Ⅳ期乳腺癌的新辅助化疗

Neoadjuvant chemotherapy for the treatment of stage Ⅳ breast cancer

目的 探讨新辅助化疗对Ⅳ期乳腺癌治疗的影响。方法 对62例Ⅳ期乳腺癌的治疗资料进行总结，并随访疗效。结果 术前化疗的36例中完全缓解（CR）7例（19．4％），部分缓解（PR）20例（55．6％），病情稳定（SD）7例（19．44％），临床获益率达到94．44％（82％～99％）。其中16例重新获得根治性手术，3年总生存率（OS）为58．33％（41％～74％），无瘤生存率（FRS）为27．8％（14％-45％）。而未做术前化疗的26例中只有5例获得根治性手术，3年OS为30．76％（14％～52％，χ^2=4．607，P=0．032），FRS为7．69％（1％～25％，χ^2=3．902，P=0．046）。结论 术前新辅助化疗能够降低Ⅳ期乳腺癌的术前TNM分期，并使一部分患者重新获得根治性手术的机会，改善了患者的生存率。

Objective To discuss the effect of preoperative chemotherapy on stage Ⅳ breast carcinoma. Methods The therapeutic effect in 62 patients with breast carcinoma of stage Ⅳ was followed up and analysed. Among them, 36 patients received preoperative chemotherapy. Results Of the 36 patients, 7 achieved complete response （19.4%）, 20 partial response（55.6%）, 7 stable state of illness（19.4%）, and the clinical benefit response rate was 94.4% （34/36）. Sixteen patients （44.4%）thereby were feasibly performed radical surgical treatment. The three-year overall survival rate was 58.33% （41%-74%）, and the relapse-free survival rate was 27.77% （14-45%）. On the contrary, for those who had not received preoperative chemotherapy, only 5 patients （19.2 %） were treated by radical operation. The three --year overall survival rate was 30.8% （14%-52%） （χ^2=4. 607,P=0. 032）, and the relapse-free survival rate was 7.69% （2/26） （χ^2 = 3. 902, P = 0. 046）. Conclusion Preoperative chemotherapy can decrease the TNM stage. Accordingly partial stage Ⅳ patients enable to be treated by radical operation, and so the survival rate will potentially be improved.