老年乳腺癌术后不同化疗方案疗效及安全性比较  

A clinical study on curative effect and safety of three chemotherapy regimens on the treatment of breast cancer in aged patients after radical mastectomy

作　　者：张新军[1,2] 李薛鑫 赵林[1] 英子伟[1] 谢贤鑫 李翔[1] 姜大庆[1] 

机构地区：[1]辽宁省肿瘤医院乳腺外科,辽宁沈阳110042 [2]大连医科大学,辽宁大连116044 [3]中国医科大学附属第四医院,辽宁沈阳110032

出　　处：《临床军医杂志》2015年第11期1134-1138,共5页Clinical Journal of Medical Officers

摘　　要：目的探讨老年乳腺癌患者应用不同辅助化疗方案治疗的有效性和安全性。方法回顾性分析辽宁省肿瘤医院2003-2010年收治的Ⅰ~Ⅲ期可手术治疗的老年（≥65岁）女性乳腺癌患者的临床资料及术后5年随访资料。按不同治疗方法分为FEC组、TC组和X组,对3组患者的临床疗效和生存率进行对照分析。结果本研究患者共466例,其中,术后接受FEC方案者145例,TC方案者192例,X方案者129例。3组患者的5年无复发生存率（RFS）分别为51%、60.4%、35.7%;总生存率（OS）分别为63.4%、64.1%、51.9%。TC组患者的PFS明显高于FEC组及X组,差异均有统计学意义（P〈0.05）;FEC组患者的PFS也高于X组（P〈0.05）。TC组和FEC组患者的OS明显高于X组,差异均有统计学意义（P〈0.05）;而TC组与FEC组间比较,差异无统计学意义（P〉0.05）。中性粒细胞减少更多发生在TC组（66.1%）和FEC组（51.7%）,明显高于X组的1.6%（P〈0.05）;且TC组与FEC组间比较,差异也有统计学意义（P〈0.05）。呕吐和心功能减退在FEC组患者中较多见,而手足综合征在X组中较多见。结论对于老年乳腺癌患者的术后辅助化疗,FEC方案与TC方案治疗效果相当,均优于X方案。3种方案的化疗均存在一定的不良反应。Objective To explore the effect and safety of chemotherapy regimens on the treatment of breast cancer in aged patients. Methods A retrospective study was performed on 466 patients aged over 65 years old of StageⅠ-Ⅲ,which were received in our de-partment from July 2003 to August 2010. All cases received chemotherapy via three different regimens after radical mastectomy,as FEC regimen,TC regimen and X regimen. Clinical effects and survival rates were analyzed among the three groups after 5 years follow-up. Results A total of 466 patients were enrolled in this study,including 145 cases in FEC group,192 cases in TC group and 129 cases in X group. According to 5-year follow-up study,the rate of recurrent-free survival （ RFS） was 51%,60. 4%,and 35. 7% in FEC,TC and X groups,respectively. RFS was higher in FEC group when compared to TC or X groups （P〈0. 05）,and PFS in FEC group was also higher than that in X group （P〈0. 05）. The overall survival （OS） rates were 63. 4%,64. 1%,and 51. 9% in FEC,TC and X groups,respectively. OS rates were higher in TC and FEC groups than that in X group （P〈0. 05）. While,there was not statistical difference between TC and FEC groups （ P〉0. 05 ） . Reduction of neutrophile granulocyte was more frequent in TC （ 66. 1%） and FEC （51. 7%） groups,when compared to X group （1. 6%）,and there was also statistical difference between TC and FEC groups （P〈0. 05）. Vomiting and heart function failing were more common in patients of FEC group,and hand-foot syndrome in X group. Conclusion FEC and TC regimens have equivalent efficacy for the chemotherapy treatment of patients with breast cancer after surger-y,which were better than X regimens. Adverse drug reactions could be observed in all three regimens.

关 键 词：老年 乳腺癌 辅助化疗 安全性 

分 类 号：R737.9[医药卫生—肿瘤]