ABSTRACT
Objective: To evaluate the efficacy and survival outcomes of dose-dense (biweekly) carboplatin plus paclitaxel (PC) as neoadjuvant chemotherapy (NAC) in triple-negative breast cancer (TNBC), and to explore an optimal neoadjuvant chemotherapy regimen for TNBC. Methods: Patients diagnosed as TNBC(cT1-4N0-3M0) in Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Between January 2008 and September 2018 who received dose-dense PC and standard 3-weekly PC as NAC were 1∶1 matched using propensity score matching (PSM) to compare the efficacy, safety and survival outcomes. Results: One hundred of TNBC patients were enrolled (50 patients were divided in dose-dense group, 50 patients in standard group). The objective response rate (ORR) of dose-dense group and standard group were both 90.0% (45/50). The grade 3-4 neutropenia in dose-dense group was less than that of standard group (32.7% vs. 68.0%, P=0.001), while the rate of ALT/AST elevation in dose-dense group was higher than that of standard group (57.1% vs. 32.0%, P=0.012). The pathological complete response (pCR) rates were 34.0% (17/50) in dose-dense group and 38.0% (19/50) in standard group, without statistically significance (P=0.677). The median follow-up time was 55 months (3-150 months). The 5-year recurrence-free survival (RFS) in dose-dense group and standard group were 83.5% and 75.2%, respectively the 5-year overall survival (OS) in dose-dense and standard group were 87.9% and 84.5% the difference were not statistically significant (P=0.322 and 0.647, respectively). Patients with residual disease (tumor size≥1 cm or lymph node positive) had poor prognosis, the 5-year RFS and OS were 59.3% and 68.5%, respectively. Conclusions: Dose-dense PC has similar efficacy with standard 3-weekly PC and has a good safety profile. Since dose-dense regimen can shorten the duration of therapy, it can be an alternative in TNBC.
Subject(s)
Humans , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carboplatin/therapeutic use , Neoadjuvant Therapy/adverse effects , Paclitaxel/therapeutic use , Treatment Outcome , Triple Negative Breast Neoplasms/pathologyABSTRACT
Objective:To investigate the plantar pressure features of diabetic patients, and design the offloading structure of insole to reduce the plantar pressure and internal stress of the soft tissue. Methods:A three-dimensional finite element model of foot was established based on CT images. Hole structure was designed in the high plantar pressure area of diabetic patients. The effects of diameter, depth and interval of holes on plantar pressure was analyzed through orthogonal test and finite element analysis, to obtain the optimal scheme; and the offloading effect was analyzed with finite element analysis and experiment. Results:The peak plantar pressure was higher in diabetic patients than in healthy individuals. The holes with 5 mm diameter, 6 mm depth and 2 mm interval in metatarsal and calcaneus regions might effectively reduce the plantar pressure and internal stress of soft tissue, which was 15.6%, 45.6%, 53.5% and 10.1% less of the peak plantar pressure on toes, metatarsal, midfoot and calcaneus area, respectively, compared to walking without insoles. Conclusion:Finite element analysis is helpful to explore the internal stress of soft tissue in diabetic patients, and insole with hole structure can reduce the plantar pressure and internal stress of soft tissue.
ABSTRACT
The optimal treatment of elderly women with breast cancer still faces many difficulties. Life expectancy, comorbidity, and functional status influence clinical decision and survival. Standard adjuvant medical treatments should not be withheld from healthy older patients with reasonable life expectancies. In this study, adjuvant medical treatment literatures for elderly breast cancer patients, including endocrine therapy, chemotherapy, and HER2-targeted therapy, were reviewed, focusing on efficacy and toxicity of drugs for elderly women.