多西他赛联合表柔比星新辅助治疗晚期乳腺癌的疗效分析

目的 分析多西他赛(DOC)联合表柔比星(EPI)新辅助治疗晚期乳腺癌的临床疗效和毒性反应,以及预后评价.方法 选择我院治疗的84例晚期乳腺癌患者,按化疗方案不同分为研究组41例,应用DOC联合EPI新辅助化疗方案；对照组43例,应用紫杉(PTX)联合EPI化疗方案.以21d为一个疗程,治疗3～4个疗程后分析临床疗效及毒性反应.随访1年,评价预后指标,即复发率及生存率.结果 研究组的总有效率(OR)为90.24％,高于对照组的79.06％(P=0.030 1);研究组的临床完全缓解率(cCR)、病理完全缓解率(pCR)与对照组比较差异无统计学意义(P＞0.05).研究组的胃肠反应、白细胞下降、外周静脉炎发生率较对照组低(P＜0.05),过敏性皮疹及脱发发生率与对照组比较差异无统计学意义(P＞0.05).研究组的复发率及生存率较对照组明显改善,分别为12.19％ vs 18.60％(P=0.028 7)、17.07％(7/41)vs 9.30％(4/43)(P=0.003 7).结论 DOC联合EPI新辅助治疗晚期乳腺癌的临床疗效显著,毒性反应较少,预后改善,是晚期乳腺癌新辅助化疗的有效方案.

Clinical effect of docetaxel combined with epirubicin as the neoadjuvant chemotherapy in the treatment of advanced breast cancer

Objective To evaluate the clinical effect, side effects and prognosis of docetaxel (DOC) combined with epirubicin (EPI) as the neoadjuvant chemotherapy in the treatment of advanced breast cancer. Methods 84 patients with advanced breast cancer were divided into two groups, research group and control group, based on distinct chemotherapies. The therapy of paclitaxel (PTX) combined with EPI (EP) was given to the patients in control group, and DOC combined with EPI(ED) was given to research group. The chemotherapy was repeated every 21 days. Efficacy and toxicities were reviewed after 3 to 4 cycles of chemotherapy. After one year follow-up, the indexes of prognosis, such as recurrence rate and survival rate, were analyzed. Results Compared to control group, the overall response rate (OR) in research group was higher, 90.24% vs 79.06% (P=0.032 4), and there was no diffenerce of cCR, pCR between two groups. In both groups side effects including hypersensitive rash and hair loss were similar, and the incidence rates of gastrointestinal reaction, leucopenia, peripheral phlebitis in control group was higher than those in reserach group (P<0.05). Recurernce rate and survival rate in research group were higher than those in control group, 12.19% vs 18.60% (P=0.028 7), 17.07% (7/41) vs 9.30% (4/43) (P=0.003 7), respectively. Conclusion The combination of docetaxel and epirubicin was effective in the treatment of advanced breast cancer as neoadjuvant chemotherapy, with less side effects and better prognosis.