新辅助化疗在老年乳腺癌治疗中的意义

Significance of Neoadjuvant Chemotherapy in Elder Breast Cancer

目的:探讨新辅助化疗在老年乳腺癌患者治疗中的意义。方法:35例老年乳腺癌患者术前用CTF方案化疗1疗程,化疗后1周手术。结果:无完全缓解病例,部分缓解4例(占11.43%),轻度缓解20例(占57.14%),无变化11例(占31.43%),无临床进展病例。病理组织学观察20例镜下见肿瘤细胞有小点片状坏死。1例因白细胞降低推迟手术,其余患者按计划手术。全组随访1～6年,在随访期间发现5例局部复发,2例骨转移,2例有肺和脑转移。6例在随访期间因本病死亡,3例因其它合并症死亡,余均健在。结论:新辅助化疗对老年乳腺癌可缩小肿瘤,增加手术机会,提高治疗效果,并可能减少术中血行转移。

Objective： To evaluate the significance of neoadjuvant chemotherapy in elder breast cancer patients. Methods： 35 elder patients with breast cancer were retreated with cyclophamide, pirarubicin and 5-fluorouracil for one cycle before operation, which was followed by operation after one week. Results： No patients achieved full response, 4 patients（ 11.43 % ） achieved partial response, 20 patients（57. 14%） achieved mild response, 11 patients（31.43%） had no change, and no patients had the disease progression. 20 eases of tumor samples could be found with focus necrosis on pathological examination after surgery. The operation was delayed in 1 patient because of leucocytopenia, and the others received operation as planned. All patients were followed up in the 1-6 years. 5 patients had been found with local relapse, 2 patients with bone metastases,and 2 patients with lung and brain metastases after the operation. 6 patient died from breast tumor in follow-up survey. 3 patients died from other complication, and the others survived. Conclusion：The elder breast tumor could become smaller after neoadjuvant chemotherapy, which could increase operation chance,improve curative effect, and reduce the metastasis in blood during operation.