多西紫杉醇联合表柔比星新辅助化疗治疗老年局部晚期乳腺癌30例

[目的]观察多两紫杉醇联合表柔比星（TE）新辅助化疗治疗老年局部晚期乳腺癌（LABC）的客观缓解率、手术切除率及毒副反应。[方法]2005年10月至2008年8月，30例经空芯针活检组织学诊断证实的老年LABC行TE方案新辅助化疗，Ⅲa期17例，Ⅲb期11例，Ⅲc期2例，中位年龄74岁；化疗剂量为：多西紫杉醇75mg/m2，d1静滴，表柔比星60mg／m2，d1静滴，每3周为1个周期：2个周期TE方案之后对病灶进行首次评估，以决定是否再给予1～2个周期TE后再接受手术或放射治疗．[结果]30例患者接受2～4个周期TE方案的新辅助化疗，25例降低了临床分期，降期率为75．0％（25／30）：临床完全缓解率（CCR）及临床部分缓解率（CPR）分别为23．3%（7／30）、53.3％（16／30）；手术切除率为96．7％（29／30）。常见毒副反应有：中性粒细胞减少症、轻中度脱发、恶心、呕吐、体液潴留、肌肉关节疼痛等。Ⅲ、Ⅳ度中性粒细胞减少症分别为23．3％（7／30）和3.3％（1／30）。[结论]TE方案新辅助化疗治疗老年LABC患者是安全有效的，可以降低临床分期，提高患者术后的生活质量。

Neoadjuvant Chemotherapy of Docetaxel Combined with Epirubicin for 30 Elderly Cases with Locally Advanced Breast Cancer

[Purposel To investigate the clinical response, tumor resection rate and toxicity of neoadjuvant chemotherapy of docetaxel combined with epirubicin （TE） for elderly locally advanced breast cancer （LABC）. [Methods] From October 2005 to August 2008, 30 cases with elderly locally advanced breast cancer pathologically proven by core needle biopsy underwent neoadjuvant chemotherapy. The medium age was 74 years. Seventeen cases was in stage Ⅲ a; 11 Ⅲ b; and 2 Ⅲc. Docetaxel 75 mg/m2 plus epirubicin 60 mg/m2 were administered as intravenous infusion on the first day of each 3-week cycle. After 2 cycles of TE, a pilot clinical response evaluation was performed for each patient to decide if she should receive another 1-2 cycles of TE before surgery or radiation therapy. [Results] Thirty cases underwent 2 to 4 cycles of TE regimen and the clinical staging got down in 25 cases （75.0%）. The clinical complete response （CCR） and clinical partial response （CPR） rates were 23.3% （7/30） and 53.3% （16/30）, respectively. Tumor resection rate was 96.7% （29/30）.The major toxicities were neutropenia, alopecia, nausea, vomiting, fluid retention, myalgia and arthralgia with mild to moderate intensity, Ⅲ and Ⅳ grades neutropenia accounted for 23.3%（7/30） and 3.3%（1/30） respectively. [Conclusion] Neoadjuvant chemotherapy with TE regimen is effective and well tolerated for elderly patients with locally advanced breast cancer. It may get down the clinical staging and improve the postoperative quality of life.