Ⅱ、Ⅲ期乳腺癌患者ATC方案新辅助化疗的临床研究

Clinical Study on New Adjuvant Chemotherapy with ATC Regimen in Patients with Period Ⅱ and Ⅲ

目的研究可手术的Ⅱ、Ⅲ期乳腺癌患者术前给予新辅助化疗(NCT)的安全性及对手术方式的影响。方法201例可手术的Ⅱ、Ⅲ期乳腺癌患者术前给予ATC(吡柔吡星、紫杉醇、环磷酰胺)方案化疗3周期,评价其近期疗效和毒性反应。结果201例患者中CR148例,PR42例,总有效率94.5%。无进展病例,主要毒性反应为胃肠道反应和骨髓抑制,胃肠道反应主要表现为恶心、呕吐,骨髓抑制以白细胞减少为主,经对症治疗后可缓解。全组没有因为化疗的毒性反应而终止治疗的病例。结论对于Ⅱ、Ⅲ期乳腺癌患者术前使用ATC方案化疗可以使原发灶明显缩小,能够为预测术后化疗效果提供理论依据,可以降低临床分期,缩小手术范围,提高患者术后的生活质量,提高生存率,并且安全可行,是乳腺癌综合治疗的重要方面。

Objective To research the safety of new adjuvant chemotherapy（NAC） with ATC regimen before operation and the influence to operation mode in patients with period Ⅱ or In breast cancer,which can be cured by operation. Methods 3 period ATC project chemotherapy was given to 201 breast cancer patients in Ⅱ or Ⅲ period. The shorterm curative effect and toxic reaction was evaluated. Results In all 201 cases, CR accounted for 148, PR for 42, RR for 190, PD for 0. The main toxic reactions were gstrointestinal tract stimulation（ naupathia and vomit） and medulla restrain（ leucopenia ） which can be improved by expectant treatments. Conclusions NAC with ATC regimen before operation is safe and feasible for breast cancer in Ⅱ and Ⅲ period. It can make the tumor reduce evidently, provide theoretical reference for the forecast of chemotherapy effort after operation, reduce clinical stages, reduce surgery area, improve the postoperative living quality of patients, increase survival rate. It is an important part of integration treatment for breast cancer.