新辅助化疗诱导的粒细胞减少症对乳腺癌预后的影响  

Prognostic impact of neoadjuvant chemotherapy induced neutropenia on operable breast cancer

作　　者：韩芸蔚[1] 王欣[1] 张斌[1] 温绍艳[1] 刘伟[1] 曹旭晨[1] 

机构地区：[1]天津医科大学附属肿瘤医院乳腺一科乳腺癌教育部防治重点实验室,300060

出　　处：《中华普通外科杂志》2011年第8期651-654,共4页Chinese Journal of General Surgery

摘　　要：目的探讨新辅助化疗诱导的粒细胞减少症与采用蒽环类联合紫杉类新辅助化疗方案进行新辅助化疗患者的疗效及远期生存率之间的关系。方法对接受4个周期蒽环类联合紫杉类新辅助化疗方案治疗的211例乳腺癌患者的资料进行回顾性分析。结果211例中51（24．2％）例为嗜中性粒减少症患者，160（75．8％）例为非嗜中性粒细胞减少症患者。嗜中性粒细胞减少症患者组的新辅助化疗反应较非嗜中性粒细胞减少症组患者为好（P〈0．05）。嗜中性粒细胞减少症患者5年无病生存率为82．4％，5年总生存率为90．2％，而非嗜中性粒细胞减少症患者的5年无病生存率为60％，5年总生存率为67．5％，两者相比差异均有统计学意义（均P〈0．01）。结论蒽环类联合紫杉类新辅助化疗方案诱导的嗜中性粒细胞减少症与可手术乳腺癌患者的预后有良好的相关性，可用来评估肿瘤对此类化疗药物的敏感性，并为个体化的治疗方案提供依据。Objective To evaluate the relationship between neoadjuvant chemotherapy （combination of taxanes and anthracyclines ） indueed-neutropenia and the efficacy of neoadjuvant chemotherapy and long-term survival in operable breast cancer patients. Methods Two hundred and eleven patients received 4 cycles of neoadjuvant chemotherapy （combination of taxanes and anthraeyclines）. Clinicopathological characteristics were compared between patients with neoadjuvant chemotherapy-induced neutropenia and patients without neutropenia. The efficacy of neoadjuvant chemotheray and long-term survival rate were analyzed. Results Among 211 patients there were 51 （24. 2% ） cases suffering from neutropenia and 160 （75.8%） cases were of no-neutropenia. The response to chemotherapy in patients with neutropenia were more effective than in no- neutropenia ones （ P 〈 0. 05 ）. The 5-year disease-free survival （DFS） in patients with neutropenia was 82.4%, while the 5-year disease-free survival （DFS） with non- neutropenia was 60% （ P 〈 0. 01 ）. Additionally, the 5-year overall survival （ OS ） in patients with neutropenia was 90. 2% and in patients with non-neutropenia patients was 67. 5% （P 〈 0. 01 ）. Conclusions Chemotherapy-induced neutropenia during neoadjuvant chemotherapy combination of taxanes and anthracyclines in patients with operable breast cancer has a better prognosis. The sensitivity of tumors given to chemotherapeutic drugs could be evaluated by chemotheraov-induced neutropenia.

关 键 词：乳腺肿瘤 中性粒细胞减少 抗肿瘤联合化疗方案 预后 

分 类 号：R737.9[医药卫生—肿瘤]