局部晚期乳腺癌新辅助化疗临床疗效及病理反应与预后的关系

目的探讨局部晚期乳腺癌新辅助化疗后,临床体征与病理改变相关性及对预后的影响。方法1999年6月至2003年6月,对46例局部晚期乳腺癌患者以针吸细胞学明确乳腺癌诊断后行新辅助化疗CAF或CEF方案2周期,化疗前、后观察肿瘤大小及术后病理表现,术后对患者进行随访。结果原发灶临床有效率为45.7%,完全缓解(CR)2.2%,部分缓解(PR)43.5%,病理有效率为54.4%,重度组织反应17.4%,中度组织反应37.0%,术后中位随访期36个月,健康生存26例,余20例中,其中有2例患者失访,18例中死亡10例,复发8例。结论新辅助化疗后,认为病理有效的患者的无瘤生存率高于临床有效的患者、生存时间长于临床有效的患者,病理有效才能影响患者的预后。

Prognostic effect of clinical and pathological curative effect in neoadjuvant chemotherapy of locally advanced breast cancer

Objective:To evaluate the relationship between prognosis and curative effect of clinic and pathologic in neoadjuvant chemotherapy of locally advanced breast cancer. Methods: From June 1999 to June 2003, forty-six patients with locally advanced breast cancer proved by cytology were treated with 2 courses CAF or CEF regimen chemotherapy before operation. Contrasting the size of tumor before and after chemotherapy, and pathologic result were observed and followed up for each patient after operation . Results: The response in the primary tumor: clinical effective rate was 45.7%( CR 2.2% and PR 43.5%) ;pathological effective rate was 54.4%( heavy response 17.4%,middle response 37.0%).The median follow-up period was 36 months in all patients ,and of them, 26 cases alive ,in the other 20 cases , 10 cases dead ,8 cases relapse and 2 cases out of following. Conclusion: After the neoadjuvant chemotherapy , the survival rate and time of no tumor pathologiclly are higher than on the clinic. Curative effect of pathology is related with prognosis.