乳腺癌新辅助化疗86例临床观察

目的：观察乳腺癌新辅助化疗的临床效果，并探讨其临床价值。方法：2004年6月-2007年2月收治乳腺癌患者86例，予以新辅助化疗（rIThpC方案），即：多西紫杉醇（艾素）100mg，d1；吡柔比星60mg，d1；环磷酰胺0．8g，d1。21d为1周期，2—5个周期后观察客观有效率、病理缓解率及新辅助化疗前后免疫组化指标的变化。结果：新辅助化疗后临床完全缓解（cCR）者19例，占22．09％，部分缓解（cPR）者51例，占59．30％，病情稳定（SD）者16例，占18．60％，无疾病进展（PD）患者；病理学完全缓解（pCR）者7例，占8．14％。21例患者新辅助化疗后的ER、PR、C-erbB-2的阳性表达率均低于新辅助化疗前，但未达到统计学差异（P〉0．05）。结论：乳腺癌新辅助化疗可以有效的缩小肿瘤，降低肿瘤分期，提高行改良根治术及保乳术几率，逆转可能存在的全身转移，为化疗方案提供药敏依据；新辅助化疗可使乳腺癌患者ER、PR、C-erbB-2的阳性表达降低，临床应根据术前免疫组化结果制定相关术后辅助治疗方案，才可能使患者有更大的获益。

Clinical observation of neoadjuvant chemotherapy on 86 breast cancer patients

Objective:To observe the clinical effect of neoadjuvant chemotherapy on breast cancer and discuss the clinical value of such a method. Methods:After giving neoadjuvant chemotherapy(TThpC regimen) to 86 breast cancer patients, adopted by my department from June 2004 to February 2007, for 2-5 cycles, we observe the response rate, the pathological relief rate and the changes of the immunohistochemical index before and after the neo-adjuvant chemotherapy.Results:After using the neo-adjuvant chemotherapy, there were clinical complete response (cCR) patients 19 (22.09%), clinical partial response (cPR) patients 51 (59.30%), stable disease (SD) patients 16 (18.60%), progressive disease (PD) patients 0, pathological complete response (pCR) patients 7 (8.14%). The datum of the positive expression rates of ER, PR and C-erbB-2 of 21 patients after the neoadjuvant chemotherapy were lower than the datum got before the neoadjuvant chemotherapy, which still couldn't reach the standard of the statistic differences(P>0.05). Conclusion:For breast cancer, the neoadjuvant chemotherapy could reduce the volume of the tumor, decrease the TNM stage, increase the probability of the modified radical mastectomy or the breast-conserving surgery, reverse the possible all-body transfer of the tumor and provide the medicine sensitivity proof for the chemotherapy. The neoadjuvant chemotherapy could decrease the positive expression of ER, PR and C-erbB-2 of the breast cancer patients. After the surgical operation, we should make an adjuvant therapy plan in reference to the immunohistochemical index got before the surgical operation, which will do best to the patients' benefits.