乳腺癌TAC与CAF方案新辅助化疗的临床观察  

Clinic study on efficacy of TAC and CAF regimens as neoadjuvant chemotherapy in breast cancer

作　　者：张爱玲[1] 张蓉[1] 邓丁梅[1] 王永霞[1] 曹茵[1] 仉玮[2] 

机构地区：[1]东莞市人民医院乳腺科,广东东莞523018 [2]广东省中医院血管外科,广东广州510120

出　　处：《中华肿瘤防治杂志》2008年第10期775-777,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:评估TAC方案在可手术乳腺癌新辅助化疗(NCT)中的临床疗效和毒副反应。方法:对80例经粗针穿刺活检病理确诊的可手术乳腺癌患者进行NCT,设置CAF方案为对照组。TAC组(40例):多西紫杉醇75mg/m2,静脉滴入,d1;吡柔比星40mg/m2,静脉推注,d1;环磷酰胺500mg/m2,静脉推注,d1。CAF组(40例):环磷酰胺500mg/m2,静脉推注,d1;吡柔比星40mg/m2,静脉滴入,d1;5-FU600mg/m2,静脉滴入,d1、d8。每21d为1个疗程,共2～4个疗程,4例锁骨上淋巴结阳性的ⅢC期患者因经2个周期的CAF变化不显著改用TAC方案而出组。结果:TAC组CR5例,PR28例,SD7例,RR为82.5%(33/40),降期率62.5%(25/40)。CAF组CR1例,PR22例,SD13例,RR为63.9%(23/36);降期率33.3%(12/36)。两组淋巴结转阴率分别为43.75%(14/32)和38.5%(10/26)。两组间在化疗临床疗效、降期率方面差异有统计学意义,P<0.05。毒副反应上TAC组和CAF组除在脱发、白细胞毒性方面差异有统计学意义外,其他差异均无统计学意义。结论:TAC在可手术乳腺癌治疗中疗效显著且耐受性良好,是优于CAF的NCT方案。OBJECTIVE：To evaluate the clinical efficacy and toxicity of TAC compared with CAF as the neoadjuvant chemotherapy regimen in the treatment of operable breast cancer （OBC）. METHODS： Eighty patients with OBC by coarse needle biopsies were treated with TAC and CAF chemotherapy before operation. Neoadjuvant chemotherapies of TAC （40 cases） containing docetaxel 75 mg/m^2 （d1）, pirarubicin 40 mg/m^2 （d1） and cyclophosphamide 500 mg/m^2 （d1）, and CAF （40 cases） containing cyclophosphamide 500 mg/m^2 （d1）, pirarubicin 40 mg/m^2 （d1） ,5-FU 600 mg/m^2 （d1 ,d8 ） ,were administered every 3 weeks for two to four cycles before local treatment, hut 4 cases were out. RESULTS： The clinical objective responses of Group TAC were 5 cases of CR,28 cases of PR,7 cases of SD and 82.5%（33/40） of RR,62.5%（25/40） were downstaged. Group CAF＇s were 1 cases of CR,22 cases of PR, 13 cases of SD and 63.9% （23/36） of RR, 33. 3%（12/36）were downstaged, and 43. 75% （14/32） and 38. 5% （10/26） of Group TAC and Group CAF respective who had positive FNA results in the axillary lymph node before the chemotherapy showed negative results in the surgery specimen. The difference of chemotherapeutic effect between the two groups had a significance （P〈0. 05）. There was a significant difference in neutropenia and trichomadesis. The other adverse effects of Group TAC and Group CAF were no significantly different. CONCLUSION ： The combination of TAC is more effective than the regimen of CAF, and it is a well-tolerated regimen as neoadjuvant chemotherapy for OBC.

关 键 词：乳腺肿瘤/药物疗法 抗肿瘤药 多剂联用 回顾性研究 

分 类 号：R737.9[医药卫生—肿瘤]