淋巴结阳性绝经前乳腺癌TEC方案新辅助化疗的临床观察  

Clinical observation of neoadjuvant chemotherapy with TEC regimen on premenopausal and node-positive breast cancer patients

作　　者：傅健飞[1] 李曙光[1] 洪中武[1] 徐熙善[1] 

机构地区：[1]金华市中心医院肿瘤科,浙江金华321000

出　　处：《中华肿瘤防治杂志》2011年第7期524-527,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：金华市科技局资助项目(2008-3-038)

摘　　要：目的:了解淋巴结阳性绝经前乳腺癌患者新辅助化疗的疗效,探索乳腺癌新辅助化疗的敏感性预测指标对预后影响。方法:收集我院2006-06-01-2009-06-01治疗并符合条件的186例乳腺癌患者,96例淋巴结阳性绝经前乳腺癌患者接受TEC方案(新辅助化疗组)。分析患者反应率,进一步根据术后免疫组化及常规病理结果分层分析可以预测敏感性的临床指标。同期入组90例直接接受手术治疗的乳腺癌患者作为对照组。结果:新辅助化疗后40例(41.7%)临床完全缓解(cCR),42例(43.8%)临床部分缓解(cPR),总反应率(ORR)为85.5%。21例(21.9%)病理完全缓解(pCR)。雌激素受体(ER)阴性患者ORR高于ER阳性患者(94.1%vs80.7%,P=0.035);浸润性导管癌患者ORR高于浸润性小叶癌患者(87.8%vs55.5%,P=0.029)。新辅助化疗与直接手术组比较,3年无瘤生存率有提高(83.5%vs68.5%,P=0.039),3年总生存率差异无统计学意义(89.9%vs88.6%,P=0.473)。结论:淋巴结阳性绝经前乳腺癌采用TEC新辅助化疗可以取得较高的反应率,ER阴性和浸润性小叶癌是新辅助化疗敏感性预测指标。TEC方案有助于提高3年无瘤生存率,但对总生存率的延长尚不明确。OBJECTIVE：To investigate the efficacy, prognosis and predictive factor of neoadjurant chemotherapy with TEC regimen on node-positive and premenopausal breast cancer patients. METHODS： From June 01 2006 to June 01 2009, 96 patients with premenopausal and node-positive breast cancer received TEC regimen neoadjuvant chemotherapy. The reaction rate of all patients was analyzed, and the predictive factors with stratification analysis according to the result of immunohistochemistry and pathology were explored. Simultaneously, 90 breast cancer pa- tients who only received postoperative chemotherapy were regarded as control group. RESULTS： A total of 40 patients（41.7%） had clinical complete response （cCR）, 42 patients （43.8 %） had clinical partition response（cPR）, and the ORR was 85.5%. To- tally 21 patients （21. 9%） had pathological complete response （pCR）. The overall reaction rate（ORR） was significantly higher in the patients with estrogen receptor（ER） negative （94. 1% vs 80.7% ,P=0. 035） and invasive ductal cancer （87.8% vs 55.5%, P=0. 029） comparing with the patients with ER positive and inrasive lobular cancer respectively. The 3-year disease-free survival rate was higher in neoadjuvant chemotherapy group than that in control group（83.5 % vs 68.5 %, P = 0. 039 ）, but 3-year overall survival rate was not different between them（89.9% vs 88. 6%, P 0. 473）. CONCLUSIONS： On the not to overall survival rate for Neoadjuvant chemotherapy with TEC regimen as an effective treatment for node-positive and premenopausal breast cancer can improve the disease-free survival. ER negative and invasive ductal cancer may be prediction factors for higher response.

关 键 词：乳腺肿瘤 新辅助化疗 反应率 预测 预后 

分 类 号：R737.9[医药卫生—肿瘤]