局部晚期乳腺癌新辅助化疗每周方案与三周方案疗效分析

目的　探讨比较局部晚期乳腺癌采用剂量密集法和非剂量密集法行新辅助化疗的近期疗效。方法　４５例ⅢＡ期乳腺癌患者随机进入密集化疗组（Ａ组）和非密集化疗组（Ｂ组）。Ａ组：紫杉醇７０ｍｇ／ｍ^２，表阿霉素３０ｍｇ／ｍ^２，每周１次，连用３周，４周为１个周期。Ｂ组：紫杉醇１３５ｍｇ／ｍ２，第１天，表阿霉素８０ｍｇ／ｍ^２，第１天，３周为１个周期。如无疾病进展，共治疗３个周期。结果　Ａ组获ＣＲ７例（３１.８２％），ＰＲ1２例（５４.５４％），ＳＤ３例（１３.６４％），ｐＣＲ５例（２２.７３％），有效率（ＲＲ）为８６.３６％。Ｂ组获ＣＲ６例（２６.０９％），ＰＲ１１例（５０％），ＳＤ６例（２６.０９％），ｐＣＲ３例（１３.０４％），ＲＲ为７３.９１％。Ａ组的ＲＲ、ＣＲ、ｐＣＲ均优于Ｂ组，但无统计学意义。进一步分层分析，不同基因型乳腺癌新辅助化疗的疗效相当，无论Ａ组或Ｂ组，其ＩｕｍｉｎａｌＢ型、Ｂａｓａｌ-ｌｉｋｅ型和ＨＥＲ ２阳性型三者之间新辅助化疗的ＲＲ、ｃＣＲ、ＰＲ、ｐＣＲ的差别无统计学意义。两组３～４级毒副反应发生率除中性粒细胞减少外均相近。两组随访期间全部存活，ＯＳ正在进一步随访中。结论　紫杉类每周方案与标准的三周方案相比，可作用于不同增殖动力学的肿瘤细胞，剂量密度增加，更易于与其他化疗药物配伍，且每周方案较三周方案有更高的疗效，急性毒性无明显增加。

Efficacy and safety of dose-dense neoadjuvant chemotherapy in treatment of local advanced breast cancer

Objective To evaluate the efficacy and safety of dose-dense neoadjuvant chemotherapy in treatment of local advanced breast cancer.Methods Forty-five patients with local advanced breast cancer were treated with dose dense chemotherapy(group A)and non dose dense chemotherapy(group B)randomly.Results In Group A,overall response rate was 86.36%.Among them,CR,PR,SD and pCR were 31.82%,54.54%,13.64% and 22.73% respectively.In Group B,overall response rate was 73.91%.CR,PR,SD and pCR were 26.09%,50%,26.09% and 13....