadjuvant chemotherapy; surgery

摘要：Background:Neoadjuvant chemotherapy (NAC) increases breast conservation rates in patients with resectable breast cancer at the associated cost of higher locoregional recurrence rates; however, the magnitude of the survival benefits of NAC for these patients remains undefined. Therefore, we aimed to clarify the survival benefit of NAC versus postoperative chemotherapy by conducting an updated meta-analysis of randomized clinical trials (RCTs).Methods:The authors searched the Cochrane Library, PubMed, Embase, Web of Science, Chinese biomedical literature database, and Chinese Scientific Journals full-text database from their inception to December 2016. The authors identified relevant RCTs that compared NAC with postoperative chemotherapy in the treatment of operable breast cancer. The main endpoints were overall survival (OS) and recurrence-free survival (RFS).Results: A total of 21 citations representing 16 unique studies were eligible. There were 787 deaths among 2794 patients assigned to NAC groups and 816 deaths among 2799 patients assigned to adjuvant chemotherapy groups. A meta-analysis of data indicated that there was no significant benefit in terms of OS ([hazard ratio [HR]=1.03, 95% confidence interval [CI]: 0.94-1.13, P=.51) and RFS (HR=1.01, 95% CI: 0.93-1.10, P=.80) between the NAC and postoperative chemotherapy groups. The pooled HR estimate for OS was not influenced by NAC cycles, the total number of chemotherapy cycles, administration of tamoxifen, administration of adjuvant chemotherapy, or type of NAC regimen. Subgroup analysis showed that the pooled HR estimate for RFS was influenced by anthracycline-containing regimens. Patients with a pathological complete response had superior survival outcomes compared with patients who had residual disease.Conclusion:The survival benefits for patients with operable breast cancer who received either NAC or adjuvant chemotherapy based on anthracycline regimens were comparable.