乳腺癌新辅助化疗不同方案疗效及安全性比较  

Efficacy and safety of different regimens of neoadjuvant chemotherapy for breast cancer

作　　者：朱元喜[1] 方志沂[1] 马淑资[1] 

机构地区：[1]天津医科大学附属肿瘤医院乳腺科,天津300060

出　　处：《中国肿瘤临床与康复》2001年第3期18-20,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的　评价三种不同化疗方案对进展期乳腺癌术前化疗近期疗效及其安全性。方法　选择Ⅱ -Ⅲ期女性乳腺癌初治患者 ,给予三种不同化疗方案 ,常规剂量CMF(CTX ,MTX ,5 Fu) ,高剂量CMF及常规剂量CEF(CTX ,EPI ,5 Fu) ,术前化疗 3周 ;治疗后第四周 ,根据WHO制定的疗效标准和毒性分级标准进行有效性和安全性评价。结果　临床疗效 :CMF常规剂量组、CMF高剂量组和CEF常规剂量组有效率分别为 60 .3 8% ,66.2 9% ,70 .2 1%。不良反应 :CMF常规剂量组 ,CMF高剂量组和CEF常规剂量组出现Ⅰ -Ⅱ度WBC下降的发生率分别为 2 .83 % ,5 .62 % ,19.14 % ;Ⅱ -Ⅲ度胃肠道反应的发生率分别为 2 1.70 % ,19.5 4% ,2 9.79%。CEF常规剂量组患者无明显胸闷、胸痛及心悸等症状 ,无明显脱发。结论　高剂量CMF化疗近期疗效优于常规剂量CMF ,而且两组化疗不良反应相似且轻微 ,主要表现为胃肠道反应。常规剂量CEF化疗近期疗效优于高剂量CMF ,但其不良反应较重 ,主要表现为胃肠道反应及血象降低。这三种不同化疗方案对乳腺癌预后影响有待于进一步研究。Objective To evaluate the efficacy and safety among three different regimens of neoadjuvant chemotherapy for advanced breast cancer before operation.Methods Female patients with stage Ⅱ-Ⅲ breast cancer randomly recieved one of three different regimens:routine-dose CMF,high-dose CMF and routine-dose CEF,for three weeks before operating.Accroding to the effect standard and toxic grading standard suggested by WHO efficacy and safety were evaluated at the fourth week.Results (1)Clinical effect:response rate in routine-dose group of CMF,high-dose group of CMF and routine-dose group of CEF was 60.38%,66.29% and 70.21%,respectively.(2)Side effect:the patients who developed grade Ⅰ or grade Ⅱ bone marrow toxicity in routine-dose group of CMF,high-dose group of CMF and routine-dose group of CEF were 2.83%,5.62%,19.14%,respectively, and the patients who developed grade Ⅱ or grade Ⅲ gastrointestinal toxicity in the routine-dose group of CMF,the high-dose group of CMF and the routine-dose group of CEF were 21.70%,19.54% and 29.79%,respectively.Conclusions The effect of hihg-dose CMF is better than that of routine-dose CMF,and there is no difference of side effect between these two regimens.The effect of routine-dose CEF is better than that of high-dose CMF,but its side effect is serious.

关 键 词：乳腺癌 新辅助化疗 不良反应 治疗 

分 类 号：R737.9[医药卫生—肿瘤]