Ⅲ期乳腺癌术前尺动脉插管灌注化疗和全身静脉化疗的疗效对比

A Comparatives Study between Preoperative Ulnaris Arterial Intubation Chemotherapy and Intravenous Chemotherapy on Stage III Breast Cancer

目的前瞻性研究术前尺动脉插管灌注化疗和全身静脉化疗在治疗Ⅲ期乳腺癌的疗效,探讨术前辅助化疗的最佳方法。方法60例Ⅲ期乳腺癌患者随机分为两组,其中术前行尺动脉插管乳腺区域灌注化疗30例(动脉组),术前全身静脉化疗30例(静脉组)。观察两组患者的临床疗效、组织学疗效、对化疗的毒副反应,以及术后3年生存率和无病存活率,并进行对比分析。结果动脉组临床总有效率为76.7%,明显高于静脉组的46.7%(P<0.05);动脉组组织学特效+显效率为86.7%,明显高于静脉组的56.7%(P<0.05)。动脉组患者恶心、呕吐等化疗毒副反应的发生率明显较静脉组低(P<0.05)。两组术后3年生存率和无病存活率相似(P>0.05)。结论术前尺动脉插管灌注化疗是治疗Ⅲ期乳腺癌的一种有效的方法,能够提高Ⅲ期乳腺癌患者的近期疗效,并减轻患者化疗的毒副反应;它的近期疗效优于术前全身静脉化疗。

Objective To prospectively evaluate the efficacy of preoperative ulnaris arterial intubation chemotherapy and intravenous chemotherapy in patients with stage Ⅲ breast cancer. Methods 60 patients with stage Ⅲ breast cancer which divided randomly into 2 group were studied. 30 patients（artery group）were treated by ulnaris arterial intubation chemotherapy and others（vein group） were treated by intravenous chemotherapy. The clinical and histological effects, toxic and side reaction of chemotherapy such as nausea and vomit, the 3-year survival rates and disease-free survival rates were analyzed. Results In patients with stage Ⅲ breast cancer, the overall clinical response rate was 76.7% in artery group and 46.7% in vein group（P〈0.05）. The histological effects was 86.7% in artery group and 56.7% in vein group（P〈0.05）. The toxic and side reaction of catheterize chemotherapy was less than vein group. Although 3-year survival rates and disease-free survival rates between two group was the same（P〉0.05）. Conclusion Preoperative ulnaris arterial intubation chemotherapy is an effective measure for the treatment of stage Ⅲ breast cancer. It can improve the short-term effects on stage Ⅲ breast cancer and decrease toxic and side reaction of chemotherapy. It surpasses than intravenous chemotherapy in short-term effects.