新辅助治疗在可手术乳腺癌中的应用  

Application of neoadjuvant chemotherapy for operable breast cancer

作　　者：郑琳[1] 高海燕[1] 张晓兰[1] 

机构地区：[1]南京医科大学附属常州二院乳腺外科,江苏常州213003

出　　处：《南方医科大学学报》2009年第12期2510-2511,共2页Journal of Southern Medical University

摘　　要：目的观察新辅助化疗对可手术乳腺癌患者的临床应用价值。方法选取我院经空芯针活检组织学诊断证实110例可手术的乳腺癌患者,随机给予TThp方案(多西他赛、吡柔比星)或TE方案(多西他赛、表柔比星)新辅助化疗2～4个周期,化疗两周后手术,评价其近期疗效、毒性反应及对术式选择的影响。结果全组患者原发灶的总有效率为87.2%,可保乳率由12.7%提高到41.8%(P<0.05),手术切除率达到97.2%。常见不良反应:白细胞减少、恶心呕吐、脱发等。结论新辅助化疗明显提高了可手术乳腺癌患者的保乳机率,降低了临床分期,缩小了手术范围,提高了患者的术后生存质量。Objective To investigate the clinical value of neoadjuvant chemotherapy in the treatment of operable breast cancer. Methods A total of 120 patients with pathologically proven operable breast cancer were randomized into two groups to receive 2-4 cycles of neoadjuvant chemotherapy with docetaxel combined with pirarubicin （TThp） or docetaxel combined with epirubicin （TE）. Operations were performed two weeks after the neoadjuvant chemotherapy. The short-term therapeutic effect, toxic reaction and the impact of neoadjuvant chemotherapy on the choice of surgical approaches were evaluated. Results The total effective rate for the primary sites was 87.2% in these patients, and the rate of breast conservation significantly increased from 12.7% to 41.8% （P〈0.05）, with a tumor resection rate of 97.2%. The major adverse effects of the therapy included leukopenia, nausea, vomiting and alopecia. Conclusion Neoadjuvant chemotherapy can enhance the breast conservation rate, lower the clinical staging of the tumors and minimize the surgery area to improve the postoperative quality of life of the patients.

关 键 词：乳腺肿瘤 辅助化疗 术式选择 

分 类 号：R737.9[医药卫生—肿瘤] R730.53[医药卫生—临床医学]