乳腺癌新辅助化疗TEC与TE方案对照观察  

Efficacy of TEC and TE regimen in neoadjuvant chemotherapy for breast cancer

作　　者：孙献甫 王莹杰 黄涛[1] 张圣泽 郭兰伟[1] 刘真真[1] SUN Xian-f u;WANG Ying-jie;HUANG Tao;ZHANG Sheng-ze;GUO Lan-wei;LIU Zhen-zhen(Department of Breast,Henan Cancer Hospital Affiliated to Zhengzhou University,Zhengzhou 450003,P.R.China)

机构地区：[1]郑州大学附属河南省肿瘤医院乳腺科

出　　处：《中华肿瘤防治杂志》2019年第18期1378-1381,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的乳腺癌新辅助化疗(neoadjuvant chemotherapy,NAC)能降低肿瘤临床分期,提高保留乳房手术率,并能协助判断肿瘤对化疗药物敏感性,在乳腺癌综合治疗中得到广泛应用,但不同化疗方案疗效及不良反应不同。本研究对比研究多西他赛联合表柔比星加或不加环磷酰胺(TE/TEC)2种NAC方案治疗乳腺癌的疗效观察和不良反应。方法回顾性分析2014-01-01-2018-01-01郑州大学附属河南省肿瘤医院乳腺科行NAC的145例Ⅱ、Ⅲ期可手术局部晚期乳腺癌患者临床资料,根据化疗方案不同将其分为TE组(68例)及TEC组(77例),2组患者均在术前完成4~6个周期化疗,并在术后继续完成剩余化疗周期数。采用触诊、超声、磁共振和病理学方法评价疗效。结果临床评价总有效率为95.86%(139/145),病理完全缓解(pathologic complete response,pCR)为7.59%(11/145)。TE组与TEC组总有效率分别为94.11%(64/68)、97.40%(75/77),差异无统计学意义,χ^2=0.498,P=0.249。TE组与TEC组PCR分别为7.35%(5/68)和7.79%(6/77),差异无统计学意义,χ^2=0.062,P=0.804。TE组与TEC组Ⅲ~Ⅳ度骨髓抑制发生率分别为44.11%(30/68)和62.33%(48/77),差异有统计学意义,χ^2=6.503,P=0.011。结论在局部晚期乳腺癌NAC中,TEC和TE方案疗效相近,但在不良反应方面,TEC方案中骨髓抑制及卵巢功能损伤较TE方案严重且发生率高。OBJECTIVE Neoadjuvant chemotherapy for breast cancer can reduce the clinical stage of breast cancer,improve the rate of breast-conserving surgery,and help to judge the sensitivity of tumor to chemotherapeutic drugs,and has been widely used in the comprehensive treatment of breast cancer.However,different chemotherapy regimens have different curative effects and toxic reactions.The purpose of this study was to compare the efficacy and adverse reactions of docetaxel combined with or without cyclophosphamide(TE/TEC)in the treatment of breast cancer.METHODS The clinical data of 145 patients with stageⅡandⅢ operable locally advanced breast cancer who underwent neoadjuvant chemotherapy in the Department of Breast,Henan Cancer Hospital Affiliated to Zhengzhou University from January 1,2014 to January 1,2018 were analyzed,retrospectively.According to the different chemotherapy regimens,they were divided into TE group(n=68)and TEC group(n=77).The patients in both groups completed 4 to 6 cycles of chemotherapy before operation and continued to complete the number of remaining chemotherapy cycles after operation.The curative effect was evaluated by palpation,ultrasound,magnetic resonance imaging and pathology.RESULTS The total effective rate of clinical evaluation was 95.86%(139/145),and the PCR of pathological evaluation was 7.59%(11/145).The total effective rates of TE group and TEC group were 94.11%(64/6)and 97.40%(75/77),respectively.There was no significant difference between the two groups(χ^2=0.498,P=0.249).The PCR of TE group and TEC group were 7.35%(5/68)and7.79%(6/77),respectively.There was no significant difference between the two groups(χ^2=0.062,P=0.804).The incidence of Ⅲ-Ⅳ degree myelosuppression in TE group and TEC group was 44.11%(30/68)and 62.33%(48/77),respectively.The difference was statistically significant(χ^2=6.503,P=0.011).CONCLUSION In neoadjuvant chemotherapy for locally advanced breast cancer,the efficacy of TEC and TE regimen is similar,but in the adverse reactions,myelosuppression and

关 键 词：乳腺癌 新辅助化疗 疗效 药物疗法 联合 

分 类 号：R737.9[医药卫生—肿瘤]