EC-T剂量密度与常规剂量在淋巴结阳性乳腺癌患者辅助化疗中的比较研究  

The Effects of Dose-dense EC-T Chemotherapy for the Prognosis of Breast Cancer with Lymph-node Metastasis

作　　者：江联萍[1] 张宁[1] 吴海霞[1] 成少华[1] 左丽[1] 李纲[1] 

机构地区：[1]复旦大学附属肿瘤医院闵行分院化疗科,上海200240

出　　处：《医学综述》2015年第22期4144-4146,共3页Medical Recapitulate

摘　　要：目的观察环磷酰胺联合表阿霉素序贯紫杉醇剂量密度化疗在淋巴结阳性乳腺癌辅助化疗中的安全性和耐受性,探讨密度方案化疗的临床效果及对乳腺癌患者预后的影响。方法选择2005年9月至2007年4月复旦大学附属肿瘤医院闵行分院收治的60例采用EC序贯T方案进行辅助化疗的女性淋巴结阳性乳腺癌术后患者为研究对象,按照随机数字表法分为剂量密度组(29例)和常规剂量组(31例),计划每例患者接受EC×4序贯T×4的化疗。剂量密度组每2周重复,常规剂量组每3周重复。观察两组患者的临床特点,Ⅲ~Ⅳ级毒性反应(包括粒细胞减少、恶心、呕吐和脱发),复发及生存情况。结果两组患者均按计划完成化疗。剂量密集组Ⅲ~Ⅳ级粒细胞减少发生率为20.7%(6/29),显著低于常规剂量组的58.1%(18/31),差异有统计学意义(P=0.034);两组均无血小板降低、贫血、心脏毒性、神经毒性发生。两组5年无病生存率和生存率比较差异无统计学意义(P>0.05)。结论 EC序贯T剂量密度方案用于淋巴结转移乳腺癌患者的辅助化疗,不良反应可以耐受,是一个安全、有潜力的方案。剂量密度方案辅助化疗与常规方案辅助化疗有相似的临床效果,均能改善乳腺癌患者预后。Objective To evaluate the effect of dose-dense adjuvant chemotherapy epirubicin/cyclo- phosphamide followed by docetaxel（EC-T） on the clinical efficacy and prognosis of breast cancer patients with lymph-node metastasis. Methods A total of 60 patients of breast cancer treated with epirubicin/cyclo- phosphamide followed by docetaxel（EC-T） admitted to the Fudan University Cancer Center Minxing Branch during Sep. 2005 and Apr. 2007 were divided into dose-dense group（29 cases） and conventional dose group （31 cases） according to random number table method. It was planned to give every patient EC x 4 sequential T ~ 4 chemotherapy, repeated every two weeks in the dose-dense group and every three weeks in the conven- tional dose group. The clinical characteristics,the grade I^-IV toxicity（ including the reduction of the granu- locyte,nausea,vomiting and alopecia）, and the recurrence and survival of the two groups were observed. Results Both groups finished the chemotherapy as planned. The grade^I-1V granular ceils reduction inci- dence of dose-dense group was 20. 7% （6/29）, which was significantly lower than that of the conventional dose group＇s 58. 1% （ 18/31 ）, the difference was statistically significant （ P = 0, 034 ） ; there were no thmm- bocytopenia, anemia, cardiac toxicity, neurotoxicity in both groups. The 5-year disease free survival and sur- vival rate of the two groups had no statistically significant difference （ P 〉 0. 05 ）. Conclusion Dose-dense adjuvant chemotherapy using epirubiein/eyelophosphamide followed by docetaxel can achieve similar clinical results as conventional adjuvant chemotherapy in breast cancer patients with lymph-node metastasis, with tol- erable adverse effects, and can improve the prognosis as well as the conventional therapy.

关 键 词：乳腺癌 辅助化疗 剂量密度 

分 类 号：R737.9[医药卫生—肿瘤]