69例年轻乳腺癌新辅助化疗的疗效和影响因素分析

目的]探讨年轻局部晚期乳腺癌的临床病理特点、新辅助治疗的疗效和影响疗效的相关因素。方法]回顾性分析中国医学科学院肿瘤医院2005年1月至2009年1月收治的年龄小于40岁的接受术前化疗的局部晚期乳腺癌患者资料。结果]全组患者病理完全缓解9例（13.0%）,有效率76.8%（53/69）;1例病情进展。5例在化疗后接受了保乳手术。单因素分析发现,含紫杉类方案（TE）是影响新辅助化疗疗效因素（P〈0.05）,而组织学分级,肿瘤大小,淋巴结状况,ER、PR、HER-2表达和分子分型与新辅助化疗疗效无关。结论]年轻局部晚期乳腺癌对术前化疗敏感,含紫杉类药物的方案有助于提高化疗疗效。

An Analysis of Influence Factors on Neoadjuvant Chemotherapy Efficacy in 69 Young Women with Breast Cancer

Purpose] To investigate the clinical characteristics,treatment and prognostic factors of neoadjuvant chemotherapy(NAC) in young patients with locally advanced breast cancer.Methods] The clinical data of 69 patients histologically diagnosed with locally advanced breast cancer at the age of ≤40 in Hospital of Chinese Academy of Medical Science and treated with NAC and surgery from January 2003 to January 2010 were analyzed retrospectively.Results] Pathologic complete response(pCR) was achieved in 13.0%(9/63),and the overall response was 76.8%(53/69);1 patient had progress disease.Five patients received breast conservative surgery after NAC.Univariate analysis showed that TE regimen was an independent factor which influenced NAC efficacy(P<0.05),but the histological grade,lymph node status,estrogen receptor,progesterone receptor,human epidermal growth factor receptor 2 were not correlated to NAC efficacy.Conclusion] Young patients with locally advanced breast cancer are chemosensitive to NAC.The regimen with anthracycline and taxane is helpful to improve NAC efficacy.