乳腺癌术后辅助化疗常规骨髓支持治疗的临床分析  

Clinical analysis of routine bone marrow supportive treatment in postoperative adjuvant chemo-therapy for breast cancer

作　　者：杨荣华[1] 虞敏晶[1] 张桂普[1] 徐玲玉[1] 

机构地区：[1]苏州大学附属常州肿瘤医院乳腺外科,213002

出　　处：《临床外科杂志》2012年第12期853-855,共3页Journal of Clinical Surgery

摘　　要：目的探讨术后采用紫杉类和蒽环类药物联合方案化疗的乳腺癌患者加用重组人粒细胞集落刺激因子（G-CSF）骨髓支持治疗的临床效果。方法将术后采用TE／TEC方案辅助化疗的乳腺癌患者112例随机分成研究1组37例、研究2组38例和对照组37例，研究1，2组化疗后分别加用G-CSF骨髓支持5d和3d，对照组不加用G-CSF，观察并比较各组间白细胞总数、中性粒细胞数和髓内外毒副反应的差异。结果各化疗周期中，研究1，2组患者的白细胞总数及中性粒细胞数均高于对照组，白细胞减少性发热的发生率较低，且程度较轻，发生倦怠、肌痛、腹泻的概率也低于对照组，差异有统计学意义（P〈0．05）。在第5、6化疗周期中，研究1组患者的白细胞总数及中性粒细胞数高于研究2组，而白细胞减少性发热则少于研究2组，但差异无统计学意义。结论紫杉类和蒽环类药物联合化疗后应用G-CSF可缓解骨髓抑制，保护骨髓功能，超过4周期化疗时应延长骨髓支持时间。Objective To analyze the clinical effectiveness of granulocyte-colony stimulating fac- tor（ G-CSF）on bone marrow supportive treatment in postoperative chemotherapy with paclitaxel and mar- cellomycin for breast cancer patients. Methods A total of 112 breast cancer patients treated with TE/TEC chemotherapy after operation were randomly divided to the study group 1 （ n = 37 ）, the study group 2 （ n = 38） and the control group（n =37）. Patients in the study group 1 were supported with G-CSF for 5 days af- ter the chemotherapy, while the study group 2 was supported for 3 days, and for the control group, G-CSF was not administered. The differences of total white blood cells, heterophil granulocyte counts and the extra and intra-marrow poisonous/adverse reactions of each group were recorded and compared. Results During the whole period of chemotherapy, total white blood cells and heterophil granulocyte counts in the study group 1 and group 2 were significantly higher than that in the control group. Incidence rate of hypolekocyto- sis fever in the two study groups was much lower. The possibility of extra-marrow poisonous/adverse reac- tions such as lassitude, myosalgia and diarrheal in study group 1 and group 2 was significantly lower than that in the control group. Compared to the Study group 2 in the 5th and 6th cycles, the total white blood cells and heterophil granulocyte counts of patients in the study group 1 were higher, and the incidence of hypolekocytosis fever was lower,but the differences were not significant. Conclusion Using G-CSF after chemotherapy schedule with paclitaxel and marcellomycin could relieve bone marrow depression and pro- tect bone marrow function. Bone marrow supportive treatment should be extended for chemotherapy over 4 cycles.

关 键 词：乳腺癌 化疗 骨髓抑制 重组人粒细胞集落刺激因子 

分 类 号：R730.261[医药卫生—肿瘤]