新辅助化疗中应用多西他赛联合顺铂治疗对蒽环类耐药的局部晚期乳腺癌的疗效研究  

Clinical study of neoadjuvant chemotherapy in anthracycine-risistance local advanced breast cancer combined with docetaxel and cispiatin

作　　者：袁松林[1] 许勇[1] 黄丽娓 

机构地区：[1]常德市第一人民医院乳腺科,湖南常德430000

出　　处：《中国现代医学杂志》2014年第19期66-68,共3页China Journal of Modern Medicine

摘　　要：目的该研究探讨在新辅助化疗中对蒽环类耐药的局部晚期乳腺癌再序贯多西他赛联合顺铂(TP)方案治疗的近期疗效及远期生存情况,并进一步探讨TP方案在三阴与非三阴乳腺癌中的疗效差异。方法对蒽环类耐药序贯TP方案的110例乳腺癌资料进行回顾与分析。用免疫组化法将ER、PR和HER-2表达均阴性的肿瘤定义为三阴性乳腺癌(三阴组),其余定义为非三阴性乳腺癌(非三阴组),分析TP方案对三阴组与非三阴组近期疗效及远期生存的情况。结果 110例中33例(30.0%)为三阴组,77例(70.0%)为非三阴组,110例患者的总有效率59.1%(65/110),其中完全缓解(CR)为25.5%(28/110),部分缓解(PR)33.6%(37/110),完全缓中病理完全缓解(PCR)为22例(20.0%),三阴组的PCR12例(39.4%)明显高于非三阴组的PCR10例(12.9%)(P=0.0042);三阴组的5年无病生存(DFS)为33.3%,低于非三阴组55.6%(P<0.05);三阴组的5年总生存率(OS)为35.2%,并低于非三阴组的58.0%(P<0.05)。获得PCR的三阴组的5年DFS(52.7%)及OS(55.1%)与非三阴组间差异无显著性(P>0.05),相反,新辅助化疗后未达到PCR的三阴组5年DFS(21.4%)与OS(25.3%)明显低于非三阴组(P<0.05)。结论新辅助化疗中对蒽环类耐约的局部晚期乳腺癌序贯应用TP方案仍有效,三阴组对TP方案更敏感更易获得PCR,获得PCR的三阴组患者预后好,未获得PCR的三阴组患者远期生存明显低于非三阴组。【Objective】To evaluate TP（doce taxol and cisplatin） neoadjuvant chemotherapy and anthracycine-resistant local advanced breast cancer, and compare the responses to TP neoadjuvant chemotherapy and survival in the patients with TNBC and non-TNBC.【Methods】One hundred and ten patientswho were anthracycine-risistance local advanced breast cancer treated with TP neoadjuvant chemotherapy were included in this restrospective study.The response and survival between TNBC and non-TNBC were analyzed.【Results】Of the 110 patients, 33（30.0%）were TNBC, 77（70.0%） was non-TNBC. The overall response rate（OR） was 59.1%（65/110）, including 25.5%（28/110）Clinical complete response（CCR） and 33.6%（37/110） clinical partial response（CPR）, the pathological complete response（PCR） was 20.0%（22/110）. The PCR was 39.4% in patients with TNBC, which was significantly higher than the PCR（12.9%） in non-TNBC patients（P 〈0.05）. Patients with TNBC had worse 5-year disease free survival（DFS）and overall survival（OS） than those with non-TNBC（P〈 0.05） IF PCR was achieved, patients with TNBC or with non-TNBC had similar DFS and OS（P 〉0.05）.【Conclusion】TP neoadjuvant chemotherapy is effective for the patients with anthracycine-resistancelocal advanced breast cancer. Patients with TNBC were more sensitive to TPneoadjuvant chemotherapy than those with non-TNBC. Patients with TNBC increased PCR rates compared with nonTNBC, and those with PCR have a good prognosis. TNBC patients achieved PCR have better prognosis,while survival for those who did not get PCR were worse with non-TNBC.

关 键 词：新辅助化疗 蒽环类耐药 多西他赛 顺铂 三阴性乳腺癌 预后 

分 类 号：R737.9[医药卫生—肿瘤]