TEC-NX方案与TEC方案在局部晚期乳腺癌辅助化疗中疗效和不良反应差异的比较  

Compare therapeutic effects and adverse effects between TEC-NX regime and TEC regime in adjuvant chemotherapy of local advanced breast cancer patients

作　　者：王志威 魏敏 王杰[1] 杨莉[1] 邵玉国[1] 籍敏[1] 何奇[1] Wang Zhiwei;Wei Min;Wang Jie;Yang Li;Shao Yuguo;Ji Min;He Qi(Department of Breast, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China)

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院乳腺科,200030

出　　处：《国际外科学杂志》2019年第5期325-329,F0004,共6页International Journal of Surgery

基　　金：国际和平妇幼保健院院级课题(GFY5502);国际和平妇幼保健院优秀青年医师培育计划(GFY9307).

摘　　要：目的比较TEC-NX方案(多西他赛+表柔比星+环磷酰胺序贯长春瑞滨+卡培他滨)与TEC方案(多西他赛+表柔比星+环磷酰胺)在局部晚期乳腺癌辅助化疗中疗效和不良反应的差异。方法采用回顾性研究方法,选取2008年4月—2015年4月上海交通大学医学院附属国际和平妇幼保健院收治的腋窝淋巴结转移≥4 枚的58例局部晚期乳腺癌患者,均为女性;平均年龄48岁,范围29~63岁。按照治疗方法的不同将患者分为TEC-NX组(n=23)和TEC组(n=35),其中TEC-NX组患者使用TEC-NX方案化疗,TEC组患者使用TEC方案化疗。比较两组患者的3年总生存率和3年无病生存率,同时比较两组患者发生骨髓抑制、肝功能异常及发热等不良反应的差异。计数资料组间比较采用χ2检验;采用Kaplan-Meier法进行生存分析。结果 TEC-NX组患者的3 年总生存率为91.3%,而TEC组为91.4%,差异无统计学意义(P=0.995)。TEC-NX组患者的3 年无病生存率为73.9%,而TEC组为85.7%,差异无统计学意义(P=0.289)。TEC-NX组患者Ⅲ度或Ⅳ度骨髓抑制的发病率为26.0%,显著低于TEC组(65.7%),差异具有统计学意义(P=0.009)。TEC-NX组患者肝功能异常的发病率为91.3%,与TEC组患者(93.5%)相比,差异无统计学意义(P=0.523)。TEC-NX组患者发热的发病率为17.4%,与TEC组患者(14.3%)相比,差异无统计学意义(P=0.749)。结论在局部晚期乳腺癌辅助化疗中,TEC-NX方案与TEC方案相比,并不能提高患者的3年总生存率和无病生存率,但TEC-NX方案可显著降低Ⅲ度或Ⅳ度骨髓抑制的发病率。Objective To compare the difference of efficacy and adverse effects between TEC-NX regimen (Docetaxel + Epirubicin + Cyclophosphamide sequential Vinorelbine + Capecitabine) with TEC regimen (Docetaxel + Epirubicin + Cyclophosphamide) in the adjuvant chemotherapy of locally advanced breast cancer.Methods A retrospective study was conducted to select 58 patients with locally advanced breast cancer who underwent ≥4 axillary lymph node metastasis from April 2008 to April 2015 at the International Peace Maternity and Child Health Hospital,Shanghai Jiao Tong University School of Medicine.All patients were female,average age was 48 years old,rang from 29 to 63 years old.Patients were divided into TEC-NX group (n =23) and TEC group (n =35) according to different treatment methods.TEC-NX group patients received chemotherapy with TEC-NX regimen and TEC group patients received chemotherapy with TEC regimen.The 3-year overall survival rate and 3-year disease-free survival rate were compared between the two groups.The differences in adverse reactions such as myelosuppression,liver dysfunction and fever were compared between the two groups.The Chi-square test was used to compare the count data between the two groups;the survival analysis was performed by Kaplan-Meier method.Results The 3-year overall survival rate was 91.3% in the TEC-NX group and 91.4% in the TEC group,and the difference was not statistically significant (P =0.995).The 3-year disease-free survival rate was 73.9% in the TEC-NX group and 85.7% in the TEC group,and the difference was not statistically significant (P=0.289).The incidence of grade Ⅲ or Ⅳ myelosuppression in the TEC-NX group was 26.0%,which was significantly lower than that in the TEC group (65.7%),and the difference was statistically significant (P =0.009).The incidence of liver dysfunction was 91.3% in the TEC-NX group,and there was not statistically significant compared with 93.5% in the TEC group (P =0.523).The incidence of fever in the TEC-NX group was 17.4%,which was not statistically s

关 键 词：乳腺肿瘤 抗肿瘤联合化疗方案 长春瑞滨 卡培他滨 治疗应用 不良反应 

分 类 号：R737.9[医药卫生—肿瘤]