三阴性乳腺癌白蛋白结合型紫杉醇与多西他赛新辅助化疗临床对照研究

目的：评价白蛋白结合型紫杉醇、表柔比星联合环磷酰胺对比多西他赛、表柔比星联合环磷酰胺新辅助化疗治疗三阴性乳腺癌的临床效果。方法：将东莞市人民医院2009—01—03—2012—01—31经病理学确诊的三阴性乳腺癌患者42例分为PEC组21例，给予白蛋白结合型紫杉醇260mg／m2，静脉滴入，表柔比星70mg／m2，静脉滴入，环磷酰胺500mg／m2，静脉滴入，3周重复，不做抗过敏预处理；TEC组21例，给予多西他赛75mg／m2，静脉滴入，表柔比星与环磷酰胺应用方法同PEC方案，3周重复，使用多西他赛前1d开始口服地塞米松片7．5mg，2次／d，连服3d。结果：两组患者均完成4个周期新辅助化疗。PEC组RR19例（90．5％）、CR8例（38．1％）、PR 11例（52．4％）、SD2例（9．5％）；TEC组RR18例（85．7％）、CR8例（38．1％）、PR10例（47．6％）和SD3例（14．3％），两组差异均无统计学意义，P〉0．05；PEC组pCR为28．6％优于TEC组的19．1％，P=0．049。随访截止2013—04—01，中位随访时间25个月（12～48个月），随访率为100．0％。毒副作用两组中性粒细胞下降、血小板减少、便秘、心脏毒性、肝功能异常、外周神经毒性、肝肾功能异常发生率相比差异均无统计学意义，P〉0．05。结论：白蛋白结合型紫杉醇、表柔比星联合环磷酰胺新辅助治疗局部晚期三阴性乳腺癌疗效显著，毒副作用可耐受，值得进一步研究。

Preliminary clinical observation of nano albumin paclitaxel or docetaxel plus epirubicin and cyclophosphamide neoadjuvant chemocherapy in patients with triple negative breast cancer

OBJECTIVE：To evaluate the clinical effect of nano albumin-bound paclitaxel, epirubiein combined with cyclophosphamide compared docetaxel, epirubicin combined with cyclophosphamide in the treatment of triple negative breast cancer. METHODS：Forty two patients were diagnosesd triple negative breast cancer in our department from January 2009 to January 2012 （ER,PR, HER-2 negative）. They were divided into two groups and one group included 21 cases treated by albumin-bound paclitaxel （260 mg/m2 , iv. drip）, epirubicincombined with cyclophosphamide （PEC）, the other group included 21 cases using docetaxel （75 mg/m2, iv. drip）, epirubicin （70 mg/m2） combined with eyclophosphamide （500 mg/m2,TEC）. RESULTS：In PEC group the total efficiency （RR） clinical complete remission rate （CR）, pathologic complete response rate （PCR） and partial remission rate （PR） were 90.5%,38.1%,28.6%,52.4% ;In TEC group they were 85.7% ,38.1% ,19.1%0,47.6% ,pathologic complete remission rate （PCR） was significantly different between the two groups,P〈0.05. The stable disease （SD） of the two group were 9.5% and 14.3% comparing the toxicites of the two groups in neutrophil cell decline, thrombocytopenia, constipation, cardiac toxicity, abnormal liver function, peripheral neurotoxicity,liver and kidney dysfunction there was no statistic difference （P〉0.05）. The follow-up time was 25 mouths （12-48 months）, and the follow-up rate was 100.0 %. CONCLUSIONS Nano albumin-bound paclitaxel epirubicin com bined with eyclophosphamide neoadjuvant treatment for locally advanced triple negative breast cancer is effective significantly. The toxicity can be tolerated and it was worthy of further study.