CET和CEF方案在乳腺癌新辅助化疗中的应用研究  

CET and CEF neoadjuvant chemotherapy regimen in the treatment of breast cancer

作　　者：魏忠[1] 王锡宏[1] 戴寅[1] 谢钊[1] 

机构地区：[1]安徽省肿瘤医院(安徽省立医院分院)普外科,安徽合肥230031

出　　处：《现代肿瘤医学》2008年第8期1331-1333,共3页Journal of Modern Oncology

摘　　要：目的:评估CET和CEF方案在可手术乳腺癌新辅助化疗(NCT)中的安全性、临床疗效及对手术方式的影响。方法:自2005年7月至2007年3月,对56例经空芯针活检组织学确诊的可手术乳腺癌患者在术前给予新辅助化疗,按随机对照原则分为CET和CEF两组。CET组(28例):CTX600mg/m2,静脉滴入,d1;Epi-ADM(艾达生)60mg/m2,静脉滴入,d1;多西他赛(艾素)75mg/m2静脉滴入,d1。CEF组(28例):CTX600mg/m2,静脉滴入,d1;Epi-ADM(艾达生)60mg/m2,静脉滴入,d1;5-FU500mg/m2,静脉滴入,d1。两组每21d为1个疗程,术前共用3个疗程。在新辅助化疗完成后,评价其临床疗效和毒性反应,化疗后接受手术治疗。结果:CET组cCR28.57%(8/28),pCR14.29%(4/28),PR46.43%(13/28),RR为75%,降期率为39.29%(11/28)。CEF组cCR10.71%(3/28),pCR7.14%(2/28),PR35.71%(10/28),RR为46.43%,降期率为46.43%(13/28)。全组无进展病例。CET和CEF组在化疗前后肿大腋窝淋巴结阴转率分别为33.34%和28.57%。全部病例均接受手术治疗,其中8例符合保乳适应症。CET和CEF两组在毒副反应差异上除Ⅲ-Ⅳ白细胞毒性方面有统计学意义(P=0.027)外,其他毒副反应差异无统计学意义。结论:CET和CEF方案的新辅助化疗在可手术乳腺癌的治疗中有较高疗效,而且扩大了保乳手术的适应症,是治疗局部晚期乳腺癌的重要方法。CET方案疗效显著且耐受性好,是优于CEF的新辅助化疗方案。Objective ：To evaluate the clinical efficacy and toxicity of CET compared with CEF as the neoadjuvant chemotherapy regimen in the treatment of operable breast cancer （OBC）. Methods ： From July 2005 to March 2007, 56 patients with OBC were randomly assigned to 2 groups treated with CET and CEF chemotherapy before operation. All patients were diagnosed by fine - needle aspiration （ FNA ） cytology. Neoadjuvant chemotherapies of CET contai- ning cyclophosphamide 600 mg/m2 （ days 1 ） , epirubicin 60 mg/m2 （ days 1 ） and docetaxel 75 mg/m2 （ days 1 ） , and CEF containing cyclophosphamide 600 mg/m2 （ days 1 ）, epirubicin 60 mg/m2 （ days 1 ） ,5 - fluorouracil 500 mg/m2 （day＇s 1 ） ,administered every 3 weeks for three cycles before local treatment. Toxicity were summarized. Results：The clinical objective responses of Group CET and group CEF respectively were 75 % vs 46.43 % [ 28.57 % （8/28） of cCR vs 10.71% （3/28） of pCR,and 46.43% （13/28） PR vs 35.71% （ 10/28 ） of PR]. Pathological complete responses of group CET and group CEF respectively were found in 4 cases （ 14.29 % ） vs 2 cases （7.14%）. Eight ca- ses and 6 cases[ 33.34% （8/24） vs 28.57% （6/21） of group CET vs group CEF] respectively who had positive FNA results in the axillary lymph node before chemotherapy showed negative results in the surgery specimen. The most common toxicities were neutropenia, alopecia and nansea/vomiting. There was a significant difference in neutropenia grade Ⅲ - Ⅳ of Group CET with group CEF, P =0.027. The other adverse effects of 2 groups were no significantly different and they were tolerable and there were no toxic deaths. All patients received operation after chemotherapy, and 8 cases among them received breast - conserving therapy. Conclusion ： CET and CEF as neoadjuvant chemotherapy regimen are effective and expand the indication for breast - conserving therapy, which is important in OBC. The combination of CET is more effective than the regimen of CEF, and

关 键 词：乳腺癌 新辅助化疗 CET方案 CEF方案 

分 类 号：R737.9[医药卫生—肿瘤]