Shiroda (capecitabine) can be used for adjuvant chemotherapy after breast cancer surgery?

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Patients: 5.10 underwent total resection and left breast sentinel, pathology showed 3 infiltrating ductal carcinoma, tumor diameter 1.5cm, n

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Patients: 5.10 underwent total resection and left breast sentinel, pathology showed 3 infiltrating ductal carcinoma, tumor diameter 1.5cm, no clear vascular cancer embolus and perineurial invasion (frozen send left axillary sentinel lymph node 123) lymph node metastasis (0/5, which left axillary sentinel lymph nodes in 1 0/3,0/1, 3 0/1) left axillary sentinel lymph node immunohistochemistry: ER (+ +), PR (+ +), Ki-67 70% for chemotherapy: Taxotere, plus oral capecitabine (I do not know is not?) Excuse me, doctor, what's the plan? How to reduce toxic side effect of chemotherapy? Thank you

Patients: female, 50 years old, perimenopause

Patients: six courses of treatment

Department of breast surgery, Guangdong Province Traditional Chinese Medical Hospital:

XT (docetaxel + capecitabine (Tai Suodi)) is certainly not appropriate, this scheme is to rescue treatment (breast cancer recurrence and metastasis after), rather than the adjuvant treatment (after surgery without recurrence before).

Your condition is relatively early (T1N0M0), ki-6770% is a little high (14% lines), so don't use paclitaxel (such as docetaxel) of these drugs, recommend the use of anthracycline regimen is sufficient (FEC scheme such as 4 cycles of AC, or 6 cycles)

You did not say your HER2 expression, if HER2 is positive, if the economic conditions allow, the use of 1 years +5 years of tamoxifen and Herceptin after sequential chemotherapy (because you are perimenopausal), if it is negative, with 5 years of tamoxifen chemotherapy after the end of the.

For your reference, again, certainly not with xeloda!

Patient: Thank you, doctor. I'll take your advice!

Patient: why can't Shiroda use it??????????????

Department of breast surgery, Guangdong Province Traditional Chinese Medical Hospital:

Shiroda has 2 relatively large clinical studies in the adjuvant therapy, a cancer leukemia research group CALGB/CTSU 49907 test, compared with the standard AC/CMF Shiroda scheme, the initial analysis found Shiroda group the recurrence rate is 2.4 times of the latter, death is 2.1 times that of the early termination of the study. Another large study is the FinXX test of Finland breast cancer study group, the experimental design is T-CEF (docetaxel, cyclophosphamide + epirubicin (+5- fluorouracil) regimen and XT-CEX is used instead of 5- fluorouracil and xeloda combined with docetaxel in advance), initial analysis (median follow-up of 3 years) were indeed Xeloda group the recurrence rate is lower, but follow up to 59 months, no recurrence between the two groups. There was no difference in overall survival (OS) rate.

If you are not a medical student may see these data is a bit confusing, it is to tell you that in the adjuvant chemotherapy of breast cancer (no postoperative recurrence before chemotherapy) in the use of Shiroda's test is a failure, there is no evidence to support the use of Shiroda in the adjuvant treatment of breast cancer.

At present, medical era has already entered the era of evidence-based medicine, diagnosis and treatment of basic concept of evidence-based medicine is that the doctor is like a case like the judge about the evidence, there is evidence to support your treatment plan will give patients bring benefits, rather than the doctor's casual opinions and personal experiences.

Currently, Shiroda has only been approved for the treatment of metastatic breast cancer in our country, which is the reason why it is not recommended for use in breast cancer adjuvant chemotherapy in the treatment of breast cancer by the use of chemotherapy in the treatment of breast cancer, which is the reason for the use of adjuvant chemotherapy in breast cancer is not recommended for use in the treatment of breast cancer, which is the reason for the use of adjuvant chemotherapy in breast cancer, which is not the reason for the use of adjuvant chemotherapy in breast cancer. That's why I personally don't think there is any evidence of support for Shiroda in adjuvant chemotherapy, which is why we can't use Shiroda in adjuvant chemotherapy.

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