Kalyuta O. Tactic of the treatment of breast cancer patients taking into account the presense of tumor cells in bone marrow

Dissertation for the candidate of medical science degree in speciality 14.01.07 - oncology. - R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology of National Academy of Sciences of Ukraine, Kiev. - 2012. Dissertation is devoted to the enhancement of treatment efficacy of breast cancer patients with disseminated tumor cells (DTC) in bone marrow (BM) by means of optimization of therapeutic regimes. DTC in BM were found in 52,1% of patients. Regional polychemotherapy was included in the combined therapy of patients with locally advanced and primary inoperable breast cancer, i.e., T3-4N2-3M0. The following schedules of polychemotherapy were used: CMF, CAF, AP. Patients with BM that was not disseminated by tumor cells have been treated with conventional standard therapeutic regimes in accordance with the stage of disease. The overall survival was used as a main criteria to evaluate the treatment efficacy. It was found that timely correction of therapeutic schedule for patients with DTC in bone marrow resulted in the 5-year survival rate of 74 % in comparison with that of 47 % for patients which were not investigated for the detection of tumor cells in BM. It was also determined that the life time of patients in comparative group was 42 months, the life time of patients with DTC - 66 months, and the life time of patients without DTC in BM - 70 months. The assessment of disease recurrence in breast cancer patients after treatment has shown that the risk of recurrence in patients in comparative group was greater by 11% and 17% in comparison with patients without DTC and with DTC, respectively. Key words: breast cancer, bone marrow hematopoiesis, disseminated tumor cells, polychemotherapy, bone marrow, survival, immunocytochemistry.