ET2周与3周方案在局部进展期乳腺癌新辅助治疗中的应用对比观察

Effect of neoadjuvant chemotherapy with ET every two weeks and ET every three weeks regimens for the treatment of locally advanced breast cancer

目的：观察对比表阿霉素联合泰索帝（ET）2周与3周化疗方案术前治疗局部进展期乳腺癌（LABC）的总有效率、病理完全缓解率、保乳率、术前等候时间以及毒副反应。方法：共有90例患者入组,随机分为ET2周组（N=48例）和ET3周组（N=42例）。ET2周组治疗方案为：表阿霉素40mg/m2,静脉滴注,d1,2;泰索帝60mg/m2,静脉滴注1小时,d3;2周为1周期,共化疗3周期;ET3周组方案用药不变,以3周做为1周期,共化疗3周期。完成3周期新辅助治疗后10-14天行手术或放疗。结果：ET2周组中48例患者病理完全缓解（pCR）6例（12.5%）,总有效率（CR＋PR）89.6%,14例（29.2%）行保乳手术,术前等待时间52-56天,中位时间53天;ET3周组42例患者：病理完全缓解（pCR）3例（7.1%）,总有效率（CR＋PR）69.1%,5例（11.9%）行保乳手术,术前等待时间73-77天,中位时间76天。治疗过程中有程度不等的骨髓抑制、胃肠道反应和脱发等毒副反应,两组无1例患者终止治疗,均未发生药物所致的死亡。结论：ET2周密集化疗方案术前治疗局部进展期乳腺癌疗效优于3周常规方案,缩短了术前等待时间,且耐受性好。

Objective：To compare the efficacy and toxicity of ET every two weeks and ET every three weeks regimens in the neoadjuvant chemotherapy of locally advanced breast cancer（LABC）. Mehtods： Ninty cases with LABC were randomly divided into two groups.The patients in group ET every two weeks （N=48） received the following regimen ： EPI 40 mg/m2,iv drop d1,2; TXT：60mg/ m2, iv drop 1h,d3,repeated once two weeks ; the patients in group ET every three weeks （N=42） received the same medicine,but repeated once three weeks .Three cycles were one course of treatment. Results： The total response rate（CR ＋ PR） of the ET every two weeks group was 89.6%, another group was 69.1% .The main toxicity of these two groups were bone marrow suppression and gastroenteric side effect. Conclusin： The two weeks regiman of taxotere combined with epirubicin is well tolerated and effective in the neoadjuvant chemotherapy of locally advanced breast cancer