TE与TEC2种新辅助化疗方案治疗乳腺癌的疗效观察

目的:观察多西他赛+吡柔比星(TE)与多西他赛+吡柔比星+环磷酰胺(TEC)2种新辅助化疗方案治疗乳腺癌的近期疗效和安全性。方法:回顾性分析2009年11月-2011年3月间我院收治的92例Ⅱ、Ⅲ期乳腺癌患者的临床病理资料,依据患者术前接受的新辅助化疗方案分为TE组(49例)与TEC组(43例)。TE方案:多西他赛75mg·m-2,第1天静脉滴注;吡柔比星50mg·m-2,第1天静脉滴注。TEC方案:多西他赛75mg·m-2,第1天静脉滴注,吡柔比星50mg·m-2,第1天静脉滴注;环磷酰胺600mg·m-2,第1天静脉滴注。以上方案均21d为1个周期,2组患者均在术前接受4个周期化疗,并在术后完成剩余化疗周期。4个周期后观察疗效,并评估不良反应,同时,通过随访对无病生存时间(DFS)和总生存时间(OS)进行评价。结果:TE组有效率为83.67%,TEC组为88.37%,2组差异无统计学意义(P=0.146);TE组病理完全缓解率为12.24%,TEC组为13.95%,2组差异无统计学意义(P=0.607)。2组主要不良反应均为中性粒细胞减少、脱发、恶心及呕吐、肝功能异常、心肌毒性,其中中性粒细胞减少TEC组发生率明显高于TE组,2组差异有统计学意义(P=0.026)。中位随访13(5～21)个月,2组DFS和OS差异无统计学意义(P=0.083和P=0.071)。结论:在Ⅱ、Ⅲ期乳腺癌患者新辅助化疗中,TE与TEC2种方案近期疗效相近,但TE方案较TEC方案更安全。

Efficacy Observation of TE and TEC Neoadjuvant Chemotherapy Regimens for Breast Cancer

OBJECTIVE： To evaluate the short-term efficacy and safety of 2 neoadjuvant chemotherapy regimens of docetaxel combined with pirarubicin （TE） and docetaxel combined with pirarubicin and cyclophosphamide （TEC） for breast cancer. METH- ODS： The pathological records of 92 patients with stage Ⅱ and IU breast cancer in our hospital during Nov. 2009-Mar. 2011 were analyzed retrospectively. These patients were divided into TE group （49 group） and TEC group （43 group） based on neoadjuvant chemotherapy regimen. TE group was given docetaxel 75mg·m^-2 and pirarubicin 50 mg·m^-2 intravenously on the first day; TEC group was given docetaxel 75mg·m^-2, pirarubicin 50mg·m^-2 and cyclophosphamide 600mg·m^-2 intravenously on the first day. A treatment course lasted for 21 days, and both groups received 4 cycles of chemotherapy. And the remaining course of treatment was completed after surgery. Therapeutic efficacy was observed after 4 courses and ADR was also evaluated. Through follow-up, disease-free survival （DFS） and overall survival （OS） were evaluated. RESULTS： The effective rate of TE group was 83.67%, and that of TEC group was 88.37%, there was no significant difference （P=0.146）. The complete response （CR） rate of TE group was 12.24 %, and that of TEC group （ 13.95 % ）, there was no statistical significance （P= 0.607）. The main ADR of 2 groups were neutropenia, alopecia, nausea and vomiting, liver dysfunction and cardiac toxicity. The incidence of neutropenia was obviously higher in the TEC group than in the TE group, there was statistical significance （P=0.026）. The medium follow-up period was 13 months （5～21 months）, there was no statistical significance in DFS and OS between 2 groups （P=0.083 and P=0.071）. CONCLUSION： Among neoadjuvant chemotherapy of stage Ⅱ and Ⅲ breast cancer, the short-term efficacy of TE and TEC regimens is similar, but TE regimen in safer than TEC regimen.