乳腺癌新辅助治疗的临床效果评价

目的 评价乳腺癌新辅助治疗的临床效果.方法 对132例乳腺癌进行新辅助治疗.其中采用新辅助内分泌者9例,紫杉醇联合表阿霉素治疗12例,CEFi方案治疗102例.新辅助治疗结束1周后.实施手术.结果 全组病例总的临床缓解率(CR PR)为87.9%(116/132).肿瘤对不同方案的新辅助治疗反应存在差异,内分泌治疗组临床缓解率仅22.2%,显著小于其余二组(CEFi 92.2%、紫杉醇 表阿霉素联合95.2%),有显著性差异(P＜0.05).结论 CEFi和联合使用紫杉醇和表阿霉素方案临床效果较好.新辅助内分泌治疗临床缓解率较低,反应缓慢.不推荐用内分泌治疗进行新辅助治疗;新辅助化疗后距离手术日一般至少1周;新辅助化疗3～4个周期后外科手术.术后再补足2～3个周期化疗;兼顾新辅助化疗、肿瘤细胞生物学和患者心理三方面.放射治疗最好放在化疗结束后.

Clinical evaluation of neoadjuvant therapy for breast cancer

Objective To evaluate the clinical efficacy of neoadjuvant therapy for breast cancer. Methods 132 patients with breast cancer were treated with neoadjuvant therapy. Nine, 21 and 102 cases were applied with neoadjuvant endocrine therapy, paclitaxel combined with epirubicin and CEFi schemes respectively. Results Total clinical response rate was 87.9%(1116/132). The response rate (22.2%) in neoadjuvant endocrine was significantly lower than that in CEFi and paclitaxel combined with epirubicin group(P<0.05). Conclusions The clinical responses in CEFi and paclitaxel combined with epirubicin are very ideal. The effect of Neoadjuvant endocrine therapy is low and slow, so endocrine therapy is not suitable for neoadjuvant therapy. Operation must be taken at least one week after neoadjuvant chemotherapy. Three to four cycles of neoadjuvant chemotherapy may be appropriate.