局部晚期乳腺癌新辅助化疗每周方案与三周方案疗效分析  

Efficacy and safety of dose-dense neoadjuvant chemotherapy in treatment of local advanced breast cancer

作　　者：王梅[1] 王雅杰[1] 施俊义[2] 李永梅[1] 

机构地区：[1]第二军医大学长海医院肿瘤科,上海200433 [2]第二军医大学长海医院乳腺外科,200433

出　　处：《临床肿瘤学杂志》2010年第4期336-338,共3页Chinese Clinical Oncology

基　　金：上海市科委重大课题资助项目(06DZ19509)

摘　　要：目的探讨比较局部晚期乳腺癌采用剂量密集法和非剂量密集法行新辅助化疗的近期疗效。方法45例ⅢA期乳腺癌患者随机进入密集化疗组(A组)和非密集化疗组(B组)。A组:紫杉醇70mg/m2,表阿霉素30mg/m2,每周1次,连用3周,4周为1个周期。B组:紫杉醇135mg/m2,第1天,表阿霉素80mg/m2,第1天,3周为1个周期。如无疾病进展,共治疗3个周期。结果A组获CR7例(31.82%),PR12例(54.54%),SD3例(13.64%),pCR5例(22.73%),有效率(RR)为86.36%。B组获CR6例(26.09%),PR11例(50%),SD6例(26.09%),pCR3例(13.04%),RR为73.91%。A组的RR、CR、pCR均优于B组,但无统计学意义。进一步分层分析,不同基因型乳腺癌新辅助化疗的疗效相当,无论A组或B组,其IuminalB型、Basal-like型和HER-2阳性型三者之间新辅助化疗的RR、cCR、PR、pCR的差别无统计学意义。两组3～4级毒副反应发生率除中性粒细胞减少外均相近。两组随访期间全部存活,OS正在进一步随访中。结论紫杉类每周方案与标准的三周方案相比,可作用于不同增殖动力学的肿瘤细胞,剂量密度增加,更易于与其他化疗药物配伍,且每周方案较三周方案有更高的疗效,急性毒性无明显增加。Objective To evaluate the efficacy and safety of dose-dense neoadjuvant chemotherapy in treatment of local advanced breast cancer.Methods Forty-five patients with local advanced breast cancer were treated with dose dense chemotherapy（group A）and non dose dense chemotherapy（group B）randomly.Results In Group A,overall response rate was 86.36%.Among them,CR,PR,SD and pCR were 31.82%,54.54%,13.64% and 22.73% respectively.In Group B,overall response rate was 73.91%.CR,PR,SD and pCR were 26.09%,50%,26.09% and 13.04% respectively.RR,CR,pCR in Group A was better than that in Group B,and there was no difference between different genotype of breast cancer in efficacy.The side effects in group A were the same in group B.Conclusion Paclitaxel combined with epirubicin weekly has higher response rate and toxic reaction can be tolerated well.

关 键 词：局部晚期乳腺癌 新辅助化疗 紫杉醇 表柔比星 

分 类 号：R737.9[医药卫生—肿瘤]