新辅助化疗方案治疗三阴性乳腺癌的效果及生存观察

目的 观察多西他赛＋吡柔比星＋环磷酰胺（TAC方案）治疗三阴性乳腺癌患者的疗效和生存情况.方法 乳腺癌患者51例,三阴组：26例三阴性乳腺癌,Ⅱ期16期,Ⅲ期10例,非三阴组：25例非三阴性乳腺癌,Ⅱ期14期,Ⅲ期11例,两组患者均接受多西他赛联合吡柔比星化疗,多西他赛75 mg/m2,静脉滴注,第1天;吡柔比星40 mg/m2,静脉滴注,第1天;环磷酰胺500 mg/m2,第1天,21d重复.51例患者中位治疗周期数为4个周期.分析乳腺癌患者的疗效和生存情况.结果 三阴组术前临床完全缓解（cCR）9例（34.62％）,临床部分缓解（cPR） 14例（53.85％）,总有效率88.46％.术后病理完全缓解（pCR）7例（26.92％）,非三阴组：术前cCR 6例（24.00％）,cPR 8例（32.00％）,总有效率56.00％,术后pCR 4例（16.00％）,两组3年的总生存率分别为73.08％、88.00％,显示三阴性乳腺癌有较差的预后,达pCR的三阴性乳腺癌患者5年生存率（88.89％）高于未达到pCR的三阴性乳腺癌患者（47.06％）.结论 TAC方案对局部晚期三阴性乳腺癌有较高缓解率和降期效果,可提高三阴性乳腺癌的疗效,安全性较好.

Efficacy and survival analysis of triple-negative breast cancer treated with neoadjuvant chemotherapy

Objective To evaluate the efficacy and survival rate of neoadjuvant chemotherapy with docetaxe and pirarubicin in triple negative breast cancer （TNBC）.Methods Total 51 breast cancer patients were divided into TNBC group （n =26,including 16 of stage Ⅱ and 10 of stage Ⅲ patients） and non-TNBC group （n =25,including 14 of stage Ⅱ and 11 of stage Ⅲ patients）.All patients received a median of 4 treatment cycles with TAC regimen docetaxe 75 mg/m2 on day 1,pirarubicin 40 mg/m2 on day 1 and cyclophosphamide （CTX） 500 mg/m2 on day 1 of each 21 day cycle].The efficacy of treatment and survival rate of two groups were evaluated.Results In TNBC group,9 out of 26 （34.62 %） patients achieved clinical complete response （cCR）,and 14 （53.85 %） had partial response （cPR）.Overall,88.46 % of TNBC patients had clinical response and 26.92 % （7/26） showed pathology complete response （pCR）.In non-TNBC group,6 （24.00 %） patients reached cCR and 8 （32.00 %） showed cPR.The overall response rate was of 56.00 %,and 4 （16.00 %） patients achieved pCR.The overall 3-year survival rates in TNBC and non-TNBC groups were 73.08 % and 88.00 %,respectively,indicating a poorer prognosis of TNBC.The 5-year survival rates of TNBC patients with and without pCR were 88.89 % and 47.06 %,respectively.Conclusion TAC regimen improves the prognosis for locally advanced TNBC,indicating that the neoadjuvant chemotherapy is effective and safe for TNBC patients.