乳腺癌改良根治术中氟尿嘧啶植入剂缓释化疗的临床疗效及安全性

目的:探讨乳腺癌改良根治术中区域性氟尿嘧啶植入剂缓释化疗的临床疗效及安全性。方法:将已行乳腺癌改良根治术患者94例随机分为植入组 48 例及对照组 46 例。两组手术方法相同，植入组在腋窝、锁骨下血管区域、胸大小肌之间多点撒入氟尿嘧啶植入剂，总剂量为400~600 mg;对照组无植入。两组均行常规术后化疗、放疗及内分泌治疗。观察两组并发症、不良反应及临床疗效，随访复发及生存情况。结果:并发症及不良反应发生率两组无统计学差异（P＞0.05）。植入组5年局部复发率明显低于对照组（35.4% vs 47.8%，P=0.016）;5年生存率明显高于对照组（81.3% vs 58.6%，P=0.041）。结论:乳腺癌改良根治术患者术中植入缓释氟尿嘧啶安全、有效，可减少乳腺癌术后局部复发，提高远期生存率，是乳腺癌术后局部化疗的有效途径。

The clinical efficacy and safety of sustained release fluorouracil implant in modified radical mastectomy of breast cancer

Objective:To explore the clinical efficacy and safety of sustained release fluorouracil implant in modified radical mastectomy of breast cancer.Methods:A total of 94 patients who have received modified radical mastectomy were randomly divided into implant group（n=48) and control group（n=46).The fluorouracil（400~600 mg) was administered to implant group in the axillary and subclavian vascular region and between pectoralismajor muscle and pectoralisminor muscle.Control group was not given fluorouracilim plant.All patients received postoperative conventional chemotherapy,radiationtherapy and endocrinetherapy.The clinical efficacy,adverse reaction and safety were observed after operation.Follow up the recurrence and survival of both the two groups.Results:There were no difference of frequency of complication and adverse reaction（P＞0.05).Compared with control group，fluorouracil implant significantly decreased local recurrence rate（35.4% vs 47.8%,P=0.016),and obviously increased 5-year survival rate（81.3% vs 58.6%,P=0.041).Conclusion:Sustained release fluorouracil implant is safe and effective in modified radical mastectomy,and can reduce local recurrence and improve long-term survival in patients with breast cancer.