长春瑞滨和表阿霉素联合新辅助化疗方案治疗局部晚期乳腺癌的临床研究

目的评估长春瑞滨和表阿霉素的联合新辅助化疗方案在局部晚期乳腺癌治疗中的临床疗效和毒性反应.方法2001年9月至2004年12月,158例经空芯针活检组织学诊断证实的局部晚期乳腺癌患者在术前接受新辅助化疗,方案为长春瑞滨25 mg/m^2（第1、8天）,表阿霉素60mg/m^2（第1天）,每3周为1个疗程共3个疗程.结果原发病灶临床有效率为81.6%,其中23.4%（37/158）达到临床完全缓解（cCR）,58.2%（92/158）达到临床部分缓解;疾病稳定（SD）16.5%（26/158）,疾病进展（PD）1.9%（3/158）.病理完全缓解29例（18.3%）,其中15例术后标本未见肿瘤残留,14例仅残留原位癌组织.68例新辅助化疗前区域淋巴结细针穿刺活检阳性的病例,化疗后18例（26.5%）手术标本中未见区域淋巴结转移.最常见的毒性反应包括中性粒细胞减少症、脱发和恶心呕吐,共有111例患者（70.3%）发生3～4度中性粒细胞减少症.无因新辅助化疗引起的败血症和死亡病例.结论长春瑞滨和表阿霉素的联合新辅助化疗方案在局部晚期乳腺癌治疗中疗效显著且耐受性良好.

A study of the combination of vinorelbine and epirubicin as neoadjuvant chemotherapy regimen in the treatment of locally advanced breast cancer

Objective To evaluate the clinical efficacy and toxicity of vinorelbine(N) and epirubicin(E) as the neoadjuvant chemotherapy regimen in the treatment of locally advanced breast cancer(LABC). Methods From September 2001 to December 2004, 158 patients with LABC were treated with NE chemotherapy before operation. Neoadjuvant chemotherapy containing vinorelbine(N), 25 mg/m~2 (days 1 and 8) and epirubicin(E), 60 mg/m~2 (days 1) was administered every 3 weeks for three cycles before local treatment.Results Response in the breast: the clinical objective response was 81.6% [23.4%(37/158) cCR and 58.2%(92/158) PR], 16.5%(26/158) SD and 1.9%(3/158) PD. Pathological complete response was found in 29 cases (18.3%). Eighteen cases (26.5%) who have positive FNA result in the axillary lymphnode before chemotherapy showed negative result in the surgery specimen. The most common toxicities were neutropenia, alopecia and nausea/vomiting. Neutropenia grade 3-4 was reported in 111 patients (70.3%) and there was no toxic deaths.Conclusions The combination of vinorelbine and epirubicin is a very active and well-tolerated regimen as neoadjuvant chemotherapy for the LABC.