乳腺癌改良根治术中局部应用洛铂的疗效观察

目的：评价乳腺癌改良根治术中局部应用洛铂的临床疗效。方法选择早期乳腺癌患者50例，随机分为观察组和对照组各25例，均行乳腺癌改良根治术。术中观察组用溶有50 mg洛铂的生理盐水冲洗并浸泡创面，15 min后吸出冲洗液。皮瓣缝合前，再将50 mg洛铂多点喷洒于瘤床、腋窝淋巴结清扫区及其他可疑残余癌细胞区域。对照组仅用等量生理盐水处理。对药物安全性、近期及远期疗效进行追踪和对比研究。结果两组术后的不良反应包括骨髓抑制（白细胞和血小板计数）、肝肾功能（血肌酐和谷丙转氨酶）、局部疼痛和胃肠道反应（恶心、呕吐和腹泻），以及Ⅰ期愈合时间等方面比较无显著差异（P＞0．05）。观察组引流液脱落癌细胞检查阳性率和局部复发率均低于对照组，差异有统计学意义（P＜0．05），而远处转移率和2年生存率比较无统计学意义（P＞0．05）。结论乳腺癌患者改良根治术中应用洛铂安全有效，可显著降低局部复发，值得临床进一步推广。

Clinical Observation of Intraoperative Local Chemotherapy with Lobaplatin for Breast Cancer Patients Underwent Modified Radical Mastectomy

Objective To evaluate the clinical efficacy of intraoperative local chemotherapy with lobaplatin for breast cancer patients underwent modified radical mastectomy .Methods 50 cases of breast cancer patients treated with modified radical mastectomy were randomly divided into 2 groups,25 cases in each group .In the observation group ,operation wound was washed and steeped by physiological saline containing 50 mg lobaplatin for 15min.After sucking out the washing fluid ,another 50 mg lobaplatin was multi-point sprayed in tumor bed ,axillary lymph node dissection area ,and any other potential area of residual canc-er cells before flap suture.The control group only received a treatment of same amount of physiological saline .Then,drug safety, short-term effects and long-term results were tracked and compared .Results Postoperative adverse effects including myelosup-pression(number of leukocytes and platelets ),hepatic and renal functions(serum creatinine and alanine aminotransferase ),local pain as well as gastrointestinal reactions (nausea,emesia and diarrhea) and phase I healing time showed no significant difference between the 2 groups(P>0.05).While exfoliative tumor cytology and local recurrence rate of the observation group were remark -ably lower than those of the control group (χ2 =4.5 andχ2 =4.7,respectively,P<0.05),distant metastasis rates and 2-year sur-vival rates had no significant difference (P>0.05).Conclusion Intraoperative local chemotherapy with lobaplatin for breast cancer patients underwent modified radical mastectomy is safe and effective ,and it could decrease local recurrence .It is worthy of further clinical promotion .