两种不同新辅助化疗方案治疗局部晚期乳腺癌的临床疗效比较  

Comparison of two different regimens for neoadjuvant chemotheray in the treatment of advanced breast cancer

作　　者：巢琳[1] 徐玉瑞[1] 陈力平[1] 

机构地区：[1]无锡市第二人民医院乳腺外科,江苏无锡214002

出　　处：《中国癌症杂志》2010年第12期926-929,共4页China Oncology

摘　　要：背景与目的:新辅助化疗已经成为治疗局部晚期乳腺癌的重要手段,不同化疗方案临床疗效有差异。本研究旨在比较XT方案(卡培他滨联合多西他赛)和传统CEF方案(环磷酰胺、表柔比星、氟尿嘧啶)两种不同的新辅助化疗方案治疗局部晚期乳腺癌的疗效及其不良反应。方法:收集采用XT或CEF方案行新辅助化疗的临床Ⅲ期乳腺癌患者48例,根据化疗方案分组,其中XT组26例,CEF组22例,化疗周期为2～4个,比较两组的近期疗效以及不良反应。结果:XT组的临床有效率(cRR)为88.46%,CEF组的临床有效率为63.64%,两组之间差异有统计学意义(P=0.041)。XT组患者获病理完全缓解(pCR)1例(3.85%),CEF组pCR 1例(4.55%),两组差异无统计学意义(P=0.721)。主要不良反应为粒细胞减少、恶心呕吐、肝功能损害、脱发、乏力和手足综合征等,但均可耐受。CEF方案的毒性较明显,出现Ⅲ/Ⅳ度的粒细胞减少,恶心呕吐、不同程度的肝功能损害均明显高于XT方案。结论:两种新辅助化疗方案对临床Ⅲ期乳腺癌均有良好的效果,XT组临床有效率优于CEF组,且患者的不良反应较CEF组轻。Background and purpose：Neoadjuvant chemotherapy has become a major therapeutic strategy for the treatment of locally advanced breast cancer.This study compared the efficacy and side effects of XT（Capecitabine and Docetaxel） and CEF（Cyclophosphamide,Epicubicin and 5-fluorouracil） as neoadjuvant chemotherapy regiments for breast cancer.Methods：Forty-eight patients with stage Ⅲ breast cancers were divided into two groups according to different regimens,26 in XT and 22 in CEF,respectively.We compared the efficacies and toxicities of the two groups after 2 to 4 cycles of chemotherapy.Results：The clinical response rate（cRR） of XT was 88.46%,and cRR of CEF was 63.64%.There were significant differences between the two groups（P=0.041）.Side effects including neutropenia,nausea,vomiting,alopecia,asthenia,liver dysfunction and hand-foot syndrome were tolerated.The incidence rate of Ⅲ/Ⅳ grade neutropenia in the CEF group was higher than that in the XT group（P=0.001）.There was also a significant difference between the two groups in terms of liver dysfunction（P0.001）.Conclusion：The two different regiments were both effective in the treatment of stage Ⅲ breast cancer.The XT regimen has higher therapeutic efficacy and fewer side effects compared with the CEF group.

关 键 词：乳腺癌 新辅助化疗 多西他赛 卡培他滨 

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