乳癌根治术后放化疗对乳腺癌中晚期患者T淋巴细胞及生存率的影响

目的探讨乳癌根治术后放化疗对乳腺癌中晚期患者T淋巴细胞及生存率的影响。方法选择本科2010年6月～2011年12月收治的乳腺癌中晚期患者56例，治疗方案为手术＋放疗＋化疗，手术方式为乳癌根治术。术后进行化疗分别于第1、8天给予多西紫杉醇75mg／m2静脉滴注，缓慢滴注时间为3h；术后第1～3天给予顺铂溶于生理盐水250ml静脉滴注，剂量20mg／m2，时间1h，3周为1个周期；三维适形放疗为DT2Gy／次。1次／d，5次／周，观察患者治疗前后相关免疫指标的变化及生存率。结果患者治疗后的CD3、CD4、CD8、CD4／CD8及NK较治疗前均降低，差异有统计学意义（P〈0．05）。乳癌根治术56例，乳癌改良根治术占33．93％（19／56）。术后随访1年局控率达到75．O％（42／56），1年生存率达到80．36％（45／56），2年局控率达到21．43％（12／56），2年生存率达到26．78％（15／56），临床总有效率为76．78％（43／56）。结论乳腺癌中晚期患者乳癌根治术后放化疗对机体免疫力可造成一定的影响，治疗中应考虑其不良反应，针对性地采取相应治疗方案，以提高临床疗效。

The impact of radiotherapy and chemotherapy after radical operation of breast cancer on T lymphocyte and survival rate in patient with advanced breast cancer

Objective To investigate the impact of radiotherapy and chemotherapy after radical operation of breast can- cer on T lymphocyte and survival rate in patient with advanced breast cancer. Methods 56 patients with advanced breast cancer in our department from June 2010 to December 2011 were selected,treatment option was surgery＋radio- therapy＋chemotherapy,operation mode was radical operation of breast cancer.Postoperative chemotherapy was given in the first 1,8 days docetaxel 75 mg/m2 intravenously,slow infusion time was 3 hours,1 to 3 days after cisplatin dissolved in 250 ml of saline infusion,the dose 20 mg/m2 infusion time 1 hour,3 weeks for 1 cycle.Three-dimensional conformal radiotherapywas DT 2 Gy/time,1 time/day,5 times/week,before and after treatment related immune system indicator and survival rate was observed respectively. Results CD3,CD4,CD8,CD4/CD8 and NK after treatment was lower than before treatment respectively,with statistical difference （P〈0.05）.56 cases of radical operation of breast cancer, modified radical mastectomy for breast cancer accounted for 33.93%（19/56）.Patients were followed up for 1-year local control rate was 75.0%（42/56）, 1-year survival rate was 80.36%（45~56）,2-year local control rate was 21.43%（12/56）,2-year survival rate was 26.78%（15~56）,the total clinical efficiency rate was 76.78%（43/56）. Conclusion Patients with advanced breast can- cer after radical radiotherapy and chemotherapy for breast cancer immunity have been affected,clinical adverse reaction should be considered in this regard,take the appropriate treatment program targeted in order to improve clinical effect.