TEC方案新辅助化疗对淋巴结阳性绝经前乳腺癌的疗效分析

目的:了解淋巴结阳性绝经前乳腺癌患者对新辅助化疗的反应,进一步探索乳腺癌新辅助化疗方法的敏感性预测指标。方法:在2006年6月～2009年6月期间,前瞻性入组96例淋巴结阳性绝经前乳腺癌患者接受TEC方案新辅助化疗。分析患者反应率,进一步根据术后免疫组化及常规病理结果分层分析可以预测敏感性的临床指标。结果:TEC方案新辅助化疗后,40例(41.7%)临床完全缓解(cCR),42例(43.8%)临床部分缓解(cPR),总反应率(ORR)为85.4%。21例(21.9%)病理完全缓解(pCR)。雌激素受体(ER)阴性患者ORR高于ER阳性患者(94.1%vs.80.7%,P=0.035);浸润性导管癌患者ORR高于浸润性小叶癌患者(87.8%vs.55.6%,P=0.029)。结论:淋巴结阳性绝经前乳腺癌采用TEC方案新辅助化疗可以取得较高的反应率,ER阴性和浸润性导管癌是新辅助化疗敏感性预测指标。

Clinical Efficacy Analysis of Neoadjuvant Chemotherapy in TEC Regimen for Premenopausal Node-positive Breast Cancer

OBJECTIVE： To investigate clinical efficacy of neoadjuvant chemotherapy in TEC regimen for premenopausal node-positive breast cancer, and to explore the sensitivity prediction indicator of neoadjuvant chemotherapy for breast cancer. METHODS： From Jun. 2006 to Jun. 2009, 96 patients with premenopausal node-positive breast cancer received neoadjuvant che- motherapy of TEC regimen. The reaction rates of patients were analyzed, and the stratification analysis for the sensitivity prediction indicator of neoadjuvant chemotherapy was explored according to the result of immunohistochemistry and pathology. RESULTS ： Af- ter treatment, 40 cases （41.7%） had clinical complete response （cCR）, 42 cases （43.8%） had clinical partition response （cPR） and the overall reaction rate （ORR） was 85.4%. 21 patients （21.9%） had pathological complete response （pCR）. The ORR in pa- tients with estrogen receptor （ER） negative was significantly higher than those with ER positive （94.1% vs. 80.7%, P=0.035）. The ORR in patients with invasive ductal cancer was significantly higher than those with invasive lobular caner （87.8% vs. 55.6%, P：0.029）. CONCLUSION： Neoadjuvant chemotherapy of TEC regimen is effective for premenopausal node-positive breast cancer with high response rate. ER negative and invasive ductal cancer may be the sensitivity prediction indicator of neoadjuvant chemotherapy for breast cancer.