多西他赛联合表柔比星密集方案与常规方案新辅助化疗三阴性乳腺癌的疗效对比  

Comparison of the efficacy of docetaxel combined with epirubicin dose-dense regimen and convention regimen neoadjuvant chemotherapy in patients with triple negative breast cancer

作　　者：吕月涛[1] 宋歌[2] 钱倩[1] 王建玲[1] Lyu Yuetao;Song Ge;Qian Qian;Wang Jianling(Department of Breast and Thyroid Surgery, Shandong fining First People＇s Hospital, Shandong Jining 272011, China)

机构地区：[1]山东省济宁市第一人民医院乳甲外科,272011 [2]山东省济宁市第一人民医院健康管理部,272011

出　　处：《中国医师进修杂志》2018年第1期37-41,共5页Chinese Journal of Postgraduates of Medicine

基　　金：山东省济宁市科技发展计划项目（2014jnwk09）

摘　　要：目的 观察比较多西他赛联合表柔比星密集方案与常规方案新辅助化疗治疗三阴性乳腺癌的临床疗效和不良反应。方法 收集2008年1月1日至2011年12月31日收治的81例术前行多西他赛联合表柔比星方案新辅助化疗的三阴性乳腺癌患者，按化疗周期不同分为密集组（40例）和常规组（41例）。术前均行2~ 6个周期的多西他赛联合表柔比星方案新辅助化疗，化疗方案：多西他赛75 mg/m2，持续1 h静脉滴注，第1天；表柔比星90 mg/m2，静脉滴注，第1天。密集组14 d为1个周期；常规组21 d为1个周期。观察比较两组患者的临床疗效及不良反应情况，随访患者的5年生存情况。结果 所有患者均可评价疗效。密集组病理完全缓解率及总有效率均显著高于常规组[20.0%（8/40）比12.2%（5/41）、85.0%（34/40）比70.7%（29/41）]，差异有统计学意义（P 〈 0.05）。密集组5年无病生存率和总生存率均高于常规组[77.5%（31/40）比58.5% （24/41）、87.5%（35/40）比73.2%（30/41）]，差异有统计学意义（P 〈 0.05）。不良反应方面，两组患者骨髓抑制、胃肠道反应、肝功能异常、脱发发生率比较差异均无统计学意义（P 〉 0.05）。结论 在多西他赛联合表柔比星新辅助化疗三阴性乳腺癌的治疗中，密集方案与常规方案相比，可以获得更高的病理完全缓解率及总有效率，延长无病生存期和总生存期，并且不良反应相当，具有更高的临床应用价值。Objective To observe the clinical efficacy and side effects of docetaxel combined with epirubicin dose-dense regimen and convention regimen neoadjuvant chemotherapy in patients with triple negative breast cancer.Methods Eighty-one patients with triple negative breast cancer from January 1, 2008 to December 31, 2011 were selected, and they were divided into dose-dense group （40 cases） and convention group （41 cases）. All the patients received 2-6 cycles of docetaxel combined with epirubicin neoadjuvant chemotherapy. Chemotherapy scheme was intravenous drip of docetaxel （75 mg/m2） for 1 h and intravenous drip of epirubicin （90 mg/m2） in Day 1. Every 14 d was 1 cycle in dose-dense group, every 21 d was 1 cycle in convention group. The clinical efficacy and side effects of 2 groups were observed and compared, and the 5-year survival rates were analyzed.Results All patients were evaluated. The pathologic complete response rate and the response rate in dose-dense group were significantly higher than those in convention group： 20.0% （8/40） vs. 12.2% （5/41） and 85.0% （34/40） vs. 70.7% （29/41）, and there were statistical differences （P〈0.05）. The 5 years disease-free survival rate and overall survival rate in dose-dense group were higher than those in convention group： 77.5% （31/40） vs. 58.5% （24/41） and 87.5% （35/40） vs. 73.2% （30/41）, and there were statistical differences （P〈0.05）. In side effects, there were no statistical differences in the incidences of bone marrow suppression, gastrointestinal reactions, abnormal liver function and hair loss between 2 groups （P 〉 0.05）.Conclusions In the neoadjuvant chemotherapy of triple negative breast cancer, compared with convention regimen, the dose-dense regimen can receive higher pathologic complete response rate and response rate, prolong disease-free survival rate and overall survival rate. Side effects is similar, and it is worth to be used in clinic.

关 键 词：乳腺肿瘤 药物疗法 联合 多西他赛 表柔比星 

分 类 号：R737.9[医药卫生—肿瘤]