进展期乳腺癌术前新辅助化疗86例

Preoperative neoadjuvant chemotherapy for 86 patients with advanced breast cancer

目的:探讨进展期乳腺癌新辅助化疗的临床意义.方法:200001/200412应用CEF方案对86例ⅡbⅢ期乳腺癌患者进行新辅助化疗.环磷酰胺(CTX)500mg/m2,d1,d8;表阿霉素(EPI)50mg/m2,d1,d8;氟尿嘧啶(5Fu)500mg/m2,d1,d8.28d为1个周期,所有患者完成2个周期新辅助化疗后评价疗效.结果:35例(40.7%)降低了临床分期;4例(4.7%)获得完全缓解(CR),37例(43.0%)部分缓解(PR),全组无疾病进展(PD)者,总有效率(CR+PR)为47.7%(43/86).新辅助化疗2个周期后有24例(28.9%)未触及肿大淋巴结,腋窝淋巴结总有效率为61.4%(51/83).副反应为白细胞下降、恶心呕吐和脱发等,患者均可耐受.结论:进展期乳腺癌新辅助化疗对原发肿瘤和腋窝淋巴结均有较好疗效,不良反应可耐受,值得推广.

AIM： To evaluate the clinical significance of CEF regimen as neoadjuvant chemotherapy for advanced breast cancer. METHODS： Eighty-six patients with stage Ⅱ b-Ⅲ breast cancer were treated with CEF regimen for 2 treatment cycles with each lasting for 28 d. According to the effect standard and toxic grading standard suggested by WHO, the efficacy and safety were evaluated, The patients received cyclophosphamide （CTX） 500 mg/m^2 on day 1 and 8, epirubincin （EPI） 50 mg/m^2 on day 1, and 8, and 5- fluorouracil （5-Fu） 500 mg/m^2 on day 1 and 8. RESULTS： The cancer degraded in 35 （40.7%） patients and the overall response rate （RR） of the primary tumor was 47.7% （43/86）. Four cases had complete response （CR）, 37 cases partial response （PR） and no disease progressive （PD） case. For axillary lymph nodes, the overall response rate （RR） was 61.4 % （51/83 ）. For clinically palpable axillary lymph nodes which had been found in 83 patients before treatment, 28.9 % （24/83） became inpalpable. The major toxicity included leukopenia, gastroenteric reactions and alopecia. CONCLUISON： Neoadjuvant chemotherapy with CEF regimen for advanced breast cancer is effective and tolerable and therefore, is warranted for wide use.