不同新辅助化疗方案治疗局部晚期乳腺癌的疗效比较

目的探讨新辅助化疗不同的治疗方案对局部晚期乳腺癌的患者的疗效。方法72例接受新辅助化疗的乳腺癌(ⅢA期)患者随机分为3组:即TA组(n=24)(紫杉醇联合吡柔比星):TXL 135 mg/m2静滴,d1,THP 40 mg/m2静推,d2。CAF组(n=24)(吡柔比星联合环磷酰胺,5-氟尿嘧啶):THP 40 mg/m2静推,d1,CTX 600 mg/m2,静推,d1.8,5-FU 12 mg/kg,d1-5,静滴。CMF组(n=24)(环磷酰胺联合5-氟尿嘧啶,氨甲喋呤):CTX 600 mg/m2静推d1.8,5-FU 12 mg/kg,静滴,d1-5,MTX 0.4 mg/kg,d1,静推。21 d为一个周期,2个周期后对乳腺癌原发病灶及腋窝淋巴结状态进行观察及分析。结果TA组总有效率为83%,CAF组总有效率为63%,CMF组总有效率25%。TA组与CMF组相比较有显著差异(P<0.05),CAF组与CMF组相比较有显著差异(P<0.05),TA组与CAF组相比较无统计学意义(t=0.022,P>0.05)。结论TA组和CAF组在局部晚期的乳腺癌新辅助治疗的过程中疗效满意,毒副反应可以耐受,值得推广。

Observation on Therapeutic Effect of Different Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer

Objective Approach on the therapeutic effect of different neoadjuvant chemotherapy in the treatment of locally advanced breast cancer. Methods Seventy-two patients with advanced breast cancer received different newly developed adjuvant chemotherapy were randomly assigned into three groups: Group TA(n=24,paclitaxel and pirarubicin),Taxol 135 mg/m~2 iv drip,d1,THP 40 mg/m~2 iv,d2;Group CAF(n=24,pirarubicin,cyclophosphamide and 5-fluorouracil),THP 40 mg/m~2 iv,d1,CTX 600 mg/m~2 iv,d1.8,5-FU 12 mg/kg,d1-5,iv drip;and Group CMF(n=24,cyclophosphamide,5-fluorouracil and methotrexate),CTX 600 mg/m~2 iv d1.8,5-FU 12 mg/kg,iv drip,d1-5,MTX 0.4 mg/kg,d1,iv.Each therapeutic course was completed within 21 days.The primary breast cancer and axillary lymphadenopathy were observed at the end after 2 therapeutic courses completed. Result The effective rate of TA was 83%,CAF was(63%),and CMF was 25%.There were significant differences between the TA and CMF groups(P<0.05)and also between the CAF and CMF groups(P<0.05),but not between the TA and CAF groups(P>0.05).Conclusion Group TA and group CAF have satisfactory effect.