晚期乳腺癌新辅助化疗的临床观察

目的探讨新辅助化疗在晚期乳腺癌治疗中的效果。方法对66例Ⅲ,Ⅳ期的乳腺癌患者行新辅助化疗,采用21d为1周期的CAF方案,共2周期〔CTX500mg/m2静脉推注(第1,8天),5-FU500mg/m2静脉推注(第1,8天),ADM30mg/m2静脉推注(第1天)〕,并与同期未行任何术前治疗的可手术的58例Ⅲa期患者作对比分析。结果新辅助化疗组的总有效率为86.36%(57/66),有62.12%(41/66)的患者分期降低。新辅助化疗组的无病生存期为57.6个月,明显高于未行化疗组的42.2个月(P<0.05),新辅助化疗组的5年无病生存率为37.89%,对照组为34.48%。结论新辅助化疗能降低晚期乳腺癌患者的分期,为手术创造最佳机会;减少或延缓肿瘤的复发、转移;并可延长晚期乳腺癌患者的无病生存期。

A clinical study of neoadjuvant chemotherapy for advanced breast cancer

Objective To study the clinical effect of neoadjuvant chemotherapy(NAC) on advanced breast cancer.Methods The CAF neoadjuvant chemotherapy [CTX500mg/m~2(1st day,8th day),5-FUmg/m~2(1st day,8th day),and ADM 30mg/m~2(1st day) every 3 weeks)]was carried out in 66 advanced breast cancer patients for 2 cycles before operation,and compared with 58 concurrent operable patients with advanced cancer,who did not receive any preoperative therapy.Results The overall response rate was 86.36%(57/66) in NAC group.The stages of 41 of the 66 patients(62.12%) was downgraded.The disease free survival time of the patients was 57.6 months which was obviously longer than that of patients without neoadjuvant chemotherapy(42.20 months,p<0.05).The 5-year disease-free survival rate of the patients with neoadjuvant chemotherapy was 37.89% which was a little higher than that(34.48%)of the patients without the chemotherapy,but the two groups had no significant difference.Conclusions Neoadjuvant chemotherapy can downgrade the stage of patients with advanced breast cancer,provide an optimal time for operation,obviously prolong the disease-free survival time of the patients,and reduce or delay recurrence or metastasis.