TAC方案联合使用绿脓杆菌制剂在乳腺癌新辅助化疗中的应用研究  

Application of PA-MSHA vaccine adjuvant therapy and TAC scheme for treatment of breast carcinoma

作　　者：陈卫东[1] 唐中华[1] 徐峰[1] 

机构地区：[1]中南大学湘雅二医院,湖南长沙410011

出　　处：《南方医科大学学报》2009年第6期1204-1207,1211,共5页Journal of Southern Medical University

摘　　要：目的评价TAC方案联合使用绿脓杆菌制剂在乳腺癌新辅助化疗中的价值。方法以随机排列表法将我院2008年1月-2008年6月收治的60例女性乳腺癌患者随机分为实验组(30例)与对照组(30例),两组均采用TAC新辅助化疗方案,实验组加用绿脓杆菌制剂,治疗结束后评价两组的疗效、毒副作用、手术方式、术后并发症及疗效-成本比。结果实验组在新辅助化疗第2、3、4疗程后总有效率(RR)均高于对照组(P<0.05);实验组化疗前后Karnofsky评分无明显差别,而对照组化疗前后Karnofsky评分显著降低(P<0.05);实验组较对照组毒性反应发生率及反应程度明显降低;两组患者手术方式的选择无明显差异;实验组患者出现皮下积液、皮瓣坏死及感染的几率较对照组降低;实验组患者经2次新辅助化疗后即行手术治疗比例较对照组显著增加(P<0.01);第2次新辅助化疗后实验组每增加1%化疗有效率需花费人民币较对照组显著减少(P<0.01)。结论绿脓杆菌制剂在新辅助化疗中的联合使用能增加化疗的疗效,同时能增加患者的化疗承受能力,减轻化疗的毒副作用,而且能减少患者术后并发症的出现,没有加重患者的经济负担,值得临床推广。Objective To evaluate the efficacy and safety of Pseudomonas aeruginosa MSHA （PA-MSHA） vaccine combined with TAC scheme in the treatment of breast carcinoma. Methods A non-blinded, randomized, controlled trial was conducted between January 2008 and June 2008 among 60 patients with breast carcinoma. The patients were randomized into control group （30 cases） with neoadjuvant chemotherapy and PA-MSHA group （30 cases） with PA-MSHA treatment in addition to neoadjuvant chemotherapy. The therapeutic effect, adverse effects, surgical approaches, postoperative complications and cost-effectiveness in both groups were analyzed before and after the treatment. Results The response rate in PA-MSHA group were significantly higher than that in the control group at 2, 3, and 4 weeks alter neoadjuvant chemotherapy （P〈0.05）. The Kamofsky scores underwent no significant changes in PA-MSHA group after the chemotherapy, but significantly reduced in the control group （P〈0.05）. The incidence and severity of the toxic reactions and the rates of subcutaneous fluid, skin flap necrosis and infection in PA-MSHA group were significantly lower than those in the control group. The rate of operation following two neoadjuvant chemotherapy sessions was significantly higher in PA-MSHA group than in the control group. The cost of neoadjuvant chemotherapy for a 1% increment of the response rate was also significantly lower in PA-MSHA than in the control group. Conclusion PA-MSHA vaccine combined with TAC scheme can significantly enhance the therapeutic effect of breast carcinoma, lowers the rate of postoperative complications, and improve the efficacy of chemotherapy.

关 键 词：乳腺癌 绿脓杆菌制剂 新辅助化疗 

分 类 号：R737.9[医药卫生—肿瘤]