乳腺癌新辅助化疗CEF方案疗效观察

The effects of neoadjuvant chemotherapy with CEF in the treatment for 38 cases of breast cancer

目的探讨乳腺癌新辅助化疗CEF方案的疗效及不良反应。方法接受CEF方案新辅助化疗的38例经病理证实的乳腺癌患者，给予术前化疗2—4个周期。每周期用药：CTX（环磷酰胺）600mg／m^2，第1d，EPI（表阿霉素）60mg／m^2，第1d,5-Fu（5-氟尿嘧啶）500mg／m^2，第1、8d.用药后3d复查血象，若白细胞轻中度偏低则应用利血生、升白胺及维生素B4等口服；若白细胞重度低下，别应用集落刺激因子等升白治疗，化疗期间出现的头晕、恶心、呕吐等不良反应可给予对症治疗，21d为周期间隔期。结果CR（完全缓解）7例，占18％，其中属于临床Ⅰ期5例，临床Ⅱ期2例。PR（部分缓解）20例，占53％，其中临床Ⅰ期3例，临床Ⅱ期8例，9例属于临床Ⅲ期以下。总有效率（CR＋PR）为71％，11例均属晚期经过2个周期化疗后观察疗效不满意即中转手术治疗。结论乳腺癌新辅助化疗CEF方案疗效肯定，对早期癌效果理想，晚期病例在化疗期间应认真观察病情变化，若疗效不满意应果断中转手术治疗。CEF方案化疗的不良反应症状轻微．经过对症治疗后病人可以耐受。

Objective To evaluate the efficacy and side effects of neoadjuvant chemotherapy with CEF in patients with breast cancer. Methods For 38 patients with breast cancer by pathological diagnosis, receiving neoadjuvant chemotherapy with CEF,2 -4 chemotherapy cycles were given：CTX 600 mg/m^2 the 1 st day, EPI 60 mg/m^2 the 1 st day, 5 - FU 500 mg/m^2 the 1 st and eighth day were used in every cycle. The hemogram was rechecked 3 days after treatment, if light middle - low leucoyte was found, leucogen, berbamine hydrochlorde and ViteB4 were given orally. If extremely low leucocyte was found, treatments for leucocyte risung as CSF should be applied. The harmful reaction of dizzy , nausea and vomiting can be symptomatic treated. The periodic interval is 21 days. Results The overall response rate was 71% （ CR ＋ PR ）, including complete remission （CR） in 7（ 18% ）cases （5 cases in clinical period Ⅰ and 2 cases in clinical period Ⅱ）and partial remission （PR） in 20（53% ） cases （3 cases in clinical period Ⅰ and 2 cases in clinical period Ⅱ while 8 cases in clinical period m ）. Ⅱ patients with advanced breast cancer were treated by operation after 2 chemotherapy cycles because of poor chemotherapy effect. Conclusion Neoadjuvant chemotherapy with CEF is an effective therapy for breast cancer , especially for early ones. For patients with advanced breast cancer , if the therapy is ineffective , operation treatment is suggested . The side effects of neoadjuvant chemotherapy with CEF are slight and tolerable by symptomatic treatment.