新辅助化疗周期对三阴性乳腺癌化疗效果的影响  

Effect of Neoadjuvant Chemotherapy Cycle on Chemotherapy Effect of Triple Negative Breast Cancer

作　　者：张璐[1] 乔健[1] 孙晓东[1] 段伟[1] 张晓飞[2] 年亮 ZHANG Lu;QIAO Jiani;SUN Xiao-dong(Oncology Department,Affiliated Hospital of Yan'an University,Shaanxi Yan'an 716000)

机构地区：[1]延安大学附属医院肿瘤科,陕西延安716000 [2]延安市人民医院肿瘤科,陕西延安716000

出　　处：《医学临床研究》2020年第11期1671-1673,1677,共4页Journal of Clinical Research

摘　　要：【目的】探讨新辅助化疗周期对三阴性乳腺癌化疗效果的影响。【方法】回顾性分析2015年6月至2019年6月在本院接受术前新辅助化疗的110例三阴性乳腺癌患者的临床资料,患者均接受表柔比星联合多西他赛、环磷酰胺新辅助化疗,按新辅助化疗周期分为短周期组(术前新辅助化疗3〜4周期,n=35)和长周期组(术前新辅助化疗6〜8周期,n=75)。比较两组患者临床及病理疗效、治疗期间不良反应发生情况及无病生存期(DFS)。【结果】两组临床总有效率差异无统计学意义(P>0.05);两组患者术后Mille-Payne病理分级差异无统计学意义(P>0.05)。共27例术后病理完全缓解(pCR),pCR率为24.5%。长周期组pCR率为24.0%(18/75),与短周期组的25.7%(9/35)比较差异无统计学意义(Х^2=0.06,P=0.80)。两组患者术前化疗期间心律失常、便血、呕吐、腹泻、血小板减少、末梢神经炎、月经消失、嗜睡发生率差异均无统计学意义(P>0.05),但长周期组肝酶异常、白细胞减少发生率高于短周期组(P<0.05)。随访时间12〜36个月,中位随访时间20.9个月,共24例DFS事件,短周期组2例,长周期组22例。Kaplan-Meier法并Log-rank检验显示,短周期与长周期组DFS差异无统计学意义(Log-rank Х^2=0.185,P=0.667)。【结论】相比3〜4周期新辅助化疗,延长新辅助化疗周期(达到6〜8周期)可能对三阴性乳腺癌患者治疗效果及预后影响不大。【Objective】To investigate the effect of neoadjuvant chemotherapy cycle on the chemotherapy effect of triple negative breast cancer.【Methods】The clinical data of HO patients with triple negative breast cancer who received preoperative neoadjuvant chemotherapy in our hospital from June 2015 to June 2019 were retrospectively analyzed.All patients received epirubicin combined with docetaxel and cyclophosphamide neoadjuvant chemotherapy.They were divided into short cycle group(preoperative neoadjuvant chemotherapy 3-4 cycles,n=35)and long cycle group(preoperative neoadjuvant chemotherapy 6-8 cycles(n=75).The clinical and pathological efficacy,adverse reactions and disease-free survival(DFS)were compared between the two groups.【Results】There was no significant difference in the clinical total effective rate between the two groups(P>0.05);there was no significant difference in the Mille Payne pathological grade between the two groups(P>0.05).The PCR rate was 24.5%.The PCR rate of the long cycle group was 24.0%(18/75),which was not significantly different from that of the short cycle group(25.7%)(χ^2=0.06,P=0.80).There was no significant difference in the incidence of arrhythmia,hematochezia,vomiting,diarrhea,thrombocytopenia,peripheral neuritis,menstrual disappearance and drowsiness between the two groups(P>0.05),but the incidence of abnormal liver enzymes and leukopenia in the long cycle group was higher than that in the short cycle group(P<0.05).The follow-up time was 12-36 months,with a median of 20.9 months.There were 24 cases of DFS,including 2 cases in the short-term group and 22 cases in the long-term group.Kaplan Meier method and Log rank test showed that there was no significant difference in DFS between the short cycle group and the long cycle group(log rankχ^2=0.185,P=0.667).【Conclusion】Compared with 3-4 cycles of neoadjuvant chemotherapy,prolonging the neoadjuvant chemotherapy cycle(up to 6-8 cycles)may have little effect on the therapeutic effect and prognosis of triple negative breast can

关 键 词：乳腺肿瘤/药物疗法 受体 erbB-2 受体 雌激素 受体 孕酮 化学疗法 辅助 

分 类 号：R737.9[医药卫生—肿瘤]