新辅助化疗对局部晚期乳腺癌的疗效分析

目的探讨新辅助化疗对局部晚期乳腺癌的疗效。方法对56例行新辅助化疗的局部晚期乳腺癌患者的临床资料进行总结分析。56例患者中ⅢA期30例，ⅢB期15例，ⅢC期11例。采用AC方案（环磷酰胺600mg/m^2静脉滴注，阿霉素60mg/m^2或表阿霉素90mg/m^2静脉滴注，第1日，21d为1个周期）或ET方案（表阿霉素90mg/m^2静脉滴注，第1日；多西他塞75mg/m^2静脉滴注，第2日；地塞米松16mg/d，第1-3日口服，21d为1个周期）。化疗3-4个周期后观察疗效，结果全部患者临床有效率（完全缓解＋部分缓解）为71.5%（40/56例），临床获益率（完全缓解＋部分缓解＋病情稳定）为95.4%，病理完全缓解率8.9%（5/56例）。38例（67.9%）重获根治手术机会，中位随访时间40个月，总生存率为62.5%（35/56例），无瘤生存率为39.3%（22/56例）。结论新辅助化疗能降低局部晚期乳腺癌术前TNM分期，使部分患者重获根治性手术机会。

An analysis of the effect of neoadjuvant chemotherapy on the locally advanced breast canoer

Objective： To investigate the effect of neoadjuvant chemotherapy on locally advanced breast carcinoma. Methods： The therapeutic effect in 56 patients with neoadjuvant chemotherapy on locally advanced breast carcinoma was summarized and analysed. Among the 56 patients, 30 cases were in the Ⅲ A stage, 15 in the Ⅲ B tage,and 11 in the Ⅲ C stage. Two therapeutic regimens were used before surgery： one was injection of cyclophosphamide （CTX） 600 mg/m^2 and adriamycin （ADM） 60 mg/m^2 or epirubieine （EPI） 90 mg/m^2 intraveously at the first day, the other was injection of EPI 90 mg/m^2 on the first day and docetaxel （TXT） 75 mg/m^2 on the second day intravenously, as well as administration of dexamethasone orally during first to third days, 21 days of treatment were considered as one therapeutic course. Three or 4 therapeutic courses later, the curative effects were observed. Results： Of the 56 patients, the clinical efficient response rate was 71.5%,and the clinical benefi- cial response rate was 95.4%. In 38 patients （67.9%） radical surgical treatment was performed. The survival rate was 62.5% and the relapse free survival rate was 39.3% after being followed-up for 40 months. Conclusion： Neoadjuvant chemotherapy can lower the TNM stage, so that a part of patients with locally advanced breast carcinoma can be further treated with radical operation with reasonably good result.